Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

Jasvinder A. Singh, Gordon Guyatt, Alexis Ogdie, Dafna D. Gladman, Chad Deal, Atulya (Atul) Deodhar, Maureen Dubreuil, Jonathan Dunham, M. Elaine Husni, Sarah Kenny, Jennifer Kwan-Morley, Janice Lin, Paula Marchetta, Philip J. Mease, Joseph F. Merola, Julie Miner, Christopher T. Ritchlin, Bernadette Siaton, Benjamin J. Smith, Abby S. Van VoorheesAnna Helena Jonsson, Amit Aakash Shah, Nancy Sullivan, Marat Turgunbaev, Laura C. Coates, Alice Gottlieb, Marina Magrey, W. Benjamin Nowell, Ana Maria Orbai, Soumya M. Reddy, Jose U. Scher, Evan Siegel, Michael Siegel, Jessica A. Walsh, Amy S. Turner, James Reston

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). Methods: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. Results: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. Conclusion: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

Original languageEnglish (US)
Pages (from-to)2-29
Number of pages28
JournalArthritis Care and Research
Volume71
Issue number1
DOIs
StatePublished - Jan 1 2019

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Psoriatic Arthritis
Psoriasis
Guidelines
Therapeutics
Health Personnel
Interleukin-23
Spondylitis
Interleukin-17
Rheumatology
Politics
Interleukin-12
Inflammatory Bowel Diseases
Patient Selection
Vaccination
Tumor Necrosis Factor-alpha

ASJC Scopus subject areas

  • Rheumatology

Cite this

Special Article : 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. / Singh, Jasvinder A.; Guyatt, Gordon; Ogdie, Alexis; Gladman, Dafna D.; Deal, Chad; Deodhar, Atulya (Atul); Dubreuil, Maureen; Dunham, Jonathan; Husni, M. Elaine; Kenny, Sarah; Kwan-Morley, Jennifer; Lin, Janice; Marchetta, Paula; Mease, Philip J.; Merola, Joseph F.; Miner, Julie; Ritchlin, Christopher T.; Siaton, Bernadette; Smith, Benjamin J.; Van Voorhees, Abby S.; Jonsson, Anna Helena; Shah, Amit Aakash; Sullivan, Nancy; Turgunbaev, Marat; Coates, Laura C.; Gottlieb, Alice; Magrey, Marina; Nowell, W. Benjamin; Orbai, Ana Maria; Reddy, Soumya M.; Scher, Jose U.; Siegel, Evan; Siegel, Michael; Walsh, Jessica A.; Turner, Amy S.; Reston, James.

In: Arthritis Care and Research, Vol. 71, No. 1, 01.01.2019, p. 2-29.

Research output: Contribution to journalArticle

Singh, JA, Guyatt, G, Ogdie, A, Gladman, DD, Deal, C, Deodhar, AA, Dubreuil, M, Dunham, J, Husni, ME, Kenny, S, Kwan-Morley, J, Lin, J, Marchetta, P, Mease, PJ, Merola, JF, Miner, J, Ritchlin, CT, Siaton, B, Smith, BJ, Van Voorhees, AS, Jonsson, AH, Shah, AA, Sullivan, N, Turgunbaev, M, Coates, LC, Gottlieb, A, Magrey, M, Nowell, WB, Orbai, AM, Reddy, SM, Scher, JU, Siegel, E, Siegel, M, Walsh, JA, Turner, AS & Reston, J 2019, 'Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis', Arthritis Care and Research, vol. 71, no. 1, pp. 2-29. https://doi.org/10.1002/acr.23789
Singh, Jasvinder A. ; Guyatt, Gordon ; Ogdie, Alexis ; Gladman, Dafna D. ; Deal, Chad ; Deodhar, Atulya (Atul) ; Dubreuil, Maureen ; Dunham, Jonathan ; Husni, M. Elaine ; Kenny, Sarah ; Kwan-Morley, Jennifer ; Lin, Janice ; Marchetta, Paula ; Mease, Philip J. ; Merola, Joseph F. ; Miner, Julie ; Ritchlin, Christopher T. ; Siaton, Bernadette ; Smith, Benjamin J. ; Van Voorhees, Abby S. ; Jonsson, Anna Helena ; Shah, Amit Aakash ; Sullivan, Nancy ; Turgunbaev, Marat ; Coates, Laura C. ; Gottlieb, Alice ; Magrey, Marina ; Nowell, W. Benjamin ; Orbai, Ana Maria ; Reddy, Soumya M. ; Scher, Jose U. ; Siegel, Evan ; Siegel, Michael ; Walsh, Jessica A. ; Turner, Amy S. ; Reston, James. / Special Article : 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. In: Arthritis Care and Research. 2019 ; Vol. 71, No. 1. pp. 2-29.
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abstract = "Objective: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). Methods: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. Results: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94{\%} conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. Conclusion: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.",
author = "Singh, {Jasvinder A.} and Gordon Guyatt and Alexis Ogdie and Gladman, {Dafna D.} and Chad Deal and Deodhar, {Atulya (Atul)} and Maureen Dubreuil and Jonathan Dunham and Husni, {M. Elaine} and Sarah Kenny and Jennifer Kwan-Morley and Janice Lin and Paula Marchetta and Mease, {Philip J.} and Merola, {Joseph F.} and Julie Miner and Ritchlin, {Christopher T.} and Bernadette Siaton and Smith, {Benjamin J.} and {Van Voorhees}, {Abby S.} and Jonsson, {Anna Helena} and Shah, {Amit Aakash} and Nancy Sullivan and Marat Turgunbaev and Coates, {Laura C.} and Alice Gottlieb and Marina Magrey and Nowell, {W. Benjamin} and Orbai, {Ana Maria} and Reddy, {Soumya M.} and Scher, {Jose U.} and Evan Siegel and Michael Siegel and Walsh, {Jessica A.} and Turner, {Amy S.} and James Reston",
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T2 - 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

AU - Singh, Jasvinder A.

AU - Guyatt, Gordon

AU - Ogdie, Alexis

AU - Gladman, Dafna D.

AU - Deal, Chad

AU - Deodhar, Atulya (Atul)

AU - Dubreuil, Maureen

AU - Dunham, Jonathan

AU - Husni, M. Elaine

AU - Kenny, Sarah

AU - Kwan-Morley, Jennifer

AU - Lin, Janice

AU - Marchetta, Paula

AU - Mease, Philip J.

AU - Merola, Joseph F.

AU - Miner, Julie

AU - Ritchlin, Christopher T.

AU - Siaton, Bernadette

AU - Smith, Benjamin J.

AU - Van Voorhees, Abby S.

AU - Jonsson, Anna Helena

AU - Shah, Amit Aakash

AU - Sullivan, Nancy

AU - Turgunbaev, Marat

AU - Coates, Laura C.

AU - Gottlieb, Alice

AU - Magrey, Marina

AU - Nowell, W. Benjamin

AU - Orbai, Ana Maria

AU - Reddy, Soumya M.

AU - Scher, Jose U.

AU - Siegel, Evan

AU - Siegel, Michael

AU - Walsh, Jessica A.

AU - Turner, Amy S.

AU - Reston, James

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