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Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021.

Coates, Laura C.; Soriano, Enrique R.; Corp, Nadia; Bertheussen, Heidi; Callis Duffin, Kristina; Campanholo, Cristiano B.; Chau, Jeffrey; Eder, Lihi; Fernández-Ávila, Daniel G.; FitzGerald, Oliver; Garg, Amit; Gladman, Dafna D.; Goel, Niti; Helliwell, Philip S.; Elaine Husni, M.; Jadon, Deepak R.; Katz, Arnon; Laheru, Dhruvkumar; Latella, John; Leung, Ying-Ying; Lindsay, Christine; Lubrano, Ennio; Daniel Mazzuoccolo, Luis; Mease, Philip J.; O’Sullivan, Denis; Ogdie, Alexis; Olsder, Wendy; Esther Palominos, Penelope; Schick, Lori; Steinkoenig, Ingrid; de Wit, Maarten; van der Windt, Danielle A.; Kavanaugh, Arthur; Recommendations domain subcommittees, GRAPPA Treatment

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Laura C. Coates

Enrique R. Soriano

Heidi Bertheussen

Kristina Callis Duffin

Cristiano B. Campanholo

Jeffrey Chau

Lihi Eder

Daniel G. Fernández-Ávila

Oliver FitzGerald

Amit Garg

Dafna D. Gladman

Niti Goel

Philip S. Helliwell

M. Elaine Husni

Deepak R. Jadon

Arnon Katz

Dhruvkumar Laheru

John Latella

Ying-Ying Leung

Christine Lindsay

Ennio Lubrano

Luis Daniel Mazzuoccolo

Philip J. Mease

Denis O’Sullivan

Alexis Ogdie

Wendy Olsder

Penelope Esther Palominos

Lori Schick

Ingrid Steinkoenig

Maarten de Wit

Arthur Kavanaugh

GRAPPA Treatment Recommendations domain subcommittees


Since the second version of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations were published in 2015, therapeutic options for psoriatic arthritis (PsA) have advanced considerably. This work reviews the literature since the previous recommendations (data published 2013-2020, including conference presentations between 2017 and 2020) and reports high-quality, evidence-based, domain-focused recommendations for medication selection in PsA developed by GRAPPA clinicians and patient research partners. The overarching principles for the management of adults with PsA were updated by consensus. Principles considering biosimilars and tapering of therapy were added, and the research agenda was revised. Literature searches covered treatments for the key domains of PsA: peripheral arthritis, axial disease, enthesitis, dactylitis, and skin and nail psoriasis; additional searches were performed for PsA-related conditions (uveitis and inflammatory bowel disease) and comorbidities. Individual subcommittees used a GRADE-informed approach, taking into account the quality of evidence for therapies, to generate recommendations for each of these domains, which were incorporated into an overall schema. Choice of therapy for an individual should ideally address all disease domains active in that patient, supporting shared decision-making. As safety issues often affect potential therapeutic choices, additional consideration was given to relevant comorbidities. These GRAPPA treatment recommendations provide up-to-date, evidence-based guidance on PsA management for clinicians and people with PsA.

Journal Article Type Article
Acceptance Date May 23, 2022
Online Publication Date Jun 27, 2022
Publication Date Aug 1, 2022
Publicly Available Date Jun 20, 2023
Journal Nature Reviews Rheumatology
Print ISSN 1759-4790
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 18
Pages 465 - 479
Publisher URL


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