GRAPPA-OMERACT consensus-based recommendations and research agenda for use of composite measures and treatment targets in PsA.
Coates LC., FitzGerald O., Merola JF., Smolen J., van Mens LJJ., Bertheussen H., Boehncke W-H., Callis Duffin K., Campbell W., de Wit M., Gladman D., Gottlieb A., James J., Kavanaugh A., Kristensen LE., Kvien TK., Luger T., McHugh N., Mease P., Nash P., Ogdie A., Rosen CF., Strand V., Tillett W., Veale DJ., Helliwell PS.
BACKGROUND: Many composite disease activity measures and targets have been developed for psoriatic arthritis (PsA). This GRAPPA-OMERACT work stream aimed to further the development of consensus among physicians and patients. METHODS: Prior to the meeting, physicians and patients were surveyed on outcome measures. A consensus meeting (26 rheumatologists, dermatologists, and patient representatives) reviewed evidence on composite measures and potential treatment targets, plus survey results. After discussions, participants voted on proposals for use and consensus was established in a second survey. RESULTS: Survey results from 128 HCPS and 139 patients were analysed alongside a SLR summarising evidence. A weighted vote was cast for composite measures (for RCTs, most popular measures were PASDAS [40 votes] and GRACE [28 votes]; for clinical practice, most popular were 3-VAS [45 votes], DAPSA [26 votes]). After discussion there was no consensus on a composite measure. The group agreed that several composite measures could be used. Future studies should allow further validation and comparison. The group unanimously agreed that remission should be the ideal target with minimal/low disease activity a feasible alternative. The target should include assessment of musculoskeletal disease, skin and health related quality of life. The group recommended a target of treatment as VLDA, or MDA. CONCLUSIONS: Consensus was not reached on a continuous measure of disease activity. In the interim the group recommends several composites. Consensus was reached on a treatment target of VLDA/MDA. An extensive research agenda was composed and recommends that data on all PsA clinical domains be collected in ongoing studies. This article is protected by copyright. All rights reserved.