Updated GRAPPA treatment guidelines for psoriatic arthritis

The Good Care Campaign for Psoriatic Arthritis

Psoriatic arthritis (PsA) affects both the joints and skin of individuals who may also have psoriasis.¹ Approximately 33% of individuals with psoriasis experience joint pain, stiffness, and swelling in the joints, leading to irreversible damage if left untreated.² PsA can also trigger inflammation in various parts of the body, such as the eyes, heart, lungs, and kidneys.³

Unfortunately, there is a lack of understanding about the nature and impact of living with this disease, including its manifestations and related symptoms.¹ Despite PsA being the second most common inflammatory joint disease,⁴ causing significant stiffness, swelling, and pain that often leads to disability,⁵ there remains a lack of awareness regarding the immense burden it places on individuals and society.¹

Access to adequate care and treatment⁶

The management of PsA often involves uncertainties, making it difficult to achieve successful outcomes for individuals affected by the disease. However, recent guidelines, such as the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) guidelines, include the implementation of treat-to-target (T2T) strategies. T2T approaches have been widely accepted in the treatment of other forms of arthritis and other inflammatory diseases, but they may not broadly be used in the management of PsA. The GRAPPA guidelines consider various domains of symptoms and tailor treatment targets accordingly. Many individuals living with PsA face significant challenges, including the inability to work due to this debilitating condition and the need for frequent and costly treatments.

Recognizing comorbidities and the need for multidisciplinary care⁶

PsA is often associated with several comorbidities, including depression, anxiety, diabetes, and inflammatory bowel disease. These associated conditions can significantly impact an individual's quality of life. Therefore, it is crucial to consider the presence of comorbidities when formulating treatment plans to provide the best possible care and prevent or treat these associated conditions. The GRAPPA guidelines support decision-making and take into account comorbidities (Figures 1 and 2).

Figure 1. Treatment schema* 

*Adapted from Coates, et al.⁶

Figure 2. Summary recommendations for PsA treatment in the case of comorbidities* 

*Adapted from Coates, et al.⁶

Addressing inclusive and comprehensive care, including sexual and reproductive concerns⁶

Women of reproductive age and their partners may experience unique symptoms that require individualized treatment options. It is essential for healthcare providers to have open conversations with patients, discussing their needs and exploring different therapy options until they find what works best for them.