TY - JOUR
T1 - Special Article
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, 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
N1 - Funding Information:
This article is published simultaneously in Arthritis Care & Research and the Journal of Psoriasis and Psoriatic Arthritis. Supported by the American College of Rheumatology and the National Psoriasis Foundation. 1Jasvinder A. Singh, MD, MPH: University of Alabama at Birmingham and Birmingham Veterans A ?airs Medical Center, Birmingham, Alabama; 2Gordon Guyatt, MD: McMaster University, Hamilton, Ontario, Canada; 3Alexis Ogdie, MD, MSCE, Jonathan Dunham, MD: University of Pennsylvania, Philadelphia; 4Dafna D. Gladman, MD: University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada; 5Chad Deal, MD, M. Elaine Husni, MD, MPH: Cleveland Clinic, Cleveland, Ohio; 6Atul Deodhar, MD: Oregon Health & Science University, Portland; 7Maureen Dubreuil, MD: Boston Medical Center, Boston, Massachusetts; 8Sarah Kenny: New York, New York; 9Jennifer Kwan-Morley, MD: Premier Orthopaedics, Malvern, Pennsylvania; 10Janice Lin, MD, MPH: Stanford University, Stanford, California; 11Paula Marchetta, MD, MBA: Concorde Medical Group, New York, New York; 12Philip J. Mease, MD: Swedish-Providence Health Systems and University of Washington, Seattle, Washington; 13Joseph F. Merola, MD, MMSc, Anna Helena Jonsson, MD, PhD: Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts; 14Julie Miner, PT: Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia; 15Christopher T. Ritchlin, MD, MPH: University of Rochester Medical Center, Rochester, New York; 16Bernadette Siaton, MD, MEHP: University of Maryland School of Medicine, Baltimore; 17Benjamin J. Smith, PA-C, DFAAPA: Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee; 18Abby S. Van Voorhees, MD: Eastern Virginia Medical School, Norfolk; 19Amit Aakash Shah, MD, MPH, Marat Turgunbaev, MD, MPH, Amy S. Turner: American College of Rheumatology, Atlanta, Georgia; 20Nancy Sullivan, James Reston, PhD, MPH: ECR 阀 阀nstitute, Plymouth Meeting, Pennsylva21niLaa; ura C. Coates, MD, PhD: University of Oxford, Oxford, UK; 22Alice Gottlieb, MD, PhD: New York Medical College at Metropolitan Hospital, New York, New York; 23Marina Magrey, MD: Case Western/MetroHealth, Cleveland, Ohio; 24Benjamin Nowell, PhD: Global Healthy Living Foundation, Nyack, New York; 25Ana-Maria Orbai, MD, MHS: Johns Hopkins University, Baltimore, Maryland; 26Soumya M. Reddy, MD, Jose U. Scher, MD: New York University School of Medicine, New York, New York; 27Evan Siegel, MD: Arthritis & Rheumatism Associates, Rockville, Maryland; 28Michael Siegel, PhD: National Psoriasis Foundation, Portland, Oregon; 29Jessica A. Walsh, MD: University of Utah and George E. Wahlen Veterans A 贀airs Medical Center, Salt Lake City, Utah.
Funding Information:
$10,000 each) and has received research support from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB. Dr. Husni has received consulting fees, speaking fees, and/or honoraria from AbbVie, Janssen, Sanofi Genzyme/ Regeneron, UCB, Novartis, and Lilly (less than $10,000 each) and is a coinventor on a patent for a psoriatic arthritis questionnaire (Psoriatic Arthritis Screening Evaluation), for which she receives royalties. Dr. Mease has received consulting fees, speaking fees, and/or honoraria from AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Celgene, Janssen, Lilly, Novartis, Pfizer, and UCB (more than $10,000 each) and from Genentech, Merck, and Sun (less than $10,000 each) and has served as a paid consultant to investment analysis companies Gerson Lehman and Guidepoint. Dr. Merola has received consulting fees, speaking fees, and/or honoraria from AbbVie, Eli Lilly, Novartis, Pfizer, UCB, Celgene, Sanofi, and Regeneron (more than $10,000 each) and from Merck, Biogen Idec, and Janssen (less than $10,000 each) and has served as a paid consultant for investment analysis companies Cowen Group and GLG. Dr. Ritchlin has received consulting fees from AbbVie, Amgen, Janssen, Novartis, Pfizer, UCB, and Celgene (less than $10,000 each) and has received research support from AbbVie, UCB, and Amgen. Mr. Smith has received consulting fees from the American Academy of Physician Assistants/Medical Logix for educational product development related to psoriatic arthritis CME courses (less than $10,000). Dr. Van Voorhees has received consulting fees, speaking fees, and/or honoraria from Dermira, Novartis, Derm Tech, WebMD, Celgene, AbbVie, Allergan, Valeant, and Merck (less than $10,000 each) and owns stock or stock options in Merck. Dr. Coates has received consulting fees from AbbVie (more than $10,000) and from Amgen, Bristol-Myers Squibb, Celgene, Pfizer, UCB, MSD, Novartis, Lilly, Janssen, Sun Pharma, Prothena, and Galapogos (less than $10,000 each). Dr. Gottlieb has received consulting fees, speaking fees, and/or honoraria from Janssen, Lilly, AbbVie, and UCB (more than $10,000 each) and from Sun, Celgene, Bristol-Myers Squibb, Beiersdorf, Incyte, Reddy, Valeant, Dermira, Allergan, and Novartis (less than $10,000 each) and has received research support from Janssen and Incyte. Dr. Nowell owns stock or stock options in AbbVie, Lilly, and Johnson & Johnson. Dr. Orbai has received consulting fees, speaking fees, and/or honoraria from Eli Lilly, Janssen, Novartis, Pfizer, and UCB (less than $10,000 each) and has received research support from Celgene, Eli Lilly, Horizon, Janssen, Novartis, and Pfizer. Dr. Reddy has received consulting fees, speaking fees, and/or honoraria from Novartis, AbbVie, and Pfizer (less than $10,000 each). Dr. Scher has received consulting fees from Janssen, UCB, AbbVie, and Novartis (less than $10,000 each). Dr. E. Siegel has received consulting fees, speaking fees, and/or honoraria from AbbVie, Lilly, and Novartis (more than $10,000 each) and from Amgen, Janssen, and Celgene (less than $10,000 each). Dr. Walsh has received consulting fees from Novartis, AbbVie, and Pfizer (less than $10,000 each).
Publisher Copyright:
© 2018, American College of Rheumatology
PY - 2019/1
Y1 - 2019/1
N2 - 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.
AB - 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.
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U2 - 10.1002/art.40726
DO - 10.1002/art.40726
M3 - Article
C2 - 30499246
AN - SCOPUS:85057852229
SN - 2326-5191
VL - 71
SP - 5
EP - 32
JO - Arthritis and Rheumatology
JF - Arthritis and Rheumatology
IS - 1
ER -