2021 GRAPPA Recommendations - Looking Back, Looking Forward

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With the recent publication of the third iteration of the GRAPPA Psoriatic Arthritis (PsA) treatment recommendations, it seems to be an auspicious time to reflect on some key considerations that arose during the development of the recommendations, as well as to look towards what the future may hold.

Toss of a Coin - How do You Choose PsA Medication?

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When balancing all these disease domains, individual phenotypes, and comorbidities, sometimes treatment decisions can feel like tossing a coin. Fortunately, numerous guidelines have been published to help us do better than tossing a coin…or do they? 

Axial Disease in Psoriatic Arthritis

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Inflammatory involvement of the axial skeleton and sacroiliac joints occurs, on average, in 40-50% of patients with psoriatic arthritis (PsA). When present, axial involvement is a “biomarker” of more severe PsA disease: more severe peripheral joint disease, enthesitis, skin disease, pain, impaired function and quality of life, and work productivity. Thus, it is important to recognize and include in a comprehensive PsA treatment approach.

The Enthesitis Challenge in Psoriatic Arthritis

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A colleague of mine once told me an interesting story of how her father, who was a doctor, misdiagnosed his wife with fibromyalgia when she actually had psoriatic arthritis with enthesitis all along. I would venture out and say that the average physician would have trouble evaluating enthesitis because even we, as rheumatologists do!