Challenges in the Management of Psoriatic Arthritis in Latin America: A Systematic Review

Ribeiro, André Lucas; Dullius, L.; Sartori, Natália Sarzi; Azeredo-da-Silva, Andre; Kohem, Charles Lubianca; Coates, Laura C.; Monticielo, Odirlei André; Palominos, Penélope Esther

doi:10.1016/j.clinthera.2023.04.005

Cited by 5 publications

(1 citation statement)

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“…For instance, a contemporary systematic review and meta-analysis that assessed 258 publications reported a remission prevalence of only 23.1% when measured by the DAPSA score [ 5 ]. Factors such as disease activity status, comorbidities, adverse reactions to therapy and limited treatment accessibility contribute to these challenges [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Deciphering difficult-to-treat psoriatic arthritis (D2T-PsA): a GRAPPA perspective from an international survey of healthcare professionals

Ribeiro,

Singla,

Chandran

et al. 2024

Rheumatology Advances in Practice

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Objectives This study contributes to the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)’s effort to define ‘difficult-to-treat’ PsA (D2T-PsA), leveraging insights of healthcare professionals who are GRAPPA members. The primary objective is to inform GRAPPA’s D2T PsA project, ensuring the consensus definition reflects clinical experience and expertise. Methods An online survey was conducted among GRAPPA’s healthcare professionals managing PsA patients. The survey covered demographic details, structured questions, and open-ended queries to gather comprehensive insights into the experts’ viewpoints. Results About 223 physicians completed the survey, comprising 179 (80.2%) rheumatologists and 40 (17.9%) dermatologists. The majority, 184 (82.5%), favoured establishing distinct definitions for D2T-PsA and complex-to-manage PsA (C2M-PsA). Furthermore, 202 (90.5%) supported a definition that includes objective inflammation signs (clinical, laboratory, imaging, among others). However, opinions varied on the criteria for prior treatment failures, with most (93, 41.7%) favouring a definition that includes at least one conventional synthetic disease-modifying anti-rheumatic drug and two or more biological- or targeted-synthetic-DMARDs with different mechanisms of action. Conclusion The survey reveals a majority opinion among GRAPPA experts favouring the differentiation between D2T-PsA and C2M-PsA, and the inclusion of objective inflammatory markers in these definitions. However, there is less than 50% agreement on the specific treatment failure criteria, particularly regarding the number of therapies needed to classify PsA as D2T. These findings suggest a need for continued discussion to reach a more unified approach in defining D2T-PsA, reflecting the complexity of the condition.

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Section: Introductionmentioning

confidence: 99%