Correction to: Difficult to treat psoriatic arthritis — how should we manage?

Kumthekar, Anand; Ashrafi, Maedeh; Deodhar, Atul

doi:10.1007/s10067-023-06627-3

Cited by 3 publications

(3 citation statements)

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“…The criteria for D2T were diverse: in some cases, it was vaguely described as multiple treatment attempts, 11 16 while in others it spanned from resistance to ≥1 tumour necrosis factor inhibitors (TNFi) 9 17–22 to failures involving ≥2 b/tsDMARDs 23–25 or even extending to ≥3 b/tsDMARDs. 26 27 Only one study included patients with prior corticosteroid use as part of the definition of D2T. 20 The review by Lubrano et al 11 was distinct, being the only study that proposed dividing into refractory disease secondary to persistent inflammation (‘refractory to treatment’ PsA) and non-remission due to pre-existing comorbidities (‘D2T’ PsA).…”

Section: Resultsmentioning

confidence: 99%

“…It spanned from number of swollen and painful joints combined with skin disease activity to more holistic definitions encompassing composite outcome measures. Of note, Perrotta et al 25 and Kumthekar et al 26 proposed detailed lists of signs signalling active or progressive disease, encompassing metrics from composite measures to perceived decline in quality of life attributed to PsA. 25 26 On detailed examination of the RCTs, a common criterion emerged.…”

Section: Psoriatic Arthritis Psoriatic Arthritis Psoriatic Arthritismentioning

confidence: 99%

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Difficult-to-treat psoriatic arthritis (D2T PsA): a scoping literature review informing a GRAPPA research project

Singla,

Ribeiro,

Torgutalp

et al. 2024

RMD Open

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BackgroundPsoriatic arthritis (PsA) is a multifaceted condition with a broad spectrum of manifestations and a range of associated comorbidities. A notable segment of patients with PsA remains resistant to even advanced therapeutic interventions. This resistance stems from myriad causes, including inflammatory and non-inflammatory factors.ObjectivesTo collate and critically assess the various definitions and criteria of difficult-to-treat (D2T PsA present in the literature.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a scoping review in July 2023, searching PubMed, American College of Rheumatology Convergence 2022, European Alliance of Associations for Rheumatology Congress 2023, Google Scholar and cited articles. Selection was made by two independent authors using Rayyan software, and conflicts were adjudicated by a third author. Eligibility criteria for PubMed focused on all article designs that were written in English, with full-text available, from the past decade, excluding only those not defining D2T PsA or targeting other populations.ResultsFrom the 565 references sourced, 15 studies were analysed, revealing considerable variations in defining both ‘active disease’ and ‘resistant PsA’, which was most often termed ‘D2T’ PsA.ConclusionThe definitions and criteria for D2T PsA and for ‘active disease’ are notably heterogeneous, with considerable variation across sources. The ongoing Group for Research and Assessment of Psoriasis and Psoriatic Arthritis initiative stands to bridge these definitional gaps and aims to provide guidance for clinicians and illuminate a path for pharmaceuticals and regulatory agencies to follow.

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Section: Resultsmentioning

confidence: 99%

Section: Psoriatic Arthritis Psoriatic Arthritis Psoriatic Arthritismentioning

confidence: 99%

Difficult-to-treat psoriatic arthritis (D2T PsA): a scoping literature review informing a GRAPPA research project

Singla,

Ribeiro,

Torgutalp

et al. 2024

RMD Open

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“…This ongoing debate and lack of uniformity in defining D2T-PsA have been the primary motivators for GRAPPA to initiate an effort to establish unified definition for D2T- and C2M-PsA. In recent efforts to better characterize D2T-PsA, several studies have focused on this area [ 27 , 29 , 30 ]. Notably, a cohort study by Philippoteaux et al applied the EULAR definition of D2T-RA to describe the characteristics of D2T-PsA patients.…”

Section: Discussionmentioning

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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Navigating the complexities of difficult-to-treat axial spondyloarthritis

Ribeiro,

Proft

2024

Joint Bone Spine

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Correction to: Difficult to treat psoriatic arthritis — how should we manage?

Cited by 3 publications

References 0 publications

Difficult-to-treat psoriatic arthritis (D2T PsA): a scoping literature review informing a GRAPPA research project

Difficult-to-treat psoriatic arthritis (D2T PsA): a scoping literature review informing a GRAPPA research project

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

Navigating the complexities of difficult-to-treat axial spondyloarthritis

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