William Tillett1,2, Neil McHugh3,4, Ana-Maria Orbai3,4, Alexis Ogdie3,4, Ying Ying Leung3,4, Laura C Coates3,4, Philip J Mease3,4, Dafna D Gladman3,4, Mel Brooke3,4, Jon Packham3,4, Denis O'Sullivan3,4, Oliver FitzGerald3,4, Philip S Helliwell3,4. 1. From the Royal National Hospital for Rheumatic Diseases, University of Bath, Bath; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Duke-National University of Singapore (NUS) Medical School, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; University of Toronto, Krembil Research Institute, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK; Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Services, Dublin; Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; Chapel Allerton Hospital, Leeds, UK. w.tillett@nhs.net. 2. W. Tillett, BSc, MB ChB, PhD, MRCP, Consultant Rheumatologist, Senior Lecturer, Royal National Hospital for Rheumatic Diseases, University of Bath; N. McHugh, MBChB, MD, FRCP, FRCPath, Department of Pharmacy and Pharmacology, University of Bath; A.M. Orbai, MD, MHS, Assistant Professor of Medicine, Director Psoriatic Arthritis Program, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; A. Ogdie, MD, MSCE, Associate Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Y.Y. Leung, MB ChB, MD, Associate Professor, Duke-NUS Medical School, and Department of Rheumatology and Immunology, Singapore General Hospital; L.C. Coates, MB ChB, PhD, NIHR Clinician Scientist, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Krembil Research Institute, and Director, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital; M. Brooke, Patient Research Partner, Royal National Hospital for Rheumatic Diseases; J. Packham, DM, FRCP, Division of Epidemiology and Public Health, University of Nottingham; D. O'Sullivan, BE, Patient Research Partner, Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Services; O. FitzGerald, MD, FRCPI, FRCP( UK), Consultant Rheumatologist and Newman Clinical Research Professor, Conway Institute for Biomolecular Research, University College Dublin; P.S. Helliwell, MD, PhD, Chapel Allerton Hospital. w.tillett@nhs.net. 3. From the Royal National Hospital for Rheumatic Diseases, University of Bath, Bath; Department of Pharmacy and Pharmacology, University of Bath, Bath, UK; Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Duke-National University of Singapore (NUS) Medical School, Singapore; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine, Seattle, Washington, USA; University of Toronto, Krembil Research Institute, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada; Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK; Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Services, Dublin; Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland; Chapel Allerton Hospital, Leeds, UK. 4. W. Tillett, BSc, MB ChB, PhD, MRCP, Consultant Rheumatologist, Senior Lecturer, Royal National Hospital for Rheumatic Diseases, University of Bath; N. McHugh, MBChB, MD, FRCP, FRCPath, Department of Pharmacy and Pharmacology, University of Bath; A.M. Orbai, MD, MHS, Assistant Professor of Medicine, Director Psoriatic Arthritis Program, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; A. Ogdie, MD, MSCE, Associate Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Y.Y. Leung, MB ChB, MD, Associate Professor, Duke-NUS Medical School, and Department of Rheumatology and Immunology, Singapore General Hospital; L.C. Coates, MB ChB, PhD, NIHR Clinician Scientist, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P.J. Mease, MD, Rheumatology Research, Swedish Medical Center/Providence St. Joseph Health and University of Washington School of Medicine; D.D. Gladman, MD, FRCPC, Professor of Medicine, University of Toronto, Senior Scientist, Krembil Research Institute, and Director, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital; M. Brooke, Patient Research Partner, Royal National Hospital for Rheumatic Diseases; J. Packham, DM, FRCP, Division of Epidemiology and Public Health, University of Nottingham; D. O'Sullivan, BE, Patient Research Partner, Rheumatic and Musculoskeletal Disease Unit, Our Lady's Hospice and Care Services; O. FitzGerald, MD, FRCPI, FRCP( UK), Consultant Rheumatologist and Newman Clinical Research Professor, Conway Institute for Biomolecular Research, University College Dublin; P.S. Helliwell, MD, PhD, Chapel Allerton Hospital.
Abstract
OBJECTIVE: Improving the assessment of psoriatic arthritis (PsA) is a key purpose of the Group for Research and Assessment of Psoriasis and PsA (GRAPPA). Herein, we report the proceedings of the GRAPPA composites workshop at the 2019 GRAPPA annual meeting and the membership's recommended next steps. METHODS: A review of continuous composite measures was conducted in an introductory workshop, followed by 10 breakout group sessions and a final plenary session for feedback and voting. RESULTS: Participants included 154 members: 87 rheumatologists, 18 dermatologists, 2 rheumatologist/dermatologists, 12 patient research partners, 14 academics, 1 methodologist, and 20 industry members. Of voting members, 88.8% agreed a need exists for a continuous composite measure for routine practice, but only 62% were currently using a composite measure. Of these, 27% were using the 28-joint count Disease Activity Score (DAS), which is not a PsA-specific measure; 20% were using a PsA-specific measure such as PsA DAS (PASDAS), Composite Psoriatic Disease Activity Index (CPDAI), or Disease Activity Index for PsA (DAPSA). Members agreed that the existing measures were not feasible in their current forms (CPDAI 83%, PASDAS 82%, and DAPSA 47%) and that modification should be tested. The majority (76%) agreed that disease effect should be measured separately from disease activity. CONCLUSION: The GRAPPA membership supports the need for a continuous composite measure of disease activity for use in routine clinical care, the separate measurement of disease effect and activity, and the testing of modifications to candidate instruments rather than the development of new measures.
OBJECTIVE: Improving the assessment of psoriatic arthritis (PsA) is a key purpose of the Group for Research and Assessment of Psoriasis and PsA (GRAPPA). Herein, we report the proceedings of the GRAPPA composites workshop at the 2019 GRAPPA annual meeting and the membership's recommended next steps. METHODS: A review of continuous composite measures was conducted in an introductory workshop, followed by 10 breakout group sessions and a final plenary session for feedback and voting. RESULTS:Participants included 154 members: 87 rheumatologists, 18 dermatologists, 2 rheumatologist/dermatologists, 12 patient research partners, 14 academics, 1 methodologist, and 20 industry members. Of voting members, 88.8% agreed a need exists for a continuous composite measure for routine practice, but only 62% were currently using a composite measure. Of these, 27% were using the 28-joint count Disease Activity Score (DAS), which is not a PsA-specific measure; 20% were using a PsA-specific measure such as PsA DAS (PASDAS), Composite Psoriatic Disease Activity Index (CPDAI), or Disease Activity Index for PsA (DAPSA). Members agreed that the existing measures were not feasible in their current forms (CPDAI 83%, PASDAS 82%, and DAPSA 47%) and that modification should be tested. The majority (76%) agreed that disease effect should be measured separately from disease activity. CONCLUSION: The GRAPPA membership supports the need for a continuous composite measure of disease activity for use in routine clinical care, the separate measurement of disease effect and activity, and the testing of modifications to candidate instruments rather than the development of new measures.