Ritchlin C T, Kavanaugh A, Gladman D D, Mease P J, Helliwell P, Boehncke W-H, de Vlam K, Fiorentino D, Fitzgerald O, Gottlieb A B, McHugh N J, Nash P, Qureshi A A, Soriano E R, Taylor W J
Clinical Immunology Research Center, University of Rochester Medical Center, 601 Elmwood Avenue, Box 695, Rochester, New York 14642, USA.
Ann Rheum Dis. 2009 Sep;68(9):1387-94. doi: 10.1136/ard.2008.094946. Epub 2008 Oct 24.
To develop comprehensive recommendations for the treatment of the various clinical manifestations of psoriatic arthritis (PsA) based on evidence obtained from a systematic review of the literature and from consensus opinion.
Formal literature reviews of treatment for the most significant discrete clinical manifestations of PsA (skin and nails, peripheral arthritis, axial disease, dactylitis and enthesitis) were performed and published by members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Treatment recommendations were drafted for each of the clinical manifestations by rheumatologists, dermatologists and PsA patients based on the literature reviews and consensus opinion. The level of agreement for the individual treatment recommendations among GRAPPA members was assessed with an online questionnaire.
Treatment recommendations were developed for peripheral arthritis, axial disease, psoriasis, nail disease, dactylitis and enthesitis in the setting of PsA. In rotal, 19 recommendations were drafted, and over 80% agreement was obtained on 16 of them. In addition, a grid that factors disease severity into each of the different disease manifestations was developed to help the clinician with treatment decisions for the individual patient from an evidenced-based perspective.
Treatment recommendations for the cardinal physical manifestations of PsA were developed based on a literature review and consensus between rheumatologists and dermatologists. In addition, a grid was established to assist in therapeutic reasoning and decision making for individual patients. It is anticipated that periodic updates will take place using this framework as new data become available.
基于对文献的系统综述及共识意见所获证据，制定针对银屑病关节炎（PsA）各种临床表现的综合治疗建议。
银屑病和银屑病关节炎研究与评估小组（GRAPPA）成员对PsA最主要的离散临床表现（皮肤和指甲、外周关节炎、中轴疾病、指（趾）炎和附着点炎）的治疗进行了正式的文献综述并发表。基于文献综述和共识意见，由风湿病学家、皮肤科医生和PsA患者为每种临床表现起草治疗建议。通过在线问卷评估GRAPPA成员对各项治疗建议的认同程度。
针对PsA背景下的外周关节炎、中轴疾病、银屑病、指甲疾病、指（趾）炎和附着点炎制定了治疗建议。总共起草了19条建议，其中16条获得了超过80%的认同。此外，还制定了一个将疾病严重程度纳入每种不同疾病表现的表格，以帮助临床医生从循证角度为个体患者做出治疗决策。
基于文献综述以及风湿病学家和皮肤科医生之间的共识，制定了PsA主要身体表现的治疗建议。此外，还建立了一个表格来协助对个体患者进行治疗推理和决策。预计随着新数据的出现，将使用该框架定期进行更新。
