Philip J Mease

Publications (90)368.52 Total impact

• Article: GRAPPA Responder Index Project (GRACE): A Report from the GRAPPA 2011 Annual Meeting.

  Philip S Helliwell, Oliver Fitzgerald, Philip J Mease, Dafna D Gladman
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  ABSTRACT: The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) established the GRAPPA Composite Exercise (GRACE) to compare existing and emerging composite disease activity and responder measures. At the GRAPPA 2010 annual meeting, initial results from this project were presented, and voting on available measures took place. At the GRAPPA 2011 meeting, further comparisons of new and existing measures were made, along with an outline plan for further work.
  The Journal of Rheumatology 11/2012; 39(11):2196-7. · 3.69 Impact Factor
• Article: Biomarkers of Radiographic Progression in Psoriatic Arthritis: A Report from the GRAPPA 2011 Annual Meeting.

  Oliver Fitzgerald, Christopher T Ritchlin, Philip J Mease
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  ABSTRACT: Clinical markers of radiographic progression have been studied in patients with psoriatic arthritis (PsA), and results have clearly confirmed the progression of radiographic damage over a 2-year period. Biomarkers of radiographic progression damage (erosion and new bone formation) have also been identified as a critical research issue in these patients. At the 2011 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members discussed development of a pivotal observational study (PsA Biodam study) to determine the validity of several soluble biomarkers in predicting structural damage in patients with PsA receiving standard therapies. Specific protocol issues discussed were the inclusion criteria, selection of candidate biomarkers, timing of sample collection, the primary radiographic outcome measure, radiographic scoring methods, possible substudies, and funding strategies.
  The Journal of Rheumatology 11/2012; 39(11):2189-92. · 3.69 Impact Factor
• Article: On Defining Musculoskeletal Inflammation: A Report from the GRAPPA 2011 Annual Meeting.

  Amit Garg, Dafna D Gladman, Philip J Mease
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  ABSTRACT: At the 2011 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members discussed the need to develop a framework for defining inflammatory arthritis, enthesitis, dactylitis, and spondylitis, particularly as they relate to psoriatic arthritis (PsA). GRAPPA members first addressed this subject at their 2010 meeting, where the CASPAR (ClASsification of Psoriatic ARthritis) criteria were discussed. Although these are classification criteria, the CASPAR are also often applied as a diagnostic measure by clinicians screening for PsA, particularly its core criterion: recognizing the presence of inflammatory musculoskeletal disease. In breakout group discussions, GRAPPA members discussed the difficulties in recognizing overlapping or mimicking features that may result in underdiagnosing or misdiagnosing PsA.
  The Journal of Rheumatology 11/2012; 39(11):2214-5. · 3.69 Impact Factor
• Source

  Available from: Valderilio Azevedo

  Article: The development of candidate composite disease activity and responder indices for psoriatic arthritis (GRACE project).

  Philip S Helliwell, Oliver Fitzgerald, Jaap Fransen, Dafna D Gladman, Gerald G Kreuger, Kristina Callis-Duffin, Neil McHugh, Philip J Mease, Vibeke Strand, Robin Waxman, [......], Roberto Ranza, Siba P Raychaudhuri, Euthalia Roussou, Raphael Scarpa, Yeong Wook Song, Enrique R Soriano, Paul P Tak, Ilona Ujfalussy, Kurt de Vlam, Jessica A Walsh
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  ABSTRACT: OBJECTIVE: To develop new composite disease activity indices for psoriatic arthritis (PsA). METHODS: Data from routine clinic visits at multiple centres were collected in a systematic manner. Data included all domains identified as important in randomised controlled trials in PsA. Decisions to change treatment were used as surrogates for high disease activity. New indices were developed by multiple linear regression (psoriatic arthritis disease activity score: PASDAS) and empirically, utilising physician-defined cut-offs for disease activity (arithmetic mean of desirability functions: AMDF). These were compared with existing composite measures: Composite Psoriatic arthritis Disease Activity Index (CPDAI), Disease Activity for PSoriatic Arthritis (DAPSA), and Disease Activity Score for rheumatoid arthritis (DAS28). RESULTS: 161/503 (32%) subjects had treatment changes. Although all measures performed well, compared with existing indices, PASDAS was better able to discriminate between high and low disease activity (area under receiver operating curves (ROC)) curve with 95% CI: PASDAS 0.773 (0.723, 0.822); AMDF 0.730 (0.680, 0.780); CPDAI 0.719 (0.668, 0.770); DAPSA 0.710 (0.654, 0.766); DAS28 0.736 (0.680, 0.792). All measures were able to discriminate between disease activity states in patients with oligoarthritis, although area under the receiver operating curves (AUC) were generally smaller. In patients with severe skin disease (psoriasis area and severity index >10) both nonparametric and AUC curve statistics were nonsignificant for all measures. CONCLUSIONS: Two new composite measures to assess disease activity in PsA have been developed. Further testing in other datasets, including comparison with existing measures, is required to validate these instruments.
  Annals of the rheumatic diseases 07/2012; · 8.11 Impact Factor
• Article: Efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis: results of a randomised placebo-controlled trial (ABILITY-1).

  Joachim Sieper, Désirée van der Heijde, Maxime Dougados, Philip J Mease, Walter P Maksymowych, Matthew A Brown, Vipin Arora, Aileen L Pangan
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  ABSTRACT: PURPOSE: To evaluate the efficacy and safety of adalimumab in patients with non-radiographic axial spondyloarthritis (nr-axSpA). METHODS: Patients fulfilled Assessment of Spondyloarthritis international Society (ASAS) criteria for axial spondyloarthritis, had a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score of ≥ 4, total back pain score of ≥ 4 (10 cm visual analogue scale) and inadequate response, intolerance or contraindication to non-steroidal anti-inflammatory drugs (NSAIDs); patients fulfilling modified New York criteria for ankylosing spondylitis were excluded. Patients were randomised to adalimumab (N=91) or placebo (N=94). The primary endpoint was the percentage of patients achieving ASAS40 at week 12. Efficacy assessments included BASDAI and Ankylosing Spondylitis Disease Activity Score (ASDAS). MRI was performed at baseline and week 12 and scored using the Spondyloarthritis Research Consortium of Canada (SPARCC) index. RESULTS: Significantly more patients in the adalimumab group achieved ASAS40 at week 12 compared with patients in the placebo group (36% vs 15%, p<0.001). Significant clinical improvements based on other ASAS responses, ASDAS and BASDAI were also detected at week 12 with adalimumab treatment, as were improvements in quality of life measures. Inflammation in the spine and sacroiliac joints on MRI significantly decreased after 12 weeks of adalimumab treatment. Shorter disease duration, younger age, elevated baseline C-reactive protein or higher SPARCC MRI sacroiliac joint scores were associated with better week 12 responses to adalimumab. The safety profile was consistent with what is known for adalimumab in ankylosing spondylitis and other diseases. CONCLUSIONS: In patients with nr-axSpA, adalimumab treatment resulted in effective control of disease activity, decreased inflammation and improved quality of life compared with placebo. Results from ABILITY-1 suggest that adalimumab has a positive benefit-risk profile in active nr-axSpA patients with inadequate response to NSAIDs.
  Annals of the rheumatic diseases 07/2012; · 8.11 Impact Factor
• Article: Development of composite measures for psoriatic arthritis: a report from the GRAPPA 2010 annual meeting.

  Philip S Helliwell, Oliver Fitzgerald, Philip J Mease
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  ABSTRACT: Composite disease outcome measures have been used in rheumatology for some time, but a disease-specific composite measure for psoriatic arthritis (PsA) has not yet been validated. Currently, instruments developed for use in rheumatoid arthritis are employed in PsA and include the American College of Rheumatology response criteria (ACR20, 50, and 70) and the Disease Activity Score for 28 and 44 joints (DAS28 and DAS44); however, these instruments do not cover the full spectrum of psoriatic disease. A composite measure is one way of incorporating an assessment of all relevant clinical outcomes into one single measure. By definition, it incorporates several dimensions of disease status, often by combining these different domains into a single score, which in the case of PsA includes joints, skin, entheses, dactylitis, and axial disease. New indices that combine these diverse clinical manifestations of PsA are under development and, in some cases, in the validation phase. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) established the GRAPPA Composite Exercise (GRACE) project to compare existing and emerging composite measures and to develop a new index. At the GRAPPA 2010 meeting, initial results from this project were presented, and existing and new candidate measures were compared.
  The Journal of Rheumatology 02/2012; 39(2):398-403. · 3.69 Impact Factor
• Article: The need to define musculoskeletal inflammation: a report from the GRAPPA 2010 annual meeting.

  Amit Garg, Dafna D Gladman, Philip J Mease
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  ABSTRACT: Psoriatic arthritis (PsA) is a form of spondyloarthritis, a group of conditions that share a spectrum of components including arthritis, enthesitis, dactylitis, and spine inflammation. In PsA, however, the unpredictable, heterogeneous, and often insidious involvement of joints or juxtaarticular tendons and ligaments can sometimes make clinical recognition of the disease a challenge. Underrecognition of PsA may be due to the absence of a single sensitive and specific diagnostic measure. Although the ClASsification of Psoriatic ARthritis (CASPAR) criteria introduced in 2006 have improved disease classification, they are designed to be applied to cases already diagnosed with inflammatory arthritis. Therefore, in order for these criteria to be applied, the clinician is required to recognize the presence of inflammatory arthritis, enthesitis, or spondylitis. At the 2010 annual meeting of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis), the need to define inflammatory arthritis, enthesitis, dactylitis, and spondylitis, especially for nonrheumatologists, was discussed. Conclusions from breakout group discussions are summarized.
  The Journal of Rheumatology 02/2012; 39(2):413-4. · 3.69 Impact Factor
• Article: Prologue: 2010 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

  Philip J Mease, Dafna D Gladman
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  ABSTRACT: The 2010 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in December 2010 in Miami Beach, Florida, USA, with attendance by rheumatologists, dermatologists, and representatives of biopharmaceutical companies and patient groups. In a training session that preceded the GRAPPA meeting, members served as faculty while rheumatology fellows and dermatology residents presented their original research. During the 2-day GRAPPA meeting, presentations included a review of composite measures for psoriatic arthritis (PsA) and psoriasis, updates on imaging in psoriatic disease (ultrasound and magnetic resonance imaging), a 3-part discussion of the definition of inflammatory musculoskeletal disease, a 4-part discussion of the status and path forward in psoriatic disease biomarker research, an update on comorbidities in psoriasis and PsA, and a review of global education and partnering opportunities. Introductions to the discussions at the GRAPPA 2010 meeting are included in this prologue.
  The Journal of Rheumatology 02/2012; 39(2):391-3. · 3.69 Impact Factor
• Article: Psoriasis and psoriatic arthritis video project: an update from the 2010 GRAPPA annual meeting.

  Jamie L Woodcock, Philip J Mease, Kristina Callis Duffin
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  ABSTRACT: Changes in severity of psoriasis and psoriatic arthritis (PsA) are assessed in clinical trials by a variety of physical examination instruments. At the 2010 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members were updated on the development and availability of modules that teach these instruments. Web-based interactive multimedia presentations for psoriasis assessments have been completed, including modules for Psoriasis Area and Severity Index and Body Surface Area, 5-point and 6-point Physician Global Assessment, the original and modified Nail Psoriasis Severity Index, the Palmar-Plantar Pustular Psoriasis Area and Severity Index, and the Psoriasis Scalp Severity Index. Rheumatology modules will include assessment of tender and swollen joints, and evaluations of enthesitis, dactylitis, and axial disease. Each module will include the background and rationale for each tool, demonstration video of each examination, diagrams and photographs to emphasize teaching points, and an optional examination at the end. The rheumatology modules have been recorded but were not yet available for review at the meeting. The dermatology modules are currently in use by pharmaceutical and biotechnology companies engaged in research on treatments for psoriasis and PsA. The next phase of this project includes analysis of interobserver reliability, translation into languages other than English for international users, and other proposed studies.
  The Journal of Rheumatology 02/2012; 39(2):421-2. · 3.69 Impact Factor
• Article: Development of responder definitions for fibromyalgia clinical trials.

  Lesley M Arnold, David A Williams, James I Hudson, Susan A Martin, Daniel J Clauw, Leslie J Crofford, Fujun Wang, Birol Emir, Chinglin Lai, Rong Zablocki, Philip J Mease
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  ABSTRACT: To develop responder definitions for fibromyalgia (FM) clinical trials using key symptom and function domains. Twenty-four candidate responder definitions were developed by expert consensus and were evaluated in 12 randomized, placebo-controlled trials of 4 medications for the treatment of FM. For each definition, the treatment effects of the medication compared with placebo were analyzed using Cochran-Mantel-Haenszel tests or chi-square tests. A meta-analysis of the pooled results for the 4 medications established risk ratios to determine the definitions that best favored medication over placebo. Two definitions performed best in the analyses. Both definitions included ≥30% reduction in pain and ≥10% improvement in physical function. The definitions differed in that one (≥30% improvement in FM [FM30] short version) included ≥30% improvement in sleep or fatigue, and the other (FM30 long version) required ≥30% improvement in 2 of the following symptoms: sleep, fatigue, depression, anxiety, or cognition. In the analysis of both versions, the response rate was ≥15% for each medication and was significantly greater compared with placebo. The risk ratio favoring drug over placebo in the pooled analysis for FM30 version 3 (short version) was 1.50 (95% confidence interval [95% CI] 1.24-1.82; P ≤ 0.0001); the risk ratio for FM30 version 6 (long version) was 1.60 (95% CI 1.31-1.96; P ≤ 0.00001). Among the 24 responder definitions tested, 2 were identified as most sensitive in identifying response to treatment. The identification of responder definitions for FM clinical trials that include assessments of key symptom and function domains may improve the sensitivity of clinical trials to identify meaningful improvements, leading to improved management of FM.
  Arthritis & Rheumatism 09/2011; 64(3):885-94. · 7.87 Impact Factor
• Source

  Available from: Jeffrey R Curtis

  Article: Retreatment with rituximab based on a treatment-to-target approach provides better disease control than treatment as needed in patients with rheumatoid arthritis: a retrospective pooled analysis.

  Paul Emery, Philip J Mease, Andrea Rubbert-Roth, Jeffrey R Curtis, Ulf Müller-Ladner, Norman B Gaylis, Sarah Williams, Mark Reynard, Helen Tyrrell
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  ABSTRACT: To assess the efficacy and safety profiles of two different rituximab retreatment regimens in patients with RA. Four hundred and ninety-three RA patients with an inadequate response to MTX recruited into rituximab Phase II/III studies received further courses of open-label rituximab based on two approaches: (i) treatment to target (TT): patients assessed 24 weeks after each course and retreated if not in remission [DAS in 28 joints based on ESR (DAS-28-ESR) ≥ 2.6]; (ii) treatment as needed (PRN): patients retreated at the physician's discretion ≥24 weeks following the first course and ≥16 weeks following further courses, if both swollen and tender joint counts were ≥8. All courses consisted of i.v. rituximab 2 × 1000 mg 2 weeks apart plus MTX. Observed data were analysed according to treatment strategy. Multiple courses of rituximab maintained or improved responses irrespective of regimen. TT provided tighter control of disease activity with significantly greater improvements in DAS-28-ESR and lower HAQ-disability index scores vs PRN. TT resulted in significantly more patients achieving major clinical response. PRN resulted in recurrence of disease symptoms between courses, with TT significantly reducing the incidence of RA flares. Despite more frequent retreatment with TT compared with PRN, the rates of serious adverse events and serious infections were comparable between regimens. Retreatment with rituximab based on 24-week evaluations and to a target of DAS-28-ESR remission leads to improved efficacy and tighter control of disease activity compared with PRN without a compromised safety profile. TT may be the preferable rituximab treatment regimen for patients with RA.
  Rheumatology (Oxford, England) 09/2011; 50(12):2223-32. · 4.24 Impact Factor
• Article: Interpreting clinical trial results for moderate-to-severe rheumatoid arthritis: practical applications for rheumatology healthcare providers.

  Nicole Furfaro, Philip J Mease
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  ABSTRACT: To provide a general overview of clinical trials and more specifically define measurements common to rheumatoid arthritis clinical trials for the purpose of providing a foundation for rheumatology healthcare providers to translate clinical trial findings into their clinical practice and enhance their patient education discussions. English-language publications cited in the MEDLINE database were used to develop the content of this review article. The role of rheumatology healthcare providers has evolved to include numerous vital functions, such as expanding communication between specialists and primary care providers, patient education and counseling, assistance with coping strategies, monitoring response to therapy, and administration of therapy. Education regarding clinical trial design, rationale, and discussion of endpoints has not been strongly emphasized for rheumatology healthcare providers who are increasingly introduced to novel agents and need to assimilate findings from clinical trials into daily practice. Familiarity with the basics of clinical trial design and efficacy endpoints of new rheumatoid arthritis therapeutics, translation and application of that knowledge into daily practice, and the ability to explain this information with patients will further enhance the ability of the rheumatology healthcare provider to optimize care for their patients with rheumatoid arthritis.
  Journal of the American Academy of Nurse Practitioners 09/2011; 23(9):479-92. · 0.82 Impact Factor
• Article: Minimally important difference of Health Assessment Questionnaire in psoriatic arthritis: relating thresholds of improvement in functional ability to patient-rated importance and satisfaction.

  Philip J Mease, J Michael Woolley, Bojena Bitman, Brian C Wang, Denise R Globe, Amitabh Singh
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  ABSTRACT: To evaluate changes in function as measured by Health Assessment Questionnaire Disability Index (HAQ-DI) and the meaningfulness of the changes, in importance and satisfaction, in patients with psoriatic arthritis (PsA). HAQ-DI was assessed at baseline and at Weeks 4, 12, and 24 in a randomized double-blind study of 205 patients with active PsA receiving etanercept 25 mg twice weekly or placebo. Concurrently, patients rated the importance of and satisfaction with their change in function on a 7-point scale (1 = not at all important/satisfied; 7 = extremely important/satisfied). Mean HAQ-DI improvement corresponding to ratings of minimally (2-3) or very (6-7) important or satisfied was determined using a posthoc linear mixed-model analysis. Patient importance ratings were used as an anchor to estimate minimally important difference (MID) for HAQ-DI; distribution-based estimates were also calculated. A total of 161 patients (69 placebo; 92 etanercept) had ≥ 1 HAQ-DI scores showing improvement from baseline and a corresponding importance or satisfaction rating. HAQ-DI improvements corresponding to importance scale ratings of 2 or 3 were 0.335 (95% CI 0.214, 0.455) and 0.360 (95% CI 0.263, 0.456), respectively, suggesting an MID of about 0.35. HAQ-DI improvements corresponding to satisfaction scale ratings of 2 and 3 were 0.293 (95% CI 0.230, 0.357) and 0.360 (95% CI 0.307, 0.413). For a given change in HAQ-DI, nearly two-thirds of patients indicated a lower rating for satisfaction than for importance. This trial was registered in the ClinicalTrials.gov registry (NCT00317499). Our study suggests the MID for HAQ-DI in PsA is about 0.35. The results may also provide insight into patient satisfaction with changes in function and expectations for therapy.
  The Journal of Rheumatology 09/2011; 38(11):2461-5. · 3.69 Impact Factor
• Article: Toward development of a fibromyalgia responder index and disease activity score: OMERACT module update.

  Philip J Mease, Daniel J Clauw, Robin Christensen, Leslie J Crofford, R Michael Gendreau, Susan A Martin, Lee S Simon, Vibeke Strand, David A Williams, Lesley M Arnold
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  ABSTRACT: Following development of the core domain set for fibromyalgia (FM) in Outcome Measures in Rheumatology Clinical Trials (OMERACT) meetings 7 to 9, the FM working group has progressed toward the development of an FM responder index and a disease activity score based on these domains, utilizing outcome indices of these domains from archived randomized clinical trials in FM. Possible clinical domains that could be included in a responder index and disease activity score include pain, fatigue, sleep disturbance, cognitive dysfunction, mood disturbance, tenderness, stiffness, and functional impairment. Outcome measures for these domains demonstrate good to adequate psychometric properties, although measures of cognitive dysfunction need to be further developed. The approach used in the development of responder indices and disease activity scores for rheumatoid arthritis and ankylosing spondylitis represents heuristic models for our work, but FM is challenging in that there is no clear algorithm of treatment that defines disease activity based on treatment decisions, nor are there objective markers that define thresholds of severity or response to treatment. The process of developing candidate dichotomous responder definitions and continuous quantitative disease activity measures is described, along with participant discussions from OMERACT 10. Final results of this work will be published in a separate report pending completion of analyses.
  The Journal of Rheumatology 07/2011; 38(7):1487-95. · 3.69 Impact Factor
• Article: Development of a disease severity and responder index for psoriatic arthritis (PsA)--report of the OMERACT 10 PsA special interest group.

  Laura C Coates, Aizad Mumtaz, Philip S Helliwell, Philip J Mease, Kristina Callis-Duffin, Gerald G Krueger, Neil J McHugh, Vibeke Strand, Dafna D Gladman, Oliver FitzGerald
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  ABSTRACT: Work within the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) to develop and validate composite disease activity measures in PsA has progressed. At the Outcome Measures in Rheumatology Clinical Trials (OMERACT) 8 meeting, a core set of domains to be assessed in randomized controlled trials (RCT) and longitudinal observational studies (LOS) of PsA was agreed upon. At OMERACT 10, work to date regarding proposed composite responder indices was presented. Five proposed composite responder definitions for PsA were reviewed and discussed including new data from the GRACE (GRAppa Composite Exercise) study. There was agreement that the work to date was promising, and that developing composite outcome measures for use in RCT and LOS was important. Further work was required, including data on followup timepoints and less common phenotypes of PsA, to ensure that all subgroups were represented within GRACE. During discussion on the concept of composite measures for PsA, based on predominant/little/no involvement in several domains (such as skin versus joints, enthesitis, dactylitis, spondyloarthritis) it was acknowledged that a simple summative score encompassing all domains of PsA would be difficult to construct psychometrically and may not be appropriate. Ideally, any composite measure should retain the ability to differentiate between activity in individual domains, such as enthesitis or skin psoriasis, so that the influence of each can be assessed independently. Further work is required within the GRACE dataset to develop an optimal composite measure for PsA. Several proposals to date have shown preliminary validity according to the OMERACT filter.
  The Journal of Rheumatology 07/2011; 38(7):1496-501. · 3.69 Impact Factor
• Source

  Available from: Dafna D Gladman

  Article: Prologue: 2009 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

  Philip J Mease, Dafna D Gladman
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  ABSTRACT: The 2009 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in June 2009 in Stockholm, Sweden, and was attended by rheumatologists, dermatologists, biopharmaceutical company representatives, and patient groups. A primary goal of GRAPPA is to foster outreach and interdisciplinary communication between the fields of rheumatology and dermatology. Several members attended an adjacent meeting of the International Federation of Psoriasis Associations; reports were also provided of recent meetings of the American Academy of Dermatology and the Assessment of SpondyloArthritis (ASAS) working group. In a training session of the GRAPPA meeting, members served as faculty while rheumatology fellows and dermatology residents presented original research work. In one module of the meeting, several response measures were discussed. In another module, discussions were held on the need for dermatologists to be able to diagnose psoriatic arthritis (PsA) among their psoriasis patients; several PsA screening questionnaires were presented, and progress was reported on developing online training videos as an aid to educate clinicians in their diagnoses. Other topics for discussion at the GRAPPA meeting included presentations on genetic associations with PsA and on comorbidities in patients with PsA. Current and future research projects also were outlined.
  The Journal of Rheumatology 03/2011; 38(3):522-5. · 3.69 Impact Factor
• Article: Psoriatic arthritis: update on pathophysiology, assessment and management.

  Philip J Mease
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  ABSTRACT: Psoriatic arthritis (PsA) is classified as a spondyloarthropathy and characterised by synovitis, enthesitis, dactylitis and spondylitis usually manifesting as skin and nail psoriasis. Our understanding about the PsA disease state, its genetics, pathophysiology and comorbidities, as well as the ability to assess and treat the disease, has advanced as a result of significant collaborative efforts by rheumatologists and dermatologists in the development of classification criteria, outcome measures to assess the various clinical domains, and treatment trials with agents also used for diseases such as rheumatoid arthritis (RA) and psoriasis. Biological agents, especially the antitumour necrosis factors, have demonstrated significant efficacy and reasonable safety in all clinical domains of the disease, resulting in amelioration of clinical symptoms, inhibition of structural damage and improvement of function and quality of life. Although there is considerable overlap with RA, there are some differences in pathophysiology and approach to assessment and management that are important to consider. This paper reviews these subjects, with an emphasis on recent data.
  Annals of the rheumatic diseases 03/2011; 70 Suppl 1:i77-84. · 8.11 Impact Factor
• Article: Rapid improvement in the signs and symptoms of rheumatoid arthritis following certolizumab pegol treatment predicts better longterm outcomes: post-hoc analysis of a randomized controlled trial.

  Edward C Keystone, Jeffrey R Curtis, Roy M Fleischmann, Daniel E Furst, Dinesh Khanna, Josef S Smolen, Philip J Mease, Michael H Schiff, Geoffroy Coteur, Owen Davies, Bernard Combe
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  ABSTRACT: To assess the kinetics of response to certolizumab pegol (CZP), and association between rapid response and longterm outcomes, in patients with active rheumatoid arthritis (RA). This was a post-hoc analysis of the randomized, double-blind RAPID 1 study in patients who received methotrexate (MTX) and either CZP 200 mg subcutaneously or placebo every 2 weeks for 52 weeks. Clinical and radiographic outcomes at Week 52 were evaluated based on the Disease Activity Score 28 (DAS28) ≥ 1.2 and American College of Rheumatology 20% (ACR20) responses at Week 6 and Week 12. Clinical responses [European League Against Rheumatism (EULAR), DAS28 ≥ 1.2, and ACR20 responses] were rapid in CZP-treated patients. Week 12 DAS28 ≥ 1.2 responders had better clinical and radiographic outcomes at Week 52 compared with nonresponders. Among Week 12 responders, incremental benefit of earlier response was observed: Week 6 DAS28 ≥ 1.2 responders and ACR20 responders had significantly higher ACR response rates and were more likely to achieve remission at Week 52 than Week 12 responders. Patients with a clinical response at Week 6 had faster, more meaningful sustained improvements in patient-derived outcomes than those responding by Week 12 only. Rapid attainment of clinical response in patients with RA is associated with improved longterm outcomes. Analysis of the kinetics of response to CZP during the first 12 weeks of therapy potentially permits informed prediction of clinical success or need to alter treatment. In patients not achieving a clinical response at Week 12 treatment adjustment should be considered. Trial registration NCT00152386.
  The Journal of Rheumatology 03/2011; 38(6):990-6. · 3.69 Impact Factor
• Article: Summary of the International Federation of Psoriasis Associations (IFPA) meeting: a report from the GRAPPA 2009 annual meeting.

  Laura C Coates, Christine L Jonckheere, Sonja Molin, Philip J Mease, Christopher T Ritchlin
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  ABSTRACT: The International Federation of Psoriasis Associations (IFPA) organized the second World Psoriasis and Psoriatic Arthritis Conference in Stockholm, Sweden, in June 2009. The 2009 collaborative multidisciplinary meeting attracted nearly 1000 clinicians and investigators from dermatology, rheumatology, basic science, and industry, as well as patients and leaders of patient organizations, from 68 countries. The major theme of the meeting was "Psoriasis - Skin and Beyond," and the primary aim was to highlight the significant effects of psoriasis and related comorbidities on patient function and quality of life. The annual meeting of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) was held concurrently, and several GRAPPA members attended both meetings. Key presentations at IFPA that GRAPPA members believed were highlights of that meeting are summarized here.
  The Journal of Rheumatology 03/2011; 38(3):530-9. · 3.69 Impact Factor
• Article: Psoriasis and Psoriatic Arthritis Video Project 2010: a report from the GRAPPA annual meeting.

  Kristina Callis Duffin, Philip J Mease
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  ABSTRACT: Investigators use several physical examination measures to assess clinical features and severity of psoriasis and psoriatic arthritis (PsA) in clinical trials, clinical registries, and clinical practice; however, no relevant training modules are widely available to teach and standardize the performance of these measures. At a GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) meeting adjacent to the 2009 International Federation of Psoriasis Associations in Stockholm, members were updated on the development status of online training videos of psoriasis and PsA examination measures. Dermatology assessment modules include the Psoriasis Area and Severity Index, the Static Physician Global Assessment, body surface area, the original and modified Nail Psoriasis Severity Index, the Palmar-Plantar Pustular Psoriasis Area and Severity Index, and the Psoriasis Scalp Severity Index. Rheumatology modules include assessment of tender and swollen joint counts used in the American College of Rheumatology criteria, Disease Activity Score, and other composite arthritis scores; enthesitis assessment used in various enthesitis scoring systems; dactylitis; and spine disease. Each module will include background information for each measure, diagrams and photographs to emphasize teaching points, demonstration video of examination where applicable, and an optional examination at the end. Future plans include evaluating the modules for their influence on interrater and intrarater reliability and development of additional modules.
  The Journal of Rheumatology 03/2011; 38(3):562-3. · 3.69 Impact Factor