William Tillett

Royal National Hospital For Rheumatic Diseases Pharmacy and Pharmacology University of Bath UK

Background Nail psoriasis is a common, physiologically, and psychologically disruptive, and yet often under-treated manifestation of psoriasis. The objectives of this analysis were to investigate the trajectory of nail psoriasis, a risk factor for psoriatic arthritis (PsA), with guselkumab vs adalimumab treatment followed by withdrawal, and determi...

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) leadership congregated for a strategic planning meeting before the 2022 GRAPPA annual meeting in New York, USA. Meeting aims were to review GRAPPA's performance in relation to its 2016 goals and identify successes and areas for further improvement, identify key GRAP...

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) pilot grant awards help support young researchers starting their careers while also encouraging them to develop a focus on psoriatic disease. In this brief report, winners of the 2020 and 2021 awards present the results of their pilot projects.

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)–Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) working group—comprising rheumatologists, dermatologists, methodologists, and patient research partners—provided updates at the GRAPPA 2022 annual meeting on its work to evaluate composite outcome...

Objectives: To assess the long-term safety and efficacy of upadacitinib in patients with psoriatic arthritis (PsA) and an inadequate response (IR) to biologic disease-modifying anti-rheumatic drugs (bDMARDs) who completed up to 152 weeks of treatment in the SELECT-PsA 2 study (ClinicalTrials.gov: NCT03104374). Methods: Patients were randomised t...

Objectives: To compare the performance of three psoriatic arthritis (PsA) screening questionnaires in a primary care psoriasis surveillance study. Methods: Participants with psoriasis, and not known to have psoriatic arthritis (PsA), were identified from general practice databases and invited to attend a secondary care centre for a clinical asse...

Introduction Ixekizumab has demonstrated efficacy in pivotal trials in patients with psoriatic arthritis (PsA), both those naïve to prior biologic therapy and those with prior inadequate response or intolerance to biologics; however, minimal information is currently available on the effectiveness of ixekizumab in routine clinical practice. The obje...

Background Cyclophosphamide (CYC) and Rituximab (RTX) have been found to be of equivalent effectiveness in remission induction of severe ANCA-associated vasculitis (AAV) (1); [2]. American College of Rheumatology in 2019, and more recently EULAR guidance on treatment of AAV, has recommended the use of RTX first-line due to a more favorable side-eff...

Background The PsA core domain set developed by the Outcome Measures in Rheumatology working group includes musculoskeletal disease, fatigue, physical function, and structural damage, of which arthritis activity, pain, and fatigue were identified as essential by both patients (Pts) and physicians (Phs). [1-2] Assessing agreement between Pt and Ph g...

Background The incidence of psoriatic arthritis (PsA) in a psoriasis population has been reported to be somewhere between 20 to 300 per 10,000 person years (p-yrs) (1,2), the wide range reflecting differences in the population setting and the methods of ascertaining a diagnosis. A higher incidence is generally found in studies combining active scre...

Background Delay in the diagnosis of psoriatic arthritis may be associated with poorer outcome. However, the effectiveness of strategies to enable early detection of psoriatic arthritis in a primary care population with psoriasis have not been investigated in a prospective randomised control trial. Objectives The primary objective was to determine...

Background Psoriatic arthritis (PsA) is a chronic inflammatory arthritis occurring in 20–30% of patients with psoriasis. [1] Timely diagnosis is important because untreated PsA can lead to irreversible joint damage [1] and functional disability. [2] While existing national and international guidelines, such as those provided by EULAR, BSR, ACR/Nati...

Background Though continuous composite measures of disease activity for psoriatic arthritis (PsA) assessment exist, abbreviated measures that are more feasible for screening in routine clinical practice are needed. The 3 Visual Analogue Scale (VAS) and 4VAS scores were developed by abridging the Group for Research and Assessment of Psoriasis and Ps...

Background There are considerable delays in the diagnosis of psoriatic arthritis (PsA) and earlier diagnosis is likely to lead to better outcomes. Objectives The aim of this study was to compare the performance of three PsA screening questionnaires in a primary care psoriasis surveillance program. Methods Participants with psoriasis, and not know...

Background Due to the chronic nature of psoriatic arthritis (PsA) and the increase in therapeutic options, many people are receiving multiple sequential lines of biologic and targeted synthetic disease modifying anti-rheumatic drugs (b/tsDMARDs). There is limited data on treatment response to advanced lines of therapy and therefore in the rationed...

Background Involvement of weight-bearing joints in patients with psoriatic arthritis (PsA) can be associated with reduced activities of daily living and quality of life. Upadacitinib (UPA) is an oral, reversible Janus kinase inhibitor approved for the treatment of active PsA in adults. In the SELECT-PsA 1 and SELECT-PsA 2 trials, treatment with onc...

Background The Group for Research and Assessment of Psoriasis and PsA advocates addressing all aspects of disease, including optimizing functional status and improving health-related quality of life (HRQoL). [1] Guselkumab (GUS) has demonstrated robust efficacy across key PsA domains at week (W) 24, with effects sustained or further enhanced throug...

Background Machine learning (ML) algorithms could facilitate the standardisation of joint damage assessment in Psoriatic Arthritis (PsA) and improve its accessibility in clinical and research settings. ML algorithms trained on manually annotated hand and wrist radiographs have promising performance characteristics [1] . A large volume of annotated...

Background Machine learning methods have the potential to optimise the diagnosis of inflammatory arthropathies and the quantification of damage over time. Objectives To summarise the literature investigating the use of machine learning methods to diagnose and detect damage in the hands and feet of patients with Rheumatoid Arthritis (RA) and Psoria...

Background The multiple joint and skin manifestations of psoriatic arthritis (PsA) place a substantial burden on patient quality of life. [1] Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits IL-17F in addition to IL-17A. Objectives To examine the association between achieving increasingly stringent clinical disease control...

Background Ixekizumab (IXE), an Interleukin (IL)-17A inhibitor (i), approved for the treatment (tx) of Psoriasis (Pso), psoriatic arthritis (PsA) and axSpA (rad/non rad) have limited real-world data. PRO-SPIRIT is the first large, prospective observational study for IXE in patients (pts) with PsA who start a new biologic/targeted synthetic disease...

Background/Aims Guselkumab, a human monoclonal antibody targeting the interleukin-23 p19 subunit, demonstrated joint and skin efficacy in patients with PsA in the Phase III DISCOVER-1/-2 trials. MDA, a multi-domain composite outcome, is a clinically relevant measure of therapeutic response in PsA. However, response dynamics and the effect of indivi...

Background/Aims Bimekizumab (BKZ) is a humanised monoclonal IgG1 antibody that acts by selectively inhibiting IL-17F in addition to IL-17A and has demonstrated clinical efficacy vs placebo (PBO) in both joint and skin outcomes in patients with active psoriatic arthritis (PsA). We report interim 24-week (wk) PsARC response rates along with HRQoL est...

Background/Aims Upadacitinib (UPA), an oral Janus kinase (JAK) inhibitor, demonstrated efficacy and safety in patients (pts) with psoriatic arthritis (PsA) and prior inadequate response or intolerance to ≥ 1 biologic disease-modifying antirheumatic drug (bDMARD) at week (wk) 56 in the phase 3 SELECT-PsA 2 study. We aimed to evaluate the efficacy an...

Background/Aims Although continuous composite measures of disease activity for PsA assessment exist, more feasible abbreviated measures are needed for routine screening. The 3VAS and 4VAS scores, developed by abridging the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Composite Exercise (GRACE) measure, are the fir...

Objectives: Psoriatic arthritis (PsA) phenotypes are typically defined by their clinical components, which may not reflect patients' overlapping symptoms. This post hoc analysis aimed to identify hypothesis-free PsA phenotype clusters using machine learning to analyse data from the phase III DISCOVER-1/DISCOVER-2 clinical trials. Methods: Pooled...

ABSTRACT Objectives To characterize the evolving demographics of participants recruited to phase III randomised controlled trials (RCTs) of biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in peripheral psoriatic arthritis (PsA). Methods We conducted a systematic review of EMBASE, MEDLINE, and the Cochrane Database...

Objectives Psoriasis and psoriatic arthritis (PsA) are independently associated with comorbidities, including obesity and metabolic syndrome, which may impact treatment outcomes. This study aimed to assess baseline differences between patients with plaque psoriasis alone and those with concomitant PsA, and to investigate the impact of these charact...

Background: Psoriatic arthritis (PsA) impacts the physical health and functional ability of patients, leading to reduced productivity. High unemployment rates and absence due to sickness have been reported in patients with PsA. Objectives: This post hoc study investigated certolizumab pegol treatment impact on workplace and household productivit...

Objective To describe psoriatic arthritis (PsA) flares and their impact on patient-reported outcomes (PROs). Methods Cross-sectional surveys of rheumatologists/dermatologists and their PsA patients were conducted in France, Germany, Italy, Spain, the United Kingdom, and the United States, capturing data on physician-reported patient flare status,...

Introduction: The phase 3 DISCOVER-2 trial evaluated the effect of guselkumab on impaired work productivity and nonwork activity in biologic-naïve patients with psoriatic arthritis (PsA). Methods: Adults with active PsA were randomized (1:1:1) to guselkumab 100 mg every 4 weeks (Q4W), guselkumab 100 mg at weeks 0 and 4 and then every 8 weeks (Q8...

IntroductionIn DISCOVER-2, guselkumab, an interleukin-23 p19 subunit inhibitor, was efficacious in biologic-naïve psoriatic arthritis (PsA) patients. We report the effect of guselkumab on health-related quality of life (HRQoL) using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Index and Visual Analog Scale (EQ-VAS) through Week 52.Methods Adults with...

Dear Editor, Upadacitinib (UPA), an oral Janus kinase inhibitor approved for the treatment of moderate to severe RA, is being introduced as a new treatment option for PsA [1] and has recently received marketing approval in Europe and the UK. Two recent randomized controlled trials, SELECT-PsA-1 and SELECT-PsA-2 have demonstrated positive results re...

Objectives Evaluate effects of long-term bimekizumab treatment on patient-reported outcome (PRO) measures, symptoms and the impact of psoriatic arthritis (PsA) on patients. Methods Patients with active PsA were enrolled into BE ACTIVE, a 48-week randomised controlled trial (NCT02969525). After week 48, patients could enter a 104-week open-label ex...

Background Psoriatic arthritis (PsA) impacts patients’ (pts) work productivity (WP) and daily activity. ¹ DISCOVER-2 (D2), a Phase 3 trial of the selective interleukin-23 p19-subunit inhibitor guselkumab (GUS) in biologic-naïve pts with PsA, ² demonstrated significant improvements in pt-reported WP and daily activity following 1 year (Y) of GUS tre...

Background Nail psoriasis can be difficult to treat, affects ~50% of patients with psoriasis and can involve the nail matrix (pitting, leukonychia) and/or nail bed (onycholysis, splinter haemorrhages). Evidence suggests nail psoriasis may be associated with risk of developing psoriatic arthritis, in particular distal interphalangeal joint erosion.1...

Background Psoriatic arthritis (PsA) is typically described by its individual domains or clinical components.1,2 Objectives This post hoc analysis aimed to identify hypothesis-free phenotype clusters according to patients’ clinical features and baseline (BL) characteristics with data from the Phase 3 DISCOVER-1 and -2 guselkumab (GUS) clinical tri...

Background Psoriatic arthritis (PsA), a chronic inflammatory disease characterized by peripheral arthritis, axial inflammation, dactylitis, enthesitis, and skin/nail psoriasis, is associated with reduced health-related quality of life (HRQoL). Objectives To assess long-term effect of guselkumab (GUS), a human monoclonal antibody that selectively t...

Background Guselkumab (GUS) is a human monoclonal antibody targeting the interleukin-23p19-subunit. It has demonstrated efficacy at Week 24 in the Phase IIIb COSMOS clinical trial of patients with active psoriatic arthritis (PsA) and inadequate response or intolerance to one or two tumour necrosis factor inhibitors (TNFis). ¹ Objectives The aim of...

Background Alignment of patient and clinician goals and perceptions of psoriatic arthritis (PsA) burden and treatment are important to improving disease management. Objectives To describe patient and rheumatologist perceptions on factors contributing to PsA severity, treatment goals, and attributes of ideal therapy. Methods Understanding Psoriati...

Background Guselkumab (GUS), a human monoclonal antibody targeting the interleukin-23p19 subunit, demonstrated joint and skin efficacy in patients with active psoriatic arthritis (PsA) in the Phase III DISCOVER-1/-2 trials.1,2 Minimal disease activity (MDA), a multi-domain composite outcome, is a clinically relevant measure of therapeutic response...

Background The multifaceted nature of psoriatic arthritis (PsA) can make it challenging to evaluate treatment targets and disease activity. Moreover, most existing assessment tools are time-consuming and not always feasible in routine clinical care, indicating a need for new disease measures that are easy to perform and calculate. Composite measure...

Background Psoriatic arthritis (PsA)/Psoriasis (PsO) patients present with multiple long-term conditions (MLTCs), and more than half of PsA patients have ≥1 LTC, which have an impact on the quality of life. We used the Clinical Practice Research Datalink (CPRD) in the UK to determine multimorbidity in patients with PsA/PsO. CPRD is a database of ro...

Background RAPID3 (Routine Assessment of Patient Index Data 3) is a disease activity index that is calculated from 3 patient-reported measures: physical function, pain, and patient global assessment. A fast and convenient tool, RAPID3 can be easily used in clinical practice and is applicable to multiple rheumatic diseases, including psoriatic arthr...

Background Upadacitinib (UPA), an oral Janus kinase (JAK) inhibitor, demonstrated efficacy and safety in patients (pts) with psoriatic arthritis (PsA) and prior inadequate response or intolerance to ≥1 biologic disease-modifying antirheumatic drug (bDMARD) at week (wk) 56 in the phase 3 SELECT-PsA 2 study. ¹ Objectives To evaluate the efficacy and...

Background Patients (pts) with oligoarticular psoriatic arthritis (PsA) report quality-of-life impairment similar to polyarticular PsA pts despite less joint involvement. In the 2020 Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) survey, we evaluated other aspects of disease burden in pts with oligoarticular (≤4 joints)...

Background Patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are often nonadherent to prescribed symptom-modifying drugs. [1] Concerns about the potential negative effects of medication have been implicated in medication nonadherence. Few evidence-based interventions to address concerns about medication and support medication-ta...

Background Achieving low disease activity (LDA) or remission is a main treatment target in PsA. Composite indices used to assess disease activity include Disease Activity index for PsA (DAPSA) and PsA Disease Activity Score (PASDAS), which both have cut points for the states of remission and LDA. In addition, LDA and remission can be assessed by th...

Background Ixekizumab (IXE), an IL-17A inhibitor, has demonstrated efficacy in clinical trials¹⁻³ but real-world effectiveness (RWE) data are limited.⁴ Objectives To describe changes in disease activity and patient-reported outcomes (PROs) at 6 and 12 months follow-up among psoriatic arthritis (PsA) patients initiating IXE in a routine clinical se...

Background Accurate assessment of psoriatic arthritis (PsA) disease activity in clinical practice requires a feasible, continuous, multidimensional composite instrument to assess key domains of this heterogeneous disease. While currently available composite tools used in PsA, including the Group for Research and Assessment of Psoriasis and Psoriati...

Aim: To describe the evolving demographics of patients recruited to phase 3 randomised controlled trials (RCTs) of biologic/targeted syntheticdisease-modifying anti-rheumatic drugs (b/tsDMARDs) in Psoriatic Arthritis (PsA). Methods: A scoping review was conducted to identify placebo-controlledphase 3 RCTs of b/tsDMARDs in PsA published up to Janua...

Background/Aims Guselkumab (GUS), a human monoclonal antibody targeting the interleukin-23p19-subunit, has demonstrated efficacy at Week 24 (W24) in the Phase IIIb COSMOS clinical trial of patients with active psoriatic arthritis (PsA) and inadequate response or intolerance to one or two tumour necrosis factor inhibitors (TNFis). This post hoc anal...

Background/Aims There are regional variations in access to biologic disease modifying anti-rheumatic drugs (bDMARDs) for patients with rheumatoid arthritis in the UK, with relative under-treatment according to established best practice. Similar concerns exist for access to biologic therapies for patients with psoriatic arthritis (PsA). In this stud...

Background/Aims Bimekizumab (BKZ), a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F and IL17A, has demonstrated an acceptable safety profile with improvements in joint and skin outcomes to 3 years in patients with active psoriatic arthritis (PsA). Psoriatic Arthritis Response Criteria (PsARC) response data can help relate c...

Introduction: Despite recent advances in treatment for psoriatic arthritis (PsA), many patients experience inadequate response or intolerance to therapy, indicating that unmet treatment-related needs remain. To further characterize these unmet needs, we evaluated patients' experiences regarding the burden of PsA symptoms and disease impacts, and p...

Objective: Evaluate the effect of upadacitinib on pain outcomes in patients with active psoriatic arthritis (PsA) or ankylosing spondylitis (AS) across 3 randomised trials (SELECT-PsA 1 and 2 for PsA; SELECT-AXIS 1 for AS). Methods: Patients were randomised to upadacitinib 15 mg once daily or placebo (all 3 studies), or adalimumab 40 mg every ot...

The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)–Outcome Measures in Rheumatology (OMERACT) Psoriatic Arthritis (PsA) Core Set working group is focused on the development of a core set of instruments used to assess the domains described in the 2016 PsA Core Domain Set. At the 2021 annual meeting, the group present...

Background Many patients with psoriatic arthritis do not reach minimal disease activity (MDA) on methotrexate alone. This phase 4 open-label study aimed to compare attainment of MDA following introduction of adalimumab with methotrexate escalation in patients with psoriatic arthritis who do not reach MDA after an initial methotrexate course (≤15 mg...

Psoriatic arthritis is a heterogeneous condition with substantial challenges in optimising outcome measures for both clinical trials and daily practice. As with other inflammatory arthritides, there is no gold standard instrument for measuring disease activity or impact, both of which are key to evaluate therapeutic approaches in trials and monitor...

Introduction: C-reactive protein (CRP) is an important non-specific marker of both acute and chronic inflammation and can be elevated in patients with psoriatic arthritis (PsA). However, the use of CRP testing in the management of PsA can vary. This study investigated how CRP testing is implemented in real-world clinical practice for disease manag...

Introduction In psoriatic arthritis (PsA), treatment recommendations support first-line use of disease-modifying antirheumatic drugs (DMARDs). There are few treatment strategy trials, and no previous studies have investigated tailored treatment choice by disease severity. Studies in oligoarthritis (<5 inflamed joints) are limited but have suggested...

Introduction La douleur est un symptôme prédominant du rhumatisme psoriasique (RP). L’efficacité et la tolérance d’upadacitinib (UPA) ont été démontrées chez des patients atteint de RP actif lors des études SELECT-PsA 1 et 2. Cette analyse vise à comparer l’efficacité d’UPA sur la douleur vs placebo (PBO) et adalimumab (ADA) au cours des 24 premièr...

Spondyloarthritis (SpA) is recognized as an overarching spectrum of disease characterized by axial SpA (axSpA), peripheral arthritis, enthesitis, and dactylitis. Despite significant overlap, patients are often characterized as having predominantly peripheral or axial involvement.

Introduction: Ixekizumab, a selective interleukin-17A antagonist, was compared with adalimumab in the SPIRIT-H2H study (NCT03151551) in patients with psoriatic arthritis (PsA) and concomitant psoriasis. This post hoc analysis reports outcomes to week 52 in patients from SPIRIT-H2H, stratified by baseline psoriasis severity. Methods: SPIRIT-H2H w...

Psoriatic arthritis (PsA) is a complex inflammatory disease with heterogeneous clinical features, which complicates psoriasis in 30% of patients. There are no diagnostic criteria or tests available. Diagnosis is most commonly made by identifying inflammatory musculoskeletal features in joints, entheses or the spine in the presence of skin and/or na...

Background Psoriatic arthritis (PsA) is a chronic, heterogeneous, immune-mediated disease manifesting as a spectrum of possible inflammatory signs and symptoms. Clinicians need therapeutic choices that work across all active PsA disease domains, as well as practical information about efficacy of available treatments for individual domains in specif...

Objectives . Physical function is one of the core domains to be measured in all trials in psoriatic arthritis (PsA). We aimed to evaluate two instruments for physical function in PsA: The Health Assessment Questionnaire-disability index (HAQ-DI) and the physical functioning subscale of the Medical Outcome Survey Short-Form 36 items (SF-36 PF). Met...

Background Up to 80% of patients with psoriatic arthritis (PsA) have comorbid psoriasis (PsO). ¹ However, data on the impact of comorbid PsA on treatment persistence in PsO patients are limited with mixed findings. 2–4 Other factors have been implicated in predicting response to treatment, including obesity, which is associated with PsA and has dem...

Background Despite recent advances in the treatment of psoriatic arthritis (PsA), many patients experience inadequate response or intolerance to therapy, indicating that unmet treatment-related needs remain. An understanding of patients’ experience with PsA and its treatment is needed to bring the patient’s perspective into treatment decision-makin...

Background Upadacitinib (UPA) is an oral Janus kinase inhibitor currently under evaluation for the treatment of psoriatic arthritis (PsA). Previous 24-week results from the SELECT-PsA 2 study in patients with PsA and prior inadequate response to ≥1 biologic disease-modifying antirheumatic drug (bDMARD) demonstrated UPA efficacy with a safety profil...