Understanding Psoriatic Arthritis
(Part II)
We now continue our discussion on the methods of treatment regarding Psoriatic Arthritis (PsA).
The updated European Alliance of Association for Rheumatism (EULAR) standardized operating procedures were applied.
In October 2018, there was a steering group created that consisted of five rheumatologists, a fellow, a patient research partner and a health professional laying out the questions to be coursed through a systematic literature review (SLR).
The SLR took place between October 2018 and May 2019, covering the years 2015–2018, and looked at the efficacy in both musculoskeletal manifestations as well as the skin and nails in patients with PsA.
The SLR did not focus on skin psoriasis trials, and the trials were not reviewed systematically or alluded to systematically here.
The data were made available and integrated at the end of the SLR.
In May 2019, the steering group as well as the taskforce had a meeting to integrate available data on disease management in PsA into practical recommendations.
The taskforce included 28 persons from 15 European countries in 15 different healthcare systems, 21 rheumatologists, 2 people affected with PsA, 1 health professional, 1 dermatologist and 3 rheumatology fellows/trainees.
The taskforce was comprised of 30% new members compared with the taskforce formed in 2015.
The process was not only evidence-based but also experience-based and consultation-based, in line with the three-tier principles of evidence-based medicine.
Benefit to cost ratios were taken into consideration in the prioritization of medications as new treatments might impose a some l burden on the healthcare budgets of EULAR and non-EULAR countries.
Treatment guidance should therefore not only include considerations about safety and efficacy but should also focus on cost of treatment.
The outcome of the SLR were revealed to the taskforce during a face-to-face meeting in May 2019, together the 2015 recommendations and proposals for changes to these recommendations presented by the steering committee.
Each recommendation was discussed in smaller groups, ≥75% vote by the taskforce was needed in order to prevent new taskforces from reformulating the methods without compelling reasons.
After the face-to- face meeting, the taskforce members were given with the category of evidence and grade of recommendation for each item, based on the Oxford Evidence Based Medicine categorization, as per the EULAR procedures.
After which an anonymous, email-based voting on the level of agreement among the taskforce members took place.
Next week we will be presenting the results of the meeting regarding the methods agreed by the experts on the treatment modalities of PsA.