GRAPPA - Group for Research and Assessment of Psoriasis and Psoriatic Arthritis
2012/03/22 - News from medical groups
GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) is organized exclusively for non-profit, educational, and scientific purposes, specifically to facilitate sharing of information related to psoriasis and psoriatic arthritis, networking among different medical disciplines that see psoriasis and psoriatic arthritis patients and to enhance research, diagnosis and treatment of psoriasis and psoriatic arthritis.
Originally inspired by the Assessment in Ankylosing Spondylitis Working Group (ASAS), GRAPPA was formed in 2003. GRAPPA has pulled together many different groups, including pre-eminent researchers and thought-leaders in psoriatic arthritis (PsA) and psoriasis (PsO). The inaugural meeting of GRAPPA was held in August 2003, where a consensus exercise started the group toward prioritizing domains of inquiry in PsA and PsO. Subsequent meetings have focused on identifying and initiating research projects, advancing standardized criteria for psoriatic arthritis registries and developing treatment guidelines for PsA.
Today, approximately 453 thought-leaders participate in GRAPPA including rheumatologists, dermatologists, radiologists, geneticists, methodologists, epidemiologists, representatives from patient service leagues and biopharmaceutical industry representatives. Approximately 60% of participants live and work outside North America, creating a truly international effort.
Here we present a few key highlights from the last GRAPPA Annual Meeting, held in Naples in July 2011.
GRAPPA Video Project
Kristina Callis Duffin and Philip Mease presented an update on the GRAPPA video project at the GRAPPA 2011 conference. The key objective of the video project was to develop and validate a set of high quality presentations for use as interactive web-based training modules. Significant progress has been made since the previous GRAPPA meeting in 2010, notably: publication of the video project in the Journal of Rheumatology, recruitment of four industry users of the video project for clinical trials, and the completion of validation exercises.
April Armstrong presented results from the validation exercises showing that prior to video training, both patients and PASI-naïve physicians tended to give higher PASI assessments for mild, moderate and severely diseased patients than PASI-experienced physicians. After the video training exercise, both patient-assessed PASI and PASI-naïve physician assessments improved to more closely match that of experienced physicians, although a statistically significant difference remained for both groups when evaluating patients with severe psoriasis.
The following modules are available: Modified NAPSI, NAPSI, PASI/BSA, PGA 5 Point (0-4), PGA 6 Point (0-5), PPPASI (palmar plantar), PSSI (scalp module), TPSS (Total Plaque Severity Score), and Assessment of Enthesitis and Dactylitis in Psoriatic Arthritis. A completion certificate may be printed after completion of a module.
Biomarkers in Psoriatic Arthritis
The diagnosis and therapy of psoriatic arthritis is often challenging because we lack susceptibility markers for arthritis in psoriasis patients and also markers that can distinguish patients who will develop radiographic progression in early disease. For this reason, the search for biomarkers to distinguish those patients with psoriasis who have developed or will develop psoriatic arthritis has been a major effort in the field. In addition, biomarkers which represent disease activity in PsA, measure treatment response and predict radiographic outcomes such as erosion and new bone formation could dramatically improve clinical care. While several potential biomarkers have been proposed, much work remains to be done to identify biomarkers that fulfil the OMERACT filter (truth, discrimination, and feasibility) in studies with well defined cases and controls. GRAPPA is in the planning stages for a large observational study known as "PsA BioDam" in conjunction with the OMERACT biomarker working group. This effort has been modelled after the RA BioDam trial, an observational biomarker study to define biomarkers in rheumatoid arthritis. The primary objective of PsA BioDam is to conduct a well designed observational study to determine the independent predictive validity of high priority candidate biomarkers for predicting structural damage in PsA. Secondary objectives including examining whether clinical and laboratory markers (alone or in combination) can predict progressive disease. Patients enrolled will be followed over the course of routine clinical care for a minimum of 24 months. Current efforts centre on finalizing the study design and procurement of funding. Details of progress in this area will be discussed at the EULAR Meeting in Berlin.
Screening Psoriasis patients for Psoriatic Arthritis
Identifying an optimal screening tool for the detection of psoriatic arthritis among patients with psoriasis has been a major initiative within GRAPPA. During the 2009 Annual GRAPPA meeting, of 47 members were surveyed, 95.7% felt that dermatologists should screen psoriasis patients for PsA and 83% thought that a questionnaire should be used for screening. Five psoriatic arthritis screening questionnaires have been designed to date: PAQ (Canada and Sweden), PASE (Boston), TOPAS (Toronto), PEST (Leeds), and PASQ (Newfoundland). TOPAS, PASE and PEST are the mostly widely used. While each performs well in the population in which it was designed, efforts are now underway to determine which questionnaire performs best overall in identifying PsA. During the 2011 GRAPPA meeting in Naples, Dr. Philip Helliwell presented initial results from a study to address this question: CONTEST (COmparisoN of ThreE Screening Tools) includes several sites in the UK (Leeds, Bath, London, Newcastle, Manchester and Bradford). As a part of the study, patients with psoriasis over the age of 16 and without a prior diagnosis of PsA were given all three surveys (randomly arranged in packets). Of 581 surveys distributed, 306 were returned and 147 patients screened positive according to at least one tool. Of those with a positive screening test, 78 patients were examined and 17 were found to have PsA. Initial area under the curve for TOPAS, PASE, and PEST were 0.65, 0.52, and 0.75 respectively. Final results from this study are expected this year. At the 2011 American College of Rheumatology Conference in Chicago, Jessica Walsh, Daniel Clegg, and Kristina Callis Duffin presented a similar study performed among 158 patients within the Utah Psoriasis Initiative; this group included patients with known PsA (44% were on DMARDs). While sensitivity was reasonable (TOPAS 0.93, PEST 0.89, PASE 0.68), specificity was low, ranging from 0.49-0.64.
- Provide a forum for networking and communication between international researchers in rheumatology and dermatology, industry, patient service leagues and regulatory agencies
- Provide the opportunity for in-person meetings and intranet communication to share knowledge, research findings, and develop or conduct collaborative research, education and other projects
- Develop and validate a criteria set for the definition of psoriatic arthritis (PsA)
- Review, develop and validate effective and feasible outcome measures for the assessment of PsA and psoriasis (PsO)
- Promote the development of national and international collaborative registries of PsA and PsO patients to standardize the data being obtained and learn more about the natural history of the disease as well as its genetic underpinnings
- Work closely with representatives of patient service leagues to promote public education and awareness of PsA and PsO
- Work closely with representatives of biopharmaceutical companies to promote and conduct research on effective therapies for PsA and PsO
- Work closely with representatives of regulatory agencies to establish appropriate guidelines for regulatory approval of new therapies
- Work with other professional bodies, such as the American College of Rheumatology, American Academy of Dermatology, and OMERACT to promote knowledge of research about PsA and PsO within the context of those disciplines
- Develop treatment guidelines for governmental and other interested parties
For further information on any of these projects or the work of GRAPPA, please contact Pam Love (project director) email@example.com.
Zoe Ash, with thanks to Alexis Ogdie, Shiu-chung Au and Pam Love
- 2020/03/13 Focus on...In Memoriam-Prof Dr Nelida Aurora Raimondo (1952–2020)News:In Memoriam-Prof Dr Nelida Aurora Raimondo (1952–2020)
- 2019/10/29 Focus on...World Psoriasis Day 2019
- 2019/08/12 Focus on...Latin American Clinical Practice Guidelines on the Systemic Treatment of Psoriasis
- 2019/06/03 Focus on...News from our SPIN Columbian members
- 2019/05/21 Focus on...SPIN2019 is now available on your screen!
Prof Nelida Aurora Raimondo
- 2020/03/13 Focus on...In Memoriam-Prof Dr Nelida Aurora Raimondo (1952–2020)News:In Memoriam-Prof Dr Nelida Aurora Raimondo (1952–2020)
News from the web office
- 2017/06/05PIN becomes SPIN - Skin Inflammation & Psoriasis International Network
- 2016/10/29PSO 2016 Congress - Webcasts Available!
- 2016/05/26PIN Survey on Phototherapy
- 2016/02/20PIN Study on Therapeutic Patient Education
- 2016/02/19World Directory of Psoriasis Medical Resources - February 2016 Update
- 2019/04/18 Focus on...SPIN Congress 2019 in Paris coming soon
- 2018/07/16SPIN Symposium at the Spring continental meeting - Tehran, 25-27 April 2018
- 2018/02/222nd National Meeting of the Egyptian Society for Psoriasis
- 2018/02/211st Psoriasis Symposium - Sarajevo 2017
- 2017/06/2815th São Paulo Meeting of Psoriasis and Vitiligo
News from medical groups
- 2018/04/183rd Turkish National Psoriasis Symposium
- 2017/06/21Brazilian Center for Psoriasis Studies joins SPIN!
- 2017/06/21Costa Rica Psoriasis Group - Meet them!
- 2017/02/02Works of the 1st Senegalese Psoriasis Day published!
- 2016/07/29Swiss S1 Guidelines for Systemic treatment of psoriasis vulgaris
News from patients associations
- 2017/02/08France Psoriasis - 2016 World Psoriasis Day
- 2016/05/26Senegal Patients Association joins PIN!
- 2015/08/04Epidermia Greece: a new partner association of PIN
- 2015/08/01Canadian Association of Psoriasis Patients joins PIN!
- 2015/04/09AEPSO Argentina launches digital map to find people with psoriasis in the country
Recent publications on Psoriasis and Atopic Dermatitis
Conformational dynamics in interleukin 17A and 17F functional complexes is a key determinant of receptor A affinity and specificity.
Cytokine. 2021 Jun , 142:155476.
The proinflammatory cytokines IL-17A and IL-17F have been identified as key drivers of a range of human inflammatory diseases, such as psoriasis, which has led to several therapeutic antibodies targeted at IL-17A. The two cytokines have been shown to tightly associate as functional homo and hetero dimers, which induce signalling via the formation of a cell surface signalling complex with a single copy of both IL-17RA and IL-17RC. Striking differences in affinity have been observed for (...)see on pubmed
Protective Effects of Polyvinylpyrrolidone-Wrapped Fullerene Against Nitric Oxide/Peroxynitrite-Induced Cellular Injury in Human Skin Keratinocytes.
J Nanosci Nanotechnol. 2021 Sep 01, 21, (9):4579-4585.
Excess ultraviolet (UV) exposure accelerates skin inflammation, melanogenesis, wrinkle formation, photoaging, and carcinogenesis through oxidative stress and deoxyribonucleic acid damage. These deleterious effects to skin are closely associated with UV-induced reactive oxygen species (ROS) and reactive nitrogen species (RNS) produced via nitric oxide (NO) generation. RNS are known to be responsible for various skin disorders, such as erythema, melanin production, reduced barrier function, (...)see on pubmed
Catalpol ameliorates psoriasis-like phenotypes via SIRT1 mediated suppression of NF-κB and MAPKs signaling pathways.
Bioengineered. 2021 Dec , 12, (1):183-195.
Psoriasis is a chronic inflammatory skin disease that affects approximately 2% of worldwide population, and causing long-term troubles to the patients. Therefore, it is urgent to develop safe and effective therapeutic drugs. Catalpol is a natural iridoid glucoside, that has several remarkable pharmacological effects, however, whether catalpol can alleviated psoriasis has not been explored. The goal of the present work is to study the role of catalpol in psoriasis in vivo and in vitro. (...)see on pubmed
Viral metagenomic identification of a novel anellovirus in blood sample of a child with atopic dermatitis.
J Med Virol. 2021 Jun , 93, (6):4038-4041.
Here, using viral metagenomics, a novel anellovirus with strain name HuAV-zj-ad1 was detected in blood sample from a child with atopic dermatitis. The complete genome sequence of HuAV-zj-ad1 was determined and fully characterized. The circular genome of HuAV-zj-ad1 is 2841 nt in length and includes four polyprotein ORFs. Phylogenetic analysis and pairwise sequence comparisons based on the amino acid sequences of ORF1, ORF2, ORF3, ORF4 indicated that HuAV-zj-ad1 belonged to a novel species (...)see on pubmed
Dupilumab therapy for patients with refractory eosinophilic otitis media associated with bronchial asthma.
Auris Nasus Larynx. 2021 Jun , 48, (3):353-360.
Eosinophilic otitis media (EOM) is an intractable otitis media mostly associated with bronchial asthma. Dupilumab, an anti-interleukin (IL)-4 receptor (R)α, is effective and has been approved for use in patients with moderate to severe bronchial asthma, atopic dermatitis and chronic rhinosinusitis with nasal polyposis, whose diseases are not controlled by previous treatments including other molecular targeted drugs. We aimed to assess efficacy of dupilumab in three EOM patients with (...)see on pubmed
Methicillin-resistant from infected skin lesions present several virulence genes and are associated with the CC30 in Brazilian children with atopic dermatitis.
Virulence. 2021 12 , 12, (1):260-269.
Atopic dermatitis (AD) is a chronic inflammatory skin disease and colonization by may affect up to 100% of these patients. Virulent and resistant isolates can worsen AD patient clinical condition and jeopardize the treatment. We aimed to detect virulence genes and to evaluate the biofilm production of isolates from infected skin lesions of children with AD. Methicillin resistance was detected by phenotypic and molecular tests and the virulence genes were detected by PCR. Biofilm formation (...)see on pubmed