The GRAPPA 2022 annual meeting, dedicated to research and assessment of psoriasis and psoriatic arthritis, was held in New York City from July 14 to 17, 2022, and drew a total of 420 attendees, composed of rheumatologists, dermatologists, scientists, allied healthcare professionals, patient advocates, and industry representatives from 31 countries. In the pre-annual meeting schedule, there were events such as a Grappa executive retreat, a Trainee Symposium, and the Patient Research Partners Network meeting. Presentations showcased advancements in basic research, focusing on biomarkers, personalized medicine strategies, and the power of single-cell omics in illuminating the underlying mechanisms of psoriatic disease (PsD). The presentations showcased guttate and plaque psoriasis (PsO), the effects of coronavirus disease 2019 (COVID-19) and its therapies on PsD patients worldwide, and the influence of sex and gender on the development of PsD. The recent publication of treatment recommendations, educational initiatives, and the Diagnostic Ultrasound Enthesitis Tool (DUET) study were included in the summaries of ongoing projects. A presentation on early detection of psoriatic arthritis (PsA) in patients with psoriasis (PsO) featured a review of screening tools for psoriatic arthritis. Debates revolved around the ability of early PsO intervention to diminish PsA, the superior therapeutic approach between IL-17 and IL-23 inhibition for PsO and PsA, the identification of distinctions and similarities between axial PsA and axial spondyloarthritis with PsO, and research concerning guttate and plaque PsO. Reports from the International Dermatology Outcome Measures (IDEOM) and Young GRAPPiAns concurrent sessions were presented, as were reports from numerous other partnering organizations. We emphasize the highlights of the annual meeting, along with the published manuscripts consolidated into a meeting report.
Psoriatic arthritis (PsA) patients often experience enthesitis, a defining disease manifestation, which considerably increases pain, lowers physical ability, and reduces their quality of life. Unfortunately, clinical evaluations of enthesitis demonstrate poor sensitivity and specificity, consequently demanding the development of superior diagnostic procedures. MRI (magnetic resonance imaging) enables a detailed evaluation of enthesitis's constituent parts, and validated MRI scoring systems exist, established through consensus. To thoroughly evaluate inflammatory conditions, the OMERACT Heel Enthesitis MRI Scoring System (HEMRIS) analyzes heel entheses, and the OMERACT MRI Whole-Body Score for Inflammation in Peripheral Joints and Entheses (MRI-WIPE) leverages whole-body MRI to assess the complete inflammatory impact on peripheral joints and entheses. The GRAPPA 2022 meeting in Brooklyn featured an MRI workshop that discussed the MRI appearances and scoring systems for peripheral enthesitis. Through the analysis of patient cases, the usefulness of MRI for enhanced enthesitis assessment was confirmed. CDDO-Im For PsA clinical trials focusing on enthesitis assessment via MRI, the presence of MRI-confirmed enthesitis should be a mandatory inclusion criterion. The use of validated MRI-based outcomes is strongly suggested to accurately gauge the impact of treatments on enthesitis.
During the 2022 GRAPPA conference, physicians specializing in psoriasis and psoriatic arthritis, including Drs. Laura Coates and Atul Deodhar's discourse revolved around the possible overlap between axial psoriatic arthritis (axPsA) and ankylosing spondylitis (AS) and the presence of psoriasis. Dr. Coates maintained that AS represents a diverse spectrum of diseases, and axPsA could be seen as part of this broader spectrum. Employing the principles of construct, content, face, and criterion validity, Dr. Deodhar differentiated axPsA and AS, classifying them as separate diseases. The arguments, central to their thesis, are outlined in this manuscript.
Seven patient research partners (PRPs) were present at the 2022 GRAPPA annual meeting, an in-person event marking a return to pre-pandemic norms, having been absent since the start of the COVID-19 pandemic. The GRAPPA PRP Network is steadfast in its commitment to providing voices that are fully invested in furthering the GRAPPA mission. This report encapsulates the present-day activities of the GRAPPA PRP Network.
Individuals who have psoriasis (PsO) often experience a heightened chance of being diagnosed with psoriatic arthritis (PsA). Early diagnosis of PsA can potentially be facilitated by screening patients presenting with PsO for the presence of PsA. Dermatologists evaluate PsO patients for musculoskeletal issues, subsequently directing them to rheumatologists for diagnosis and therapy.
Interleukin (IL)-17 and IL-23 inhibitors are among the approved therapies for moderate-to-severe plaque psoriasis (PsO) and psoriatic arthritis (PsA). Due to a dearth of comparative studies, the selection of the most effective treatment for individuals with moderate-to-severe psoriasis and mild psoriatic arthritis is ambiguous. Dr. April Armstrong and Dr. , during the 2022 GRAPPA conference, discussed their research. Joseph Merola deliberated over the selection of the most fitting biological classification for this patient base. deformed wing virus In favor of IL-17 inhibition, Armstrong argued, while Merola's presentation focused on the rationale behind inhibiting IL-23. The document provides a summary of their central arguments.
In a presentation at the 2022 GRAPPA annual meeting, the GRAPPA-OMERACT PsA working group, composed of rheumatologists, dermatologists, methodologists, and patient partners, provided details on their ongoing work to evaluate composite PsA outcome measures. Ten composite outcome measures were among the key factors in the study. To begin, the population, intended use, and anticipated advantages and disadvantages of the ten candidate composite instruments for PsA were established. Within the working group and GRAPPA stakeholder assessments, preliminary Delphi exercises found minimal disease activity (MDA) to be a top priority. Disease Activity in PsA (DAPSA), American College of Rheumatology (ACR) response criteria, Psoriatic Arthritis Disease Activity Score (PASDAS), Composite Psoriatic Disease Activity Index (CPDAI), 3 and 4 visual analog scales (VAS) received a medium priority rating. Finally, Disease Activity Score in 28 joints (DAS28), Psoriatic Arthritis Responder Criteria (PsARC), and Routine Assessment of Patient Index Data 3 (RAPID3) were considered the lowest priority. Further review of the candidate composite instruments' qualities is in progress.
GRAPPA, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis, dedicates itself to globally providing educational resources regarding psoriasis and psoriatic arthritis. This multifaceted project, aimed at clinicians and researchers in psoriatic disease (PsD) care, integrates in-person and virtual lectures, interactive discussions, podcasts, and archived video resources. Partnering with patient service associations, we also seek to impart knowledge to patients diagnosed with PsD. At the 2022 annual conference, attendees received an update regarding ongoing and forthcoming educational endeavors. In collaboration with the Assessment of Spondyloarthritis international Society (ASAS), the Axial Involvement in Psoriatic Arthritis (AXIS) cohort was conceived and developed as a high-value project for education and research. The project's present status is summarized below.
The GRAPPA 2022 annual meeting saw the presentation of the newly published GRAPPA recommendations, showcasing their global reach, patient-centered approach from the initial stages, collaboration between rheumatologists and dermatologists, consideration of the diverse aspects of psoriatic arthritis, and the integration of comorbidities to predict potential adverse effects and their impact on treatment selections.
Currently classified within the subgenus Hulecoeteomyia Theobald, the species Aedes yunnanensis (Gaschen) is now assigned to the newly formed, single-species subgenus Orohylomyia Somboon & Harbach. Based on morphological assessments of adult male and female genitalia, larvae, and pupae, and phylogenetic analyses, novel insights have been gleaned. A comprehensive account of the newly recognized subgenus and its prototypical species is given.
Chronic kidney disease (CKD) is signified by the presence of elevated interstitial fibrosis and tubular atrophy (IFTA) throughout the kidney's nephrons. Chronic hematuria, a prevalent symptom of several human kidney diseases, is commonly seen in individuals undergoing anticoagulation. nanoparticle biosynthesis Previous research from our group demonstrated that the association of chronic hematuria with warfarin treatment resulted in increased IFTA levels in 5/6 nephrectomy rats, concurrent with an increase in kidney reactive oxygen species. The study examined the effect of N-acetylcysteine (NAC), an antioxidant, on the progression of IFTA in 5/6 nephrectomized mice. The 5/6NE C57BL/6 and 5/6NE 129S1/SvImJ mice received warfarin, either by itself or alongside NAC, for a period of 23 weeks. Serum creatinine (SCr), hematuria, blood pressure (BP), and renal organ systems (ROSs) were measured, and kidney morphology was assessed. The prothrombin time (PT) was elevated to the levels consistent with therapeutic human doses through the precise adjustment of warfarin doses. Both mouse strains subjected to warfarin treatment experienced an escalation of serum creatinine (SCr), systolic blood pressure (SBP), and hematuria, accompanied by a rise in TGF-beta and reactive oxygen species (ROS) production in their kidneys. A rise in serum tumor necrosis factor alpha (TNF-) levels was observed in 5/6NE mice that had been treated with warfarin. IFTA levels exhibited a rise above control 5/6NE mouse values, and this rise was more significant in 129S1/SvImJ mice when compared to C57BL/6 mice. The warfarin-related increase in SCr and BP was reduced by NAC, but hematuria was not. The combination of NAC and warfarin in mice led to lower levels of IFTA, TGF-, and ROS in the kidney, and a decrease in serum TNF- levels, as compared to warfarin-monotherapy.