S3 Episode 2: Rundown: What Changed in the GRAPPA Guidelines for PsA?

. Dafna Gladman has been interested in psoriatic arthritis for a very long time and she was excited by these new developments. A bunch of people — I'm going to leave some out — but especially Phil Helliwell, in Leeds in the UK, who is working with a number of people, including Will Tillett, on developing assessments in diagnostic criteria and classification criteria and outcomes in psoriatic arthritis.

. We're going to recognize that. We're talking about IBD and we're not making recommendations for GI doctors by any means, but IBD concomitant involvement is so important, and it affects treatments and decisions. We certainly include them.I think that's an important advance in the recommendation. Your group uses the GRADE-informed methodology, which is themethodology.

GRADE works well in a very simplistic manner if you strictly apply it. A two-by-two table is where GRADE has great utility. For example, you might want to know what the best hypertensive drug is for a person with diabetes and you say beta-blockers vs ACE inhibitors — you have data that speaks to that directly. Well, psoriatic arthritis is so heterogeneous it would lead to a myriad of two-by-two tables. That's why we say it's a GRADE-informed process.

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