medwireNews: The International League of Associations for Rheumatology (ILAR) has released recommendations for the management of psoriatic arthritis (PsA) in resource-limited countries.
Vinod Chandran (University of Toronto, Ontario, Canada) and co-authors explain that the latest iterations of the EULAR and Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) guidelines “are primarily based on studies conducted in resource replete countries and may not be applicable in countries in the Americas (except Canada and USA) and Africa.”
The taskforce – comprising rheumatologists and dermatologists from the Americas, Africa, and the UK – therefore adapted the EULAR and GRAPPA guidelines for use in resource-poor settings using the systematic ADAPTE approach.
They report in Clinical Rheumatology that while “the goals of treatment, assessment of disease and associated comorbidities, and principles of safety and follow up are similar to the source recommendations,” the nature and severity of comorbid conditions are likely to be different in resource-poor settings. Chandran and colleagues also highlight that evidence from these settings “was weak or non-existent,” meaning the recommendations were largely based on expert opinion.
The team also used gaps in knowledge to formulate a research agenda for resource-poor settings, including pragmatic trials of newer agents, investigations into the efficacy and safety of combination therapies, and the development of optimal strategies for patient monitoring.
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