A Unique Structure for Tackling Psoriatic Disease

Luis R. Espinoza, MD, chief of the section of rheumatology and professor of medicine at Louisiana State University Health Science Center in New Orleans, a long-time researcher in PsA, is proud of the international outreach efforts. “GRAPPA fosters interrelationship between groups,” he notes, “and it’s really open now. It’s not just an American or a European organization—it is global, an international organization.” He credits Dr. Sergio Toloza, an Argentinian rheumatologist, and Dr. Rafael Valle-Oñate from Bogota, Colombia, who have spearheaded the LAPPAS/GRAPPA partnership in this area.

Missions Accomplished?

Following the publication of several key projects, such as the core set of domains for PsA and international treatment guidelines for psoriatic arthritis, the group has several concurrent projects.^4,5 Oliver FitzGerald, MD, Newman Clinical Research Professor in the School of Medicine and Medical Science at St. Vincent’s University Hospital in Dublin, Ireland, and Dr. Helliwell are lead investigators on one of the largest, the GRACE project. Data have now been collected on 450 PsA patients, and the group is working closely with OMERACT to develop composite measures of disease activity and response to therapy, accounting for the complex interplay of musculoskeletal and skin elements of PsA and PsC. With new drugs surfacing every year, says Dr. Helliwell, “they are going to have to be evaluated, and our organization is leading the evaluation and outcomes science in PsA.” Plans are also in the works for a multicenter study that will focus on identifying markers that predict which patients are going to do poorly based on X-ray indicators, according to Dr. FitzGerald.

Members of GRAPPA participated in the Brazilian Rheumatology Congress in September 2010 in Porto Alegre.

Dr. Ritchlin has been working with Dr. Gladman and J.T. Elder on a 4,000-patient clinical registry currently funded through the Canadian Institutes of Health Research. The hope is to secure additional funding to link the registry to the entire GRAPPA organization.

GRAPPA leaders admit that challenges remain for their organization. Funding will continue to be an issue going forward, says Dr. Gladman, as they seek to expand the clinical registries. Encouraging more dermatologists to actively lead GRAPPA projects is also key, says Dr. Gelfand. Dr. Qureshi believes GRAPPA’s challenge is “to promote clinical, basic science, and translational research that is on the fringes of dermatology and rheumatology, because that is its strength.” Dr. FitzGerald says, “The challenge will be to maintain the momentum and to make sure there are others who will take the mantle on and continue the good work.”