September 15, 2025
7 min watch
In this Healio video, Philip J. Mease, MD, director of rheumatology research at Providence Swedish Medical Center in Seattle, discusses recently developed definitions for difficult-to-treat and complex-to-manage psoriatic arthritis.
“What do we do about the patient who comes into our clinic who has now been on multiple different biologics?” Mease said about the results of the research project presented at the EULAR annual meeting.
Some patients fail to respond to PsA treatments such as TNF inhibitors, interleukin-1 7 inhibitors and IL-23 inhibitors, Mease said, and these groups of patients with difficult-to-treat disease lacked precise definitions. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) has recently developed a set of definitions for difficult-to-treat and complex-to-manage psoriatic arthritis.
GRAPPA defined patients with difficult-to-treat disease as those who experience persistent inflammation despite three or more prior therapies that included two or more targeted synthetic or biologic disease-modifying antirheumatic drugs, according to the clinical abstract.
In addition, complex-to-manage PsA was defined as being difficult to treat with complications including comorbidities, chronic pain or treatment intolerance.
A total of 95% of GRAPPA members voted in favor of these definitions, according to the abstract.
The EULAR group also released a similar set of definitions for difficult-to-treat PsA, Mease said.
“Because it overlaps so significantly with the GRAPPA recommendations, I think the same set of principles applies,” he said.
Reference:
- Proft F. Abstract OP0175. Presented at: EULAR 2025 Congress; June 11-14, 2025; Barcelona, Spain.
Sources/Disclosures
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Disclosures:
Mease reports receiving research grants, consultation fees and/or speaker honoraria from AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Century, Cullinan, Eli Lilly, Immagene, Janssen, Moonlake Pharma, Novartis, Pfizer, Spyre, Takeda and UCB.
