OP0229 THE GROUP FOR RESEARCH AND ASSESSMENT OF PSORIASIS AND PSORIATIC ARTHRITIS (GRAPPA) TREATMENT RECOMMENDATIONS 2021

Background: Since the 2015 GRAPPA treatment recommendations were published, therapeutic options and management strategies for psoriatic arthritis (PsA) have advanced considerably. Objectives: The goal of update is to develop high quality, evidence-based PsA, including related conditions comorbidities. Methods: rheumatologists, dermatologists patient research partners (PRPs) updated overarching principles adults with PsA by consensus. Principles considering use biosimilars tapering/discontinuing therapy added this update. Systematic literature searches based on data publicly available from three databases (MEDLINE, EMBASE, Cochrane CENTRAL) conducted end previous recommendations’ through August 2020. Additional abstract performed conference presentations in 2017-2020. Searches covered treatments (peripheral arthritis, axial enthesitis, dactylitis, skin, nail disease). (uveitis IBD) comorbidities evaluating their impact safety outcomes. Individual groups assessed risk bias applied GRADE system generate strong or conditional therapies within domain conditions. These then incorporated into an overall schema. Results: Updated, are shown (Table 1). 2015, many new medications been incorporated. results older medications, such as methotrexate, published across domains. Based evidence, developed individual schema spondylitis, disease associated (Figure Choice should ideally address all domains that patient, supporting shared decision making involved. consideration was given key these often choice. Conclusion: provide up date, guidance providers who manage treat adult patients PsA. domain-based strategy supplemented consensus members. Indication Strong For Conditional Against Insufficient evidence Peripheral Arthritis DMARD Naïve csDMARDs, TNFi, PDE4i, IL-12/23i, IL-17i, IL-23i, JAKi NSAIDs, oral CS, IA IL-6i, IR other csDMARD, bDMARD JAKi, CTLA-4-Ig Axial Biologic Physiotherapy, simple analgesia, CS SIJ injections, bisphosphonates IL-23i Enthesitis physiotherapy, MTX Other csDMARDs Dactylitis TNFi PDE4i Psoriasis Topicals, phototherapy, Acitretin Nail psoriasis IL12/23i, IL17i, IL23i, Topical tacrolimus calcipotriol combination therapies, Pulsed dye laser, acitretin, Cyclosporine / Tazarotene, Fumarate, Fumaric Acid Esters, UVA UVB Phototherapy, Alitretinoin IBD (not ETN), IL-17i Uveitis ETN) Disclosure Interests: Laura C Coates Speakers bureau: AbbVie, Amgen, Biogen, Celgene, Gilead, Eli Lilly, Janssen, Medac, Novartis, Pfizer, UCB, Consultant of: Boehringer Ingelheim, Bristol-Myers Squibb, Grant/research support from: Enrique Soriano Squibb,GSK, Genzyme, Roche, Sandoz, Sanofi, Novartis Pharma, Nadia Corp: None declared, Heidi Bertheussen Kristina Callis-Duffin Sienna Biopharmaceuticals, Stiefel Laboratories, Ortho Dermatologics, Inc, Regeneron Pharmaceuticals, Inc., Anaptys Bio, Ingelheim., Cristiano Barbosa Campanholo Jeffrey Chau: Lihi Eder Abbvie, Lily, Daniel Fernandez Amgen Brystol, Oliver FitzGerald Janssen Pfizer BMS, Amit Garg Asana Biosciences, Bristol Myers Incyte, InflaRx, Viela Dafna D Gladman Galapagos, Jansen, Niti Goel: Suzanne Grieb: Philip Helliwell M Elaine Husni Regeneron, Deepak Jadon Healthcare Celltrion, MSD, Arnon Katz: Dhruvkumar Laheru: John Latella: Ying Leung Christine Lindsay Shareholder Employee Aurinia pharmaceuticals, Ennio Lubrano Alfa-Sigma, Cilag, Lilly., Luis Mazzuoccolo Elli Roland McDonald: J Mease Gilead Sciences, GlaxoSmithKline, SUN Denis O’Sullivan: Alexis Ogdie Corrona, Wendy Olsder: Lori Schick: Ingrid Steinkoenig: Maarten de Wit Danielle van der Windt: Arthur Kavanaugh UCB