Supported by

and poster production/management fees paid for by Astellas.P2631 Group for research and assessment of psoriasis and psoriatic arthriti-seinternational multi-center psoriasis and psoriatic arthritis reliabilitytrial (GRAPPA-IMPART): Assessment of psoriasis, nail lesions, peripheralarthritis, and dactylitis Alice Gottlieb, MD, PhD, Tufts-New England Medical Center, Boston, MA, UnitedStates; Richard Cook, PhD, Toronto Western Hospital, Toronto, Canada; CherylRosen, MD, Toronto Western Hospital, Toronto, Canada; Amit Garg, MD, UMassMemorial Healthcare, Worcester, MA, United States Up to 30% of patients with psoriasis (Ps) have psoriatic arthritis (PsA). It has notbeen determined whether the assessment of arthritis and dactylitis by dermatolo-gists and the assessment of skin and nails by rheumatologists are reliable. A group of10 rheumatologists and 9 dermatologists from 7 countries with expertise in Ps andPsA met for a physical examination exercise to assess 20 patients with PsA and Ps. Amodified Latin square design that enabled evaluation of patient, assessor and ordereffect was used. A training session lasting 2.5 hours was conducted before patientassessments. The number of tender joints (ACR 68), number of swollen joints (ACR66), dactylitis, Physician’s Global Assessment of PsA disease activity (PGA-PsA), bodysurface area involved with Ps (BSA), Psoriasis Area and Severity Index score (PASI),Lattice System Physician’s Global Assessment of Ps (LS-PGA), National PsoriasisFoundation Psoriasis Score (NPF), modified Nail Psoriasis Severity Index (mNAPSI),number of nails with nail changes and Physician’s Global Assessment of Ps activity(PGA-Ps) were completed by each assessor on 10 patients. Patients were divided into2 groups of 10, and within each group, each patient was assessed by the same 10observers (5 rheumatologists and 4/5 dermatologists). Data were analyzed usingintra-class correlation coefficient (ICC) adjusted for order of measurements. Among rheumatologists, there was good agreement in the assessment of tender jointcount [0.81(0.68,0.91)] and mNAPSI [0.85(0.74,0.93), good agreement on numberof digits with dactylitis [0.69(0.52,0.84)], PASI score [0.70(0.53,0.85)] and numberof fingernails with nail changes [0.66(0.47,0.82)], moderate agreement on swollenjoint count [0.42(0.23,0.65)], LS-PGA [0.43(0.23,0.65)], NPF [0.52(0.32,0.73)] andPGA-Ps [0.49(0.29,0.70)] and poor agreement on PGA-PsA [0.29(0.11,0.54)] andBSA [0.3(0.11,0.54)]. Among dermatologists, there was good agreement on tenderjoint count [0.73(0.56,0.86), BSA [0.65(0.47,0.82)], PASI score [0.74(0.58,0.87)], LS-PGA [0.73(0.56,0.86)], NPF [0.66(0.47,0.82)], number of fingernails with nailchanges [0.77(0.69,0.89)], mNAPSI [0.78(0.63,0.89)] and PGA-Ps [0.66(0.48,0.82)],moderate agreement on PGA-PsA [0.50(0.29,0.72)], poor agreement on swollenjoints [0.31(0.12,0.57)] and no agreement on number of digits with dactylitis [0.08( 0.07,0.32)]. The majority of the variance was contributed by the patients.Observer effect was noted for PGA-PsA, PASI score, mNAPSI, PGA-Ps, LS-PGA andNPF score. There was no order effect. Overall there was good agreement on theassessment of tender joints, PASI score and mNAPSI among both rheumatologistsand dermatologists. However, there is a need for an educational program for theassessment of swollen joints, dactylitis and body surface area. Commercial support: None identified.