8
Consider which domains are involved, patient
preference, previous/concomitant therapies; choice of
therapy should address as many domains as possible
Treatment
Figure 2. GRAPPA 2021 Treatment Schema
Bold text indicates a strong recommendation, standard text indicates a conditional recommendation.
Axial disease
Switch
bDMARD
(TNFi, IL-17i)
or JAKi
bDMARDs
(TNFi, IL-17i)
or JAKi
Enthesitis
Switch
bDMARD
(TNFi,
IL-12/23i,
IL-17i, IL-23i,
CTLA4-Ig),
JAKi, or PDE4i
MTX,
bDMARDs
(TNFi,
IL-12/23i,
IL-17i, IL-23i,
CTLA4-Ig),
JAKi, or PDE4i
Dactylitis
MTX,
bDMARDs
(TNFi,
IL-12/23i,
IL-17i, IL-23i,
CTLA4-Ig),
JAKi, or PDE4i
Switch
bDMARD
(TNFi,
IL-12/23i,
IL-17i, IL-23i,
CTLA4-Ig),
JAKi, or PDE4i
Peripheral
arthritis
csDMARD;
bDMARDs
(TNFi,
IL-12/23i,
IL-17i, IL-23i,
CTLA4-Ig),
JAKi, or PDE4i
Switch
bDMARD
(TNFi,
IL-12/23i,
IL-17i, IL-23i,
CTLA4-Ig),
JAKi, or PDE4i
NSAIDs, physiotherapy, injections (GCs)
a
