PPACMAN aims to optimize shared psoriatic disease clinics

In this issue of Healio Psoriatic Disease, we focus on shared dermatology-rheumatology clinics and how they aim to advance the treatment of psoriasis and psoriatic arthritis.

The Psoriasis & Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN) is a 501(c)(3) nonprofit organization dedicated to assisting practitioners who embark on the shared clinic model.

Healio Psoriatic Disease spoke with Joseph F. Merola, MD, MMSc, an associate professor at Harvard Medical School, president of PPACMAN and director of the Center for Skin and Related Musculoskeletal Diseases at Brigham and Women’s Hospital, about the organization, its mission and the goal of helping clinicians in a combined clinic.

Q: What is PPACMAN’s main goals and mission?

Merola: The PPACMAN mission is to optimize the clinical care of patients with psoriatic disease through multidisciplinary collaboration, education and innovative research.

Having established a network of combined clinics and local/regional partnerships, the goals of PPACMAN are to:

• improve education for health care providers about the importance of early identification of psoriatic arthritis and the value of collaborative care for patients with psoriatic disease;
• support the formation of effective combined clinics and local/regional collaborative partnerships; and
• demonstrate the effectiveness of these care models and harness the power of these unique combined clinic sites for innovative cross-disciplinary studies in advancing the care of patients with psoriatic disease.

Q: Why is it important for those treating psoriatic disease to work together with their dermatologist or rheumatologist counterparts?

Merola: An often-siloed approach to care of the patient with psoriatic disease leads to fragmented care, including undertreatment of psoriasis, delayed referral and diagnosis of psoriatic arthritis, and inadequate management of other comorbidities.

Dermatologists, rheumatologists, ancillary providers and other specialists play a key role in the management of psoriatic arthritis (PsA), and a combined clinic model benefits the patient by ways of:

• patient education and support across the breadth of disease manifestations;
• decreased visit burden;
• access to a wider array of therapies;
• combined discussion with the patient;
• comorbidities screening, assessment and treatment; and
• quicker transition to appropriate systemic treatments.

Q: What are some of the organization’s resources for practitioners?

Merola: Providers can download electronic medical record templates from the PPACMAN website (www.ppacman.org) that are open-source and modifiable to practice needs. These templates include PsA screening tools, vaccination recommendations, treat-to-target recommendations, comorbidities assessments and other useful content.

Q: How can the organization help to advance psoriatic disease research?

Merola: PPACMAN has harnessed the incredibly unique opportunity present in a combined clinic setting to bring together clinical experts in dermatology for skin phenotyping of the at-risk population for PsA, rheumatologists positioned to perform rheumatologic assessments including ultrasound imaging, clinical and basic scientists, patient-research partners and trialists.

PPACMAN has many innovative and active research initiatives. One is PSORCAST, a collaboration with the Sage Digital Bionetworks group to develop, validate and implement a smartphone-based app to forecast the development of psoriatic arthritis and assess the activity of skin and joint disease using novel methods including passive and active biometric measurements.

Another initiative is PAMPA, the Preventing Arthritis in a Multicenter Psoriasis At-risk Population study group. It has developed consensus terminology for research studies in preclinical phases of PsA. It has also designed and is implementing the first of its kind prospective interventional trial for psoriatic arthritis prevention.

• For more information:
• Joseph F. Merola, MD, MMSc, can be reached at Brigham and Women’s Hospital, 41 Avenue Louis Psteur, 319, Boston, MA 02115; email: jfmerola@bwh.harvard.edu.