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Psoriatic arthritis and psoriasis: classification, clinical features, pathophysiology, immunology, genetics

Seronegative spondyloarthropathies: to lump or split?

P Nash¹, P J Mease², J Braun³, D van der Heijde⁴

¹ Rheumatology Research Unit, Nambour Hospital, Sunshine Coast, Department of Medicine, University of Queensland, Queensland, Australia
² Seattle Rheumatology Associates, Rheumatology Clinical Research, Swedish Hospital Medical Center, University of Washington School of Medicine, Seattle, Washington, USA
³ Rheumazentrum Ruhrgebiet, Herne and Ruhr-Universität Bochum, Germany
⁴ Department of Internal Medicine, Division of Rheumatology and Caphri Research Institute, University of Maastricht, the Netherlands

Correspondence to:
Correspondence to:
P Nash
pnash{at}tpg.com.au

The advent of novel biological therapies for the treatment of rheumatic disease has renewed interest in the seronegative spondyloarthropathies (SpAs). International efforts are redefining disease classification and measures of disease activity, outcome, metrology, and imaging. However, opinion is divided between those who propose that the SpA group represents the same disease with variable expression (the "lumpers") and those who consider these to be separate diseases with shared clinical features (the "splitters"). This review presents the evidence for both approaches.

Abbreviations: BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; ESSG, European Spondyloarthropathy Study Group; PsA, psoriatic arthritis; RA, rheumatoid arthritis; SpA, spondyloarthropathy

Keywords: seronegative spondyloarthropathy; assessment; classification

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This article has been cited by other articles:

• Mease, P J, Gladman, D D, Krueger, G G (2005). Prologue: Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Ann Rheum Dis 64: ii1-ii2 [Full Text]