From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis

April W. Armstrong*, Michael P. Siegel, Jerry Bagel, Erin E. Boh, Megan Buell, Kevin D. Cooper, Kristina Callis Duffin, Lawrence F. Eichenfield, Amit Garg, Joel M. Gelfand, Alice B. Gottlieb, John Y.M. Koo, Neil J. Korman, Gerald G. Krueger, Mark G. Lebwohl, Craig L. Leonardi, Arthur M. Mandelin, M. Alan Menter, Joseph F. Merola, David M. PariserRonald B. Prussick, Caitriona Ryan, Jerry Bagel, Jeffrey M. Weinberg, Mary Jane O.U. Williams, Jashin J. Wu, Paul S. Yamauchi, Abby S. Van Voorhees

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

Background An urgent need exists in the United States to establish treatment goals in psoriasis. Objective We aim to establish defined treatment targets toward which clinicians and patients with psoriasis can strive to inform treatment decisions, reduce disease burden, and improve outcomes in practice. Methods The National Psoriasis Foundation conducted a consensus-building study among psoriasis experts using the Delphi method. The process consisted of: (1) literature review, (2) pre-Delphi question selection and input from general dermatologists and patients, and (3) 4 Delphi rounds. Results A total of 25 psoriasis experts participated in the Delphi process. The most preferred instrument was body surface area (BSA). The most preferred time for evaluating patient response after starting new therapies was at 3 months. The acceptable response at 3 months postinitiation was either BSA 3% or less or BSA improvement 75% or more from baseline. The target response at 3 months postinitiation was BSA 1% or less. During the maintenance period, evaluation every 6 months was most preferred. The target response at every 6 months maintenance evaluation is BSA 1% or less. Limitations Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects. Conclusion With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient.

Original languageEnglish (US)
Pages (from-to)290-298
Number of pages9
JournalJournal of the American Academy of Dermatology
Volume76
Issue number2
DOIs
StatePublished - Feb 2017

Keywords

  • Physician Global Assessment
  • biologics
  • body surface area
  • outcome measures
  • psoriasis
  • systemic therapies
  • treat to target
  • treatment
  • treatment goals

ASJC Scopus subject areas

  • Dermatology

Fingerprint Dive into the research topics of 'From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis'. Together they form a unique fingerprint.

Cite this