Definition of treatment goals for moderate to severe psoriasis: a European consensus
Top Cited Papers
Open Access
- 21 September 2010
- journal article
- review article
- Published by Springer Science and Business Media LLC in Archiv für dermatologische Forschung
- Vol. 303 (1), 1-10
- https://doi.org/10.1007/s00403-010-1080-1
Abstract
Patients with moderate to severe psoriasis are undertreated. To solve this persistent problem, the consensus programme was performed to define goals for treatment of plaque psoriasis with systemic therapy and to improve patient care. An expert consensus meeting and a collaborative Delphi procedure were carried out. Nineteen dermatologists from different European countries met for a face-to-face discussion and defined items through a four-round Delphi process. Severity of plaque psoriasis was graded into mild and moderate to severe disease. Mild disease was defined as body surface area (BSA) ≤10 and psoriasis area and severity index (PASI) ≤10 and dermatology life quality index (DLQI) ≤10 and moderate to severe psoriasis as (BSA > 10 or PASI > 10) and DLQI > 10. Special clinical situations may change mild psoriasis to moderate to severe including involvement of visible areas or severe nail involvement. For systemic therapy of plaque psoriasis two treatment phases were defined: (1) induction phase as the treatment period until week 16; however, depending on the type of drug and dose regimen used, this phase may be extended until week 24 and (2) maintenance phase for all drugs was defined as the treatment period after the induction phase. For the definition of treatment goals in plaque psoriasis, the change of PASI from baseline until the time of evaluation (ΔPASI) and the absolute DLQI were used. After induction and during maintenance therapy, treatment can be continued if reduction in PASI is ≥75%. The treatment regimen should be modified if improvement of PASI is <50%. In a situation where the therapeutic response improved ≥50% but 5 but can be continued if the DLQI is ≤5. This programme defines the severity of plaque psoriasis for the first time using a formal consensus of 19 European experts. In addition, treatment goals for moderate to severe disease were established. Implementation of treatment goals in the daily management of psoriasis will improve patient care and mitigate the problem of undertreatment. It is planned to evaluate the implementation of these treatment goals in a subsequent programme involving patients and physicians.Keywords
This publication has 27 references indexed in Scilit:
- Managing comorbid disease in patients with psoriasisBMJ, 2010
- British Association of Dermatologists’ guidelines for biologic interventions for psoriasis 2009British Journal of Dermatology, 2009
- European S3‐Guidelines on the systemic treatment of psoriasis vulgarisJournal of the European Academy of Dermatology and Venereology, 2009
- PsoriasisThe New England Journal of Medicine, 2009
- Do guidelines change the way we treat? Studying prescription behaviour among private practitioners before and after the publication of the German Psoriasis GuidelinesArchiv für dermatologische Forschung, 2009
- Efficacy and safety of fumaric acid esters in the long‐term treatment of psoriasis – A retrospective study (FUTURE)JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 2009
- Assessing adequate treatment response in patients with rheumatoid arthritisClinical Therapeutics, 2009
- Follow-up standards and treatment targets in rheumatoid arthritis: results of a questionnaire at the EULAR 2008Annals Of The Rheumatic Diseases, 2009
- One in 3 prescriptions are never redeemed: Primary nonadherence in an outpatient clinicJournal of the American Academy of Dermatology, 2008
- Disease Severity, Quality of Life and Health Care in Plaque-Type Psoriasis: A Multicenter Cross-Sectional Study in GermanyDermatology, 2008