1. Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations
- Author
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Luca Stingeni, Andrea Chiricozzi, Piergiorgio Malagoli, Anna Campanati, Marina Venturini, Antonio Costanzo, Anna Balato, Paolo Gisondi, Clara De Simone, Giampiero Girolomoni, Maria Letizia Musumeci, Aurora Parodi, Franco Rongioletti, Angelo Cattaneo, Claudia Lasagni, Santo Raffaele Mercuri, Valentina Dini, Francesca Prignano, Federico Bardazzi, Concetta Potenza, Claudio Guarneri, Ada Lo Schiavo, Ketty Peris, A. M. Offidani, Manuela Papini, Paolo Dapavo, Francesco Loconsole, Maria Laura Flori, Francesco Cusano, Maria Concetta Fargnoli, Stefano Piaserico, Marco Galluzzo, Paolo Amerio, Piergiacomo Calzavara Pinton, Luca Bianchi, Marina Talamonti, Luigi Naldi, Rossana Tiberio, G. Malara, Gisondi, Paolo, Talamonti, Marina, Chiricozzi, Andrea, Piaserico, Stefano, Amerio, Paolo, Balato, Anna, Bardazzi, Federico, Calzavara Pinton, Piergiacomo, Campanati, Anna, Cattaneo, Angelo, Dapavo, Paolo, De Simone, Clara, Dini, Valentina, Fargnoli, Maria C, Flori, Maria L, Galluzzo, Marco, Guarneri, Claudio, Lasagni, Claudia, Loconsole, Francesco, Lo Schiavo, Ada, Malagoli, Piergiorgio, Malara, Giovanna, Mercuri, Santo R, Musumeci, Maria L, Naldi, Luigi, Papini, Manuela, Parodi, Aurora, Potenza, Concetta, Prignano, Francesca, Rongioletti, Franco, Stingeni, Luca, Tiberio, Rossana, Venturini, Marina, Bianchi, Luca, Costanzo, Antonio, Cusano, Francesco, Girolomoni, Giampiero, Offidani, Anna M, Peris, Ketty, Gisondi, P., Talamonti, M., Chiricozzi, A., Piaserico, S., Amerio, P., Balato, A., Bardazzi, F., Calzavara Pinton, P., Campanati, A., Cattaneo, A., Dapavo, P., De Simone, C., Dini, V., Fargnoli, M. C., Flori, M. L., Galluzzo, M., Guarneri, C., Lasagni, C., Loconsole, F., Lo Schiavo, A., Malagoli, P., Malara, G., Mercuri, S. R., Musumeci, M. L., Naldi, L., Papini, M., Parodi, A., Potenza, C., Prignano, F., Rongioletti, F., Stingeni, L., Tiberio, R., Venturini, M., Bianchi, L., Costanzo, A., Cusano, F., Girolomoni, G., Offidani, A. M., and Peris, K.
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Quality of life ,Moderate to severe ,medicine.medical_specialty ,Consensus ,Delphi method ,Consensu ,Dermatology ,Plaque psoriasis ,Systemic inflammation ,Treat-to-target ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Settore MED/35 ,0302 clinical medicine ,Quality of life (healthcare) ,Psoriasis Area and Severity Index ,Psoriasis ,consensus ,plaque psoriasis ,quality of life ,systemic inflammation ,treatto-target ,medicine ,Intensive care medicine ,Original Research ,business.industry ,Treat to target ,Dermatology Life Quality Index ,medicine.disease ,Plaque psoriasi ,030220 oncology & carcinogenesis ,Settore MED/35 - MALATTIE CUTANEE E VENEREE ,business - Abstract
Introduction: Treat-to-target strategies are used in several chronic diseases to improve outcomes. Treatment goals have also been suggested for psoriasis, but there is currently no consensus on targets, and guidance is needed to implement this strategy in clinical practice. The project ‘Treat to Target Italia’ was launched by a scientific board (SB) of 10 psoriasis experts to generate expert consensus recommendations. Methods: On the basis of the published literature, their clinical experience, and the results of a survey among Italian dermatologists, the SB identified four relevant topics: (1) clinical remission; (2) quality of life; (3) abrogation of systemic inflammation; (4) safety. They drafted 20 statements addressing these four topics and submitted them to a panel of 28 dermatologists, in a Delphi process, to achieve consensus (greater than 80% agreement). Results: Consensus was reached on all statements. Treatment goals defining clinical remission should include a 90% improvement from baseline in the Psoriasis Area and Severity Index (PASI90 response) or an absolute PASI score of less than or equal to 3. Patient’s quality of life and satisfaction are important targets. If PASI targets are achieved, there should be no or very low impact of psoriasis on quality of life [Dermatology Life Quality Index (DLQI) score less than or equal to 3]. If PASI or DLQI goals are not achieved within 3–4months, treatment should be changed. Abrogation of systemic inflammation may be crucial for preventing or delaying inflammatory comorbidities. Safety is an equally important target as efficacy. Conclusion: These 20 consensus statements define the parameters of a treat-to-target strategy for psoriasis in Italy. It is hoped that use of these in the management of patients with psoriasis will improve treatment outcomes and patient health-related quality of life.
- Published
- 2021