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Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations
- Source :
- Dermatology and Therapy
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
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.
- Subjects :
- 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
Subjects
Details
- ISSN :
- 21909172 and 21938210
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Dermatology and Therapy
- Accession number :
- edsair.doi.dedup.....c003906cd4cf4a9d2d90839d0aac3f55