New Psoriasis Guidelines: Individualizing, Evaluating, and Adjusting Therapies
The National Psoriasis Foundation (NPF) has published guidelines for clinicians treating psoriasis as a response to the urgent need for treatment goals in the United States.
To construct the guidelines, the NPF conducted a study to build a consensus among 25 psoriasis experts.
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Using the Delphi method, the experts reviewed the literature, used pre-Delphi question selection and input from general dermatologists and patients, and considered 4 Delphi rounds.
Overall, the results indicated that:
- Body surface area (BSA) was the most preferred instrument.
- Three months was the most preferred time for evaluating patient response after starting new therapies.
- Either BSA 3% or less, or BSA improvement 75% or greater from baseline is an acceptable response at 3 months after initiation.
- BSA 1% or less is the target response at 3 months after initiation.
- Evaluation every 6 months was most preferred during the maintenance period.
- BSA 1% or less is the target response at every 6 months maintenance evalution.
“Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects,” the research team concluded.
“With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient.”
Armstrong AW, Siegel MP, Bagel J, et al. From the medical board of the National Psoriasis Foundation: treatment targets for plaque psoriasis [published online November 28, 2016]. J Am Acad Dermatol. dx.doi.org/10.1016/j.jaad.2016.10.017.