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Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document

OBJECTIVE: To critically analyse and define therapeutic objectives, response to treatment evaluation and related decisions in psoriasis. METHODS: Expert consensus meetings, a systematic and narrative reviews and a collaborative Delphi procedure were carried out. A steering committee from the Spanish...

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Autores principales: Belinchón Romero, Isabel, Dauden, Esteban, Ferrándiz Foraster, Carlos, González-Cantero, Álvaro, Carrascosa Carrillo, Jose Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491706/
https://www.ncbi.nlm.nih.gov/pubmed/34601988
http://dx.doi.org/10.1080/07853890.2021.1986637
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author Belinchón Romero, Isabel
Dauden, Esteban
Ferrándiz Foraster, Carlos
González-Cantero, Álvaro
Carrascosa Carrillo, Jose Manuel
author_facet Belinchón Romero, Isabel
Dauden, Esteban
Ferrándiz Foraster, Carlos
González-Cantero, Álvaro
Carrascosa Carrillo, Jose Manuel
author_sort Belinchón Romero, Isabel
collection PubMed
description OBJECTIVE: To critically analyse and define therapeutic objectives, response to treatment evaluation and related decisions in psoriasis. METHODS: Expert consensus meetings, a systematic and narrative reviews and a collaborative Delphi procedure were carried out. A steering committee from the Spanish Group of Psoriasis was established who based on the reviews generated a set of related statements. Subsequently, a group of 40 experts tested their agreement with the statements, through 3 Delphi rounds. RESULTS: We found a great variability in clinical guidelines regarding to the definition of treatment goal and the response. In general, treatment failure was considered if a PASI50 is not achieved. The panel of experts agreed on (1) clearly differentiate between ideal and a realistic goals when establishing the therapeutic goal in moderate to severe psoriasis; (2) treatment goals should be in general established regardless of the type of drug for psoriasis; (3) treatment failure if PASI75 response is not reached; (4) an absolute PASI is in general preferred to the rate of PASI improvement from baseline; (5) disease characteristics, patients and physicians opinions/needs and treatment adherence influence treatment goals. CONCLUSIONS: A clear treatment decision making framework is vital to improve management of psoriasis. KEY MESSAGES: Psoriasis characteristics, patients and physicians opinions/needs and treatment adherence influence treatment goals. Different disease indexes could be used to assess treatment response but absolute PASI is preferred. In general psoriasis treatment failure should be considered if PASI75 response is not reached.
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spelling pubmed-84917062021-10-06 Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document Belinchón Romero, Isabel Dauden, Esteban Ferrándiz Foraster, Carlos González-Cantero, Álvaro Carrascosa Carrillo, Jose Manuel Ann Med Dermatology OBJECTIVE: To critically analyse and define therapeutic objectives, response to treatment evaluation and related decisions in psoriasis. METHODS: Expert consensus meetings, a systematic and narrative reviews and a collaborative Delphi procedure were carried out. A steering committee from the Spanish Group of Psoriasis was established who based on the reviews generated a set of related statements. Subsequently, a group of 40 experts tested their agreement with the statements, through 3 Delphi rounds. RESULTS: We found a great variability in clinical guidelines regarding to the definition of treatment goal and the response. In general, treatment failure was considered if a PASI50 is not achieved. The panel of experts agreed on (1) clearly differentiate between ideal and a realistic goals when establishing the therapeutic goal in moderate to severe psoriasis; (2) treatment goals should be in general established regardless of the type of drug for psoriasis; (3) treatment failure if PASI75 response is not reached; (4) an absolute PASI is in general preferred to the rate of PASI improvement from baseline; (5) disease characteristics, patients and physicians opinions/needs and treatment adherence influence treatment goals. CONCLUSIONS: A clear treatment decision making framework is vital to improve management of psoriasis. KEY MESSAGES: Psoriasis characteristics, patients and physicians opinions/needs and treatment adherence influence treatment goals. Different disease indexes could be used to assess treatment response but absolute PASI is preferred. In general psoriasis treatment failure should be considered if PASI75 response is not reached. Taylor & Francis 2021-10-03 /pmc/articles/PMC8491706/ /pubmed/34601988 http://dx.doi.org/10.1080/07853890.2021.1986637 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Dermatology
Belinchón Romero, Isabel
Dauden, Esteban
Ferrándiz Foraster, Carlos
González-Cantero, Álvaro
Carrascosa Carrillo, Jose Manuel
Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document
title Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document
title_full Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document
title_fullStr Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document
title_full_unstemmed Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document
title_short Therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document
title_sort therapeutic goals and treatment response evaluation in moderate to severe psoriasis: an experts opinion document
topic Dermatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491706/
https://www.ncbi.nlm.nih.gov/pubmed/34601988
http://dx.doi.org/10.1080/07853890.2021.1986637
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