Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations

Andrea Chiricozzi, Clara De Simone, Ketty Peris, Maria Concetta Fargnoli, Paolo Gisondi, Marina Talamonti, Stefano Piaserico, Paolo Amerio, Anna Balato, Federico Bardazzi, Piergiacomo Calzavara Pinton, Anna Campanati, Angelo Cattaneo, Paolo Dapavo, Valentina Dini, Maria L Flori, Marco Galluzzo, Claudio Guarneri, Claudia Lasagni, Francesco LoconsoleAda Lo Schiavo, Piergiorgio Malagoli, Giovanna Malara, Santo R Mercuri, Maria L Musumeci, Luigi Naldi, Manuela Papini, Aurora Parodi, Concetta Potenza, Francesca Prignano, Franco Rongioletti, Luca Stingeni, Rossana Tiberio, Marina Venturini, Luca Bianchi, Antonio Costanzo, Francesco Cusano, Giampiero Girolomoni, Anna M Offidani

Risultato della ricerca: Contributo in rivistaArticolo in rivista

2 Citazioni (Scopus)

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 3-4 months, 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.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaDermatology and Therapy
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Consensus
  • Plaque psoriasis
  • Quality of life
  • Systemic inflammation
  • Treat-to-target

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