TY - JOUR
T1 - Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations
AU - Gisondi, Paolo
AU - Talamonti, Marina
AU - Chiricozzi, Andrea
AU - Piaserico, Stefano
AU - Amerio, Paolo
AU - Balato, Anna
AU - Bardazzi, Federico
AU - Calzavara Pinton, Piergiacomo
AU - Campanati, Anna
AU - Cattaneo, Angelo
AU - Dapavo, Paolo
AU - De Simone, Clara
AU - Dini, Valentina
AU - Fargnoli, Maria C.
AU - Fargnoli, Maria Concetta
AU - Flori, Maria L.
AU - Galluzzo, Marco
AU - Guarneri, Claudio
AU - Lasagni, Claudia
AU - Loconsole, Francesco
AU - Lo Schiavo, Ada
AU - Malagoli, Piergiorgio
AU - Malara, Giovanna
AU - Mercuri, Santo R.
AU - Musumeci, Maria L.
AU - Naldi, Luigi
AU - Papini, Manuela
AU - Parodi, Aurora
AU - Potenza, Concetta
AU - Prignano, Francesca
AU - Rongioletti, Franco
AU - Stingeni, Luca
AU - Tiberio, Rossana
AU - Venturini, Marina
AU - Bianchi, Luca
AU - Costanzo, Antonio
AU - Cusano, Francesco
AU - Girolomoni, Giampiero
AU - Offidani, Anna M.
AU - Peris, Ketty
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Consensus
KW - Plaque psoriasis
KW - Quality of life
KW - Systemic inflammation
KW - Treat-to-target
KW - Consensus
KW - Plaque psoriasis
KW - Quality of life
KW - Systemic inflammation
KW - Treat-to-target
UR - http://hdl.handle.net/10807/167174
U2 - 10.1007/s13555-020-00475-8
DO - 10.1007/s13555-020-00475-8
M3 - Article
SN - 2193-8210
SP - N/A-N/A
JO - Dermatology and Therapy
JF - Dermatology and Therapy
ER -