Treatment Goals for Psoriasis: Defined Targets Can Improve Outcomes
Psoriasis affects nearly 8 million Americans, leads to decreased quality of life for patients and presents a significant disease burden due to both the cutaneous manifestations and the multiple comorbidities. In addition, psoriasis poses a substantial economic burden, and a recent estimate puts US costs at around $112 billion. Despite these facts, undertreatment remains a significant problem, and more than half of US patients that suffer from psoriasis report dissatisfaction with their treatment.
Part of the difficulty with advocating for patients and ensuring best care, is a lack of defined treatment goals for psoriasis in the United States. Experts agree that treatment goals and defined targets reduce variability in treatment expectation and therefore improve quality of care. A recent article published in the Journal of the American Academy of Dermatology (JAAD) laid out defined treatment targets with the goal of informing treatment decisions, reducing disease burden, and improving patient outcomes in clinical practice. The targets were derived from a consensus-building study among psoriasis experts, conducted by the National Psoriasis Foundation.
Key findings for treatment targets are that the most preferred acceptable response to treatment at 3 months after treatment initiation is either body surface area (BSA) 3% or less or BSA improvement 75% or greater from baseline; the target response to treatment at 3 months after treatment initiation is BSA 1% or less; and the target response during the every 6-month maintenance evaluation is BSA 1% or less.
Other notable findings include the preference of using a single criterion to achieve treatment goals. The authors point out the following ways that clinicians can use these goals:
• Treatment targets are goals toward which the clinicians and patients can strive during the course of psoriasis management. Targets provide guidance on what to strive toward but not how to achieve these goals.
• Clinicians and patients can use these treatment targets to monitor disease progression and evaluate patient response.
• If the treatment goals are not met at defined time intervals, clinician and patient can re-evaluate the disease state and the existing treatment regimen.
• The authors conclude that efforts to create valid, feasible, and clinically relevant measures in psoriasis will positively impact future treat-to-target endeavors.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: February 27, 2017
Adapted from the original article.