A multileveled approach in psoriasis assessment and follow-up: A proposal for a tailored guide for the dermatological practice

DeCoster, Eveline; Medeiros, Ana Alves de; Bostoen, Jessica; Stockman, Annelies; Geel, Nanja van; Lapeere, Hilde; Lambert, Jo

doi:10.3109/09546634.2015.1117566

Cited by 9 publications

(15 citation statements)

References 127 publications

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“…Genetic background of Ps has been confirmed by population and family studies as well as higher concordance rates in monozygotic twins [ 8 , 9 ]. Genetic studies of Ps background have also led to the identification of the mutation in the IL-36RN gene encoding the anti-inflammatory IL-36 receptor antagonist (IL-36Ra) and have supported the hypothesis that generalized pustular psoriasis (GPP) is a disease of distinct etiology [ 10 ].…”

Section: Personalized Therapy In Psoriasismentioning

confidence: 99%

Genetic polymorphism in psoriasis and its meaning for the treatment efficacy in the future

Osmola‐Mańkowska¹,

Teresiak-Mikołajczak²,

Skrzypczak-Zielińska³

et al. 2018

pdia

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The concept of personalized medicine is a new individualized approach which helps application of the targeted therapy. In fact, tailored medicine is mostly present in the field of life-threatening diseases such as oncology. However, skin diseases as such might be regarded as a potential area of implementation of this approach in the future. Stratified medicine in polygenetic and heterogeneous diseases, such as psoriasis, is more complex. Rapid development of science and novel molecular techniques led to better understanding of molecular pathogenetic pathways of many diseases including psoriasis. Identification of the particular immunopathogenetic pathways led to further development of targeted therapies such as biologic drugs. Actually the goal of individualized therapy is to determine the identical homogenous subgroups of patients, according to a biomarker, in which the response to that therapy will be the best and will carry the lowest risk of side effects. This review attempts to analyze the associations between polymorphisms of certain genes and the increased risk of developing psoriasis or psoriatic arthritis. The review of literature has also included the studies investigating the associations between gene polymorphisms and response to biologic therapy in psoriasis and psoriatic arthritis patients.

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Section: Personalized Therapy In Psoriasismentioning

confidence: 99%

Genetic polymorphism in psoriasis and its meaning for the treatment efficacy in the future

Osmola‐Mańkowska¹,

Teresiak-Mikołajczak²,

Skrzypczak-Zielińska³

et al. 2018

pdia

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“…Yet, taking the Tight Control for RA and PsA (TICORA and TICOPA, respectively) studies into account, multidimensionality better reflects the patient's global status. We illustrated this need by developing a specialized consultation to manage psoriasis according to its multileveled needs . In addition, targets for a T2T approach need to be well‐defined: the Canadian definition includes a ‘satisfied patient’, but lacks a validated patient‐reported outcome (PRO) to define this.…”

Section: Introductionmentioning

confidence: 99%

“…We illustrated this need by developing a specialized consultation to manage psoriasis according to its multileveled needs. 34 In addition, targets for a T2T approach need to be well-defined: the Canadian definition includes a 'satisfied patient', but lacks a validated patient-reported outcome (PRO) to define this. Moreover, patient-centred care stipulates that the patient becomes a full partner in choosing preventive and therapeutic measures for his/ her disease.…”

Section: Introductionmentioning

confidence: 99%

A Belgian consensus on the definition of a treat‐to‐target outcome set in psoriasis management

Grine

Brassinne

Ghislain

et al. 2020

Acad Dermatol Venereol

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Objective Treat‐to‐target (T2T) is an algorithm to reach a predefined outcome. Here, we define a T2T outcome for moderate‐to‐severe psoriasis vulgaris. Methods Briefly, the study included a literature review, discussions with key opinion leaders, recruitment of additional dermatologists with experience in managing moderate‐to‐severe psoriasis, 3 eDelphi survey rounds and a patient focus group. Relevant topics were selected during discussions prior to the survey for the statements. Surveys were based on the eDelphi methodology for consensus‐building using a series of statements. Consensus was defined as at least 80% of participants agreeing. A psoriasis patient focus group provided feedback on topic selection and outcome. Results A total of 5 discussions were held, and 3 eDelphi rounds were conducted with an average of 19 participants per round. The T2T outcome was set assuming shared decision between patient and dermatologist, awareness and referral for comorbidities by the dermatologist and appropriate treatment adherence by the patient. We defined ‘ideal’ and ‘acceptable’ targets; the latter referring to conditions restricting certain drugs. The T2T outcome was multidimensional, including ≥ ΔPASI90/75 or PGA ≤ 1, itch VAS score ≤ 1, absence of disturbing lesions, DLQI ≤ 1/3, incapacity daily functioning VAS score ≤ 1, safety ≤ mild side‐effects and full/mild tolerability of treatment for the ideal and acceptable target, respectively. Finally, time to achieve the T2T outcome was set at 12 weeks after initiation for all treatments. At all times, safety should not exceed the presence of mild side‐effects. Conclusion With this novel T2T composite outcome for psoriasis, clinicians and patients can make shared decisions on the treatment goals they envisage, as a guidance for future treatment steps – leading to a tight control management of the disease.

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“…One year later, Mrowietz and colleagues have proposed a shift towards 'management'-based psoriasis treatment, approaching skin inflammation and comorbidities (cardiovascular diseases and psychiatric disorders) together with negative consequences on QoL [5]. Finally, in 2016, our group (from Belgium) published a proposal for a multileveled consultation format for psoriasis [12]. In this work, an extensive consultation outline was generated, called PsoPlus, which addresses aspects beyond comorbidities and QoL in psoriasis that, in the end, affect management decisions.…”

Section: Introductionmentioning

confidence: 99%

“…In the General consultation, the dermatologist classically questions and fills out (electronically) four main information domains: medical history and current complaint, clinical examination, diagnosis and treatment. In the PsoPlus format, two healthcare professionals fill out a comprehensive psoriasis specific checklist, as described previously [12]. The PsoPlus consultation consequently takes forty minutes, twice as long as the General consultation.…”

Section: Introductionmentioning

confidence: 99%

The implementation of a structured specialized consultation for psoriasis management

Lambert

Medeiros

Reempts

et al. 2020

Acta Clinica Belgica

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Objectives: Psoriasis is a chronic skin disease requiring a multidimensional approach, given its varying appearance, presence of comorbidities and complex treatment regimens. Psoriasis care is however often performed fragmented and, in case of flares, reactive with little integrated information on and for the patient. Literature suggests a multileveled approach of psoriasis, but the effects of its implementation have not yet been validated. The aim of this study is to analyze the impact of a multileveled psoriasis consultation format, named PsoPlus, which has been implemented since 2012 in the Department of Dermatology at Ghent University Hospital in Belgium.Methods: The patient population was divided into two groups: one following the regular consultation and one following the PsoPlus format. Demographic data, clinical outcome and treatment approach of psoriasis patients were compared.Results: Patients who opted for the specialized PsoPlus consultation were younger and had longer disease duration. Decision parameters such as disease severity and quality of life were reported more often in the PsoPlus group. In the latter, a higher rate of patients were started on systemic therapy compared to the regular consultation group, and reporting on adverse events was done more frequently. Conclusion:The implementation of a specialized consultation with comprehensive guidance facilitates documentation on disease-relevant parameters such as disease severity and quality of life. This format can be seen as a guidance for capturing data in a structured manner, with evidence showing that it significantly impacts treatment decision, treating not only psoriasis but the patient as a whole.

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A multileveled approach in psoriasis assessment and follow-up: A proposal for a tailored guide for the dermatological practice

Abstract: Our comprehensive overview can be used as a consultation checklist for good clinical practice in psoriasis patient management and aid in treatment decision.

Cited by 9 publications

References 127 publications

Genetic polymorphism in psoriasis and its meaning for the treatment efficacy in the future

Genetic polymorphism in psoriasis and its meaning for the treatment efficacy in the future

A Belgian consensus on the definition of a treat‐to‐target outcome set in psoriasis management

The implementation of a structured specialized consultation for psoriasis management

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