Clinical meaningfulness of complete skin clearance in psoriasis

Strober, Bruce; Papp, Kim; Lebwohl, Mark; Reich, Kristian; Paul, C.; Blauvelt, Andrew; Gordon, Kenneth B.; Milmont, Cassandra E; Viswanathan, Hema N.; Li, Joanne; Pinto, Lionel; Harrison, David J.; Kricorian, Greg; Nirula, Ajay; Klekotka, Paul

doi:10.1016/j.jaad.2016.03.026

Cited by 101 publications

(108 citation statements)

References 15 publications

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“…A PASI75 response is now widely accepted as a clinically meaningful improvement, and it also serves as the central evidence‐based efficacy parameter in European guidelines . However, the ultimate goal of therapy is the complete or almost complete clearing and an improvement of 90% or greater (PASI90 response) is currently considered as the most relevant treatment outcome, especially in patients with severe disease . We discussed the opportunity of achieving a minimal absolute PASI value (i.e.…”

Section: Resultsmentioning

confidence: 99%

Italian guidelines on the systemic treatments of moderate‐to‐severe plaque psoriasis

Gisondi

Altomare

Ayala

et al. 2017

Acad Dermatol Venereol

151

159

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Psoriasis is a common disease, which has a considerable impact on the healthcare system. Therefore, appropriate use of therapeutic resources is very important. Management of psoriasis in daily clinical practice is highly variable because many issues are still debated and not definitely addressed by the evidence-based medicine. Moreover, the different availability and reimbursability of drugs in each country justifies national guidelines. Expert consensus can provide helpful guidelines for optimizing patient care. A total of 20 dermatologists from different areas of Italy and with large experience in the treatment of psoriasis agreed to participate in the guidelines expert panel who aimed to reach consensus on the factors influencing psoriasis severity, the indications for systemic treatments, the parameters to be considered in the choice of treatment, and the factors to be considered in the choice of biological treatment. The recommendations for the use, screening and monitoring of systemic therapies were based on the 2015 S3 European Dermatology Forum/European Academy of Dermatology and Venereology psoriasis guidelines. Recommendations on the treatment of psoriasis in special patient populations were also agreed. The final document was discussed in a meeting moderated by a facilitator with participation of the entire group and adopting a nominal group technique to reach consensus. A statement was regarded as consented when agreement was achieved by at least 75% of the voting experts according to the Delphi procedure.

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Section: Resultsmentioning

confidence: 99%

Italian guidelines on the systemic treatments of moderate‐to‐severe plaque psoriasis

Gisondi

Altomare

Ayala

et al. 2017

Acad Dermatol Venereol

151

159

View full text Add to dashboard Cite

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“…D ear E ditor , The incremental benefits of obtaining high levels of skin clearance for patients with psoriasis have been established across several patient‐reported outcomes (PROs). Patients who obtain clear or almost‐clear skin are more likely to report that psoriasis has no impact on their health‐related quality of life (HRQoL) and other measures of symptoms . Although the benefits of obtaining high skin clearance have been reported using different therapeutic agents, the question of whether the benefits of such high levels of response may be offset by an increased risk for adverse outcomes has not been fully explored with biologics .…”

Section: Patient‐reported Outcomes and Safety Analyses At Week 12mentioning

confidence: 99%

Reaching complete or near-complete resolution of psoriasis: benefit and risk considerations

et al. 2017

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“…Several therapeutic options have been carried out considering severity of skin lesions, the comorbidities or impairment of patients’ QOL. Among them, biologics, which enable approximately 60–70% of psoriatic patients to achieve 90% improvement of Psoriasis Area and Severity Index (PASI‐90), bring the greatest impact on therapeutic strategy of psoriasis to date, and the PASI‐90 or more improvement is closely correlated with significant improvement of patients’ impaired QOL . However, the cost of biologic therapy is generally high, and it is important to select the therapeutic options, including biologics, by considering a patient's disease activity and other personal background .…”

Section: Introductionmentioning

confidence: 99%

Alteration of serum thymus and activation‐regulated chemokine level during biologic therapy for psoriasis: Possibility as a marker reflecting favorable response to anti‐interleukin‐17A agents

Shibuya

Honma

Iinuma

et al. 2018

The Journal of Dermatology

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Biologics show great efficacy in treating psoriasis, a chronic inflammatory skin disease. The high cost and side-effects of biologics, dose-reduction, elongation of administration interval and suspension are possible options. However, there has been no reliable biomarker we can use when we consider these moderations in therapy. This study was conducted to test the possibility of using serum thymus and activation-regulated chemokine (TARC) level as an indicator for step down of biologic therapy. Serum TARC level was measured in 70 psoriatic patients at Asahikawa Medical University, and a correlation of TARC and severity of skin lesions was analyzed. Referring to serum TARC level, psoriatic patients can be divided into two groups. One is a population in which serum TARC level is positively correlated with severity of skin lesions, and the other is a population with low psoriatic severity and high TARC level. Serum TARC level was higher in the group that achieved PASI-clear with biologics than in the group which did not achieve PASI-clear. Among biologics, the group treated with secukinumab, an anti-interleukin (IL)-17A agent, showed significantly higher TARC level compared with the group treated with anti-tumor necrosis factor agents. In certain populations achieving PASI-clear, serum TARC level may be a potent marker reflecting better response to IL-17A inhibitors, and in this case step down of treatment for psoriasis is possible.

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Clinical meaningfulness of complete skin clearance in psoriasis

Cited by 101 publications

References 15 publications

Italian guidelines on the systemic treatments of moderate‐to‐severe plaque psoriasis

Italian guidelines on the systemic treatments of moderate‐to‐severe plaque psoriasis

Reaching complete or near-complete resolution of psoriasis: benefit and risk considerations

Alteration of serum thymus and activation‐regulated chemokine level during biologic therapy for psoriasis: Possibility as a marker reflecting favorable response to anti‐interleukin‐17A agents

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