Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council

Strober, Bruce; Ryan, Caitriona; Kerkhof, Peter van de; Walt, Joelle van der; Kimball, Alexa B.; Barker, Jonathan; Blauvelt, Andrew; Bourcier, Marc; Carvalho, André Vicente Esteves de; Cohen, Arnon D.; Foley, Peter; Evans, Colby; Gisondi, Paolo; Griffiths, Chris; El-Sayed, Mahira Hamdy; Eschevarria, Cristina; Finlay, Andrew Y.; Kalb, Robert E.; Leonardi, Craig L.; Lynde, Chuck W; Murphy, Ruth; Murakami, Masamoto; Okubo, Yukari; Prens, Errol P.; Puig, Lluís; Seyger, M.M.B.; Skov, Lone; Terada, Tadashi; Valenzuela, Fernando; Ward, Nicole L.; Wu, Jashin J.; Zheng, Min

doi:10.1016/j.jaad.2019.08.026

Cited by 130 publications

(143 citation statements)

References 20 publications

(21 reference statements)

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“…Disease mechanisms are multifactorial, with immune dysregulation important for both conditions, and mainstays of treatment immune‐modulation 5 . Systemic therapy is preferred for psoriasis treatment in patients with body surface area >10%, involvement of sensitive areas or topical therapy failure 6 . Systemic treatment is recommended for AD patients with severe disease or recalcitrant to topical therapy 7 .…”

Section: Introductionmentioning

confidence: 99%

Considerations for safety in the use of systemic medications for psoriasis and atopic dermatitis during theCOVID‐19 pandemic

Ricardo

Lipner

2020

Dermatologic Therapy

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Coronavirus disease 2019 (COVID-19) is responsible for at least 2 546 527 cases and 175 812 deaths as of April 21, 2020. Psoriasis and atopic dermatitis (AD) are common, chronic, inflammatory skin conditions, with immune dysregulation as a shared mechanism; therefore, mainstays of treatment include systemic immunomodulating therapies. It is unknown whether these therapies are associated with increased COVID-19 susceptibility or worse outcomes in infected patients. In this review, we discuss overall infection risks of nonbiologic and biologic systemic medications for psoriasis and AD and provide therapeutic recommendations. In summary, in patients with active infection, systemic conventional medications, the Janus kinase inhibitor tofacitinib, and biologics for psoriasis should be temporarily held until there is more data; in uninfected patients switching to safer alternatives should be considered. Interleukin (IL)-17, IL-12/23, and IL-23 inhibitors are associated with low infection risk, with IL-17 and IL-23 favored over IL-12/23 inhibitors. Pivotal trials and postmarketing data also suggest that IL-17 and IL-23 blockers are safer than tumor necrosis factor alpha blockers. Apremilast, acitretin, and dupilumab have favorable safety data and may be safely initiated and continued in uninfected patients. Without definitive COVID-19 data, these recommendations may be useful in guiding treatment of psoriasis and AD patients during the COVID-19 pandemic.

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Section: Introductionmentioning

confidence: 99%

Considerations for safety in the use of systemic medications for psoriasis and atopic dermatitis during theCOVID‐19 pandemic

Ricardo

Lipner

2020

Dermatologic Therapy

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“…This Delphi process involved a limited number of stakeholders and, as with any Delphi exercise, may also be biased by those who chose to participate [ 31 ]. For example, a number of issues were not considered such as the evolution of the biosimilar production process over time.…”

Section: Discussionmentioning

confidence: 99%

Sustainability of Biosimilars in Europe: A Delphi Panel Consensus with Systematic Literature Review

et al. 2020

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Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.

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“…Historical objective severity cutoffs can be a barrier to our ambition to realize optimal, the International Psoriasis Council has proposed a recategorization of disease severity, defining mild psoriasis as a disease severity which can be managed with topical treatments and severe psoriasis as a severity which requires systemic treatment (29). In case the patient has psoriasis at difficult sites or in case the extent of lesions is at least 10%, the patient can be treated with a systemic treatment immediately, without failure of prior topical treatment.…”

Section: Our Ambition In a Changing Landscape Of Psoriasis Treatmentsmentioning

confidence: 99%

Our ambition in a changing landscape of psoriasis treatments

Kerkhof

Feldman

2020

Journal of Dermatological Treatment

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Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council

Cited by 130 publications

References 20 publications

Considerations for safety in the use of systemic medications for psoriasis and atopic dermatitis during theCOVID‐19 pandemic

Considerations for safety in the use of systemic medications for psoriasis and atopic dermatitis during theCOVID‐19 pandemic

Sustainability of Biosimilars in Europe: A Delphi Panel Consensus with Systematic Literature Review

Our ambition in a changing landscape of psoriasis treatments

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