Treatment goals for moderate to severe psoriasis: An Australian consensus

Abstract

Background/Objectives: The high incidence of

Assessing Psoriasis Severity and Outcomes for Clinical Trials and Routine Clinical Practice

“…The principle of the "Rule of Tens," in which scores greater than 10 of any 1 of 3 measures, percent BSA involvement, PASI, or DLQI, would constitute evidence of current severe psoriasis, 32 has been adopted with minor modifications in a number of guidelines for the management of psoriasis. 17,[33][34][35] There are, however, other dimensions of psoriasis that may be equally relevant in helping patients and clinicians to make informed decisions about management but that may not be captured by these tools. These omissions may in part be attributed to the deficiencies of PASI itself as an assessment tool or to the absence of a number of important items from DLQI, such as sleep deprivation or the economic cost of having psoriasis.…”

Patient-reported outcomes for psoriasis patients with clear versus almost clear skin in the clinical setting

“…4 In an effort to improve treatment outcomes and satisfaction, guidelines for appropriate psoriasis treatment largely based on expert consensus have been created in Canada, Europe, the United Kingdom, and Australia. 5–9 Recognizing the evidence that suggests that typical physician-reported measures of psoriasis severity (e.g., body surface area [BSA] affected, Psoriasis Area and Severity Index [PASI], and Physician Global Assessment [PGA]) may not adequately capture psoriasis severity from the patient’s perspective, 10,11 patient-reported outcomes which are metrics that assess a patient’s health status or quality of life [QoL] from the patient perspective are increasingly being used to guide clinical care. In fact, recommendations for treatment goals in many of the aforementioned psoriasis treatment guidelines incorporate both physician- and patient-reported outcomes (e.g., the Dermatology Quality Life Index (DLQI), a validated and widely used dermatology-specific health-related quality of life [HRQoL] measure) 12,13 as measures of treatment response.…”

Treat-to-target and Improving Outcomes in Psoriasis: A Report from the GRAPPA 2014 Annual Meeting

“…Many treatment guidelines 29,30,31,34 also incorporate a patient-reported dermatology-specific health-related quality of life (QoL) measure, most commonly the Dermatology Life Quality Index (DLQI) 35,36 , where suggested secondary treatment goals include ≥ 5-point improvement in DLQI score 31 , DLQI ≤ 1 29 (i.e., no effect of patient's skin disease on QoL), or DLQI ≤ 5 30,37 (i.e., no effect to small effect on QoL). In general, objective data supporting the use of PRO or objective disease activity measures as targets in psoriasis are sparse.…”