From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis
From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis
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DOI：
10.1016/j.jaad.2016.10.017
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发表时间：
2017-02-01
影响因子：
13.8
通讯作者：
Van Voorhees, Abby S.
中科院分区：
文献类型：
--
作者：
Armstrong, April W.;Siegel, Michael P.;Van Voorhees, Abby S.
背景资料：存在一个迫切需要在美国建立治疗目标在psorias.Objective：我们的目标是建立明确的治疗目标，临床医生和银屑病患者可以努力告知治疗决策，减少疾病负担，并改善在practice.Methods的结果：国家银屑病基金会进行了一项共识建设研究银屑病专家之间使用的德尔菲法。该进程包括：（1）文献回顾，（2）专家咨询前的问题选择和一般皮肤科医生和患者的输入，（3）4轮德尔菲咨询。最优选的仪器是体表面积（BSA）。开始新治疗后评价患者反应的最佳时间为3个月。开始治疗后3个月的可接受缓解为BSA 3%或更低或BSA较基线改善75%或更高。治疗后3个月的目标反应为BSA 1%或更低。在维持期内，最好每6个月进行一次评估。目标反应在每6个月的维护evaluation是BSA 1%或less.Limitations：虽然BSA是可行的，在实践中，它不包括健康相关的生活质量，成本和风险的副作用.Conclusion：与定义的治疗目标，临床医生和患者可以定期评估治疗反应，并进行个性化的治疗方案的获益-风险评估的患者。
Background: An urgent need exists in the United States to establish treatment goals in psoriasis.Objective: We aim to establish defined treatment targets toward which clinicians and patients with psoriasis can strive to inform treatment decisions, reduce disease burden, and improve outcomes in practice.Methods: The National Psoriasis Foundation conducted a consensus-building study among psoriasis experts using the Delphi method. The process consisted of: (1) literature review, (2) pre-Delphi question selection and input from general dermatologists and patients, and (3) 4 Delphi rounds.Results: A total of 25 psoriasis experts participated in the Delphi process. The most preferred instrument was body surface area (BSA). The most preferred time for evaluating patient response after starting new therapies was at 3 months. The acceptable response at 3 months postinitiation was either BSA 3% or less or BSA improvement 75% or more from baseline. The target response at 3 months postinitiation was BSA 1% or less. During the maintenance period, evaluation every 6 months was most preferred. The target response at every 6 months maintenance evaluation is BSA 1% or less.Limitations: Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects.Conclusion: With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient.