Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations.

Consensus Plaque psoriasis Quality of life Systemic inflammation Treat-to-target

Journal

Dermatology and therapy
ISSN: 2193-8210
Titre abrégé: Dermatol Ther (Heidelb)
Pays: Switzerland
ID NLM: 101590450

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 05 11 2020
accepted: 02 12 2020
pubmed: 12 1 2021
medline: 12 1 2021
entrez: 11 1 2021
Statut: ppublish

Résumé

Treat-to-target strategies are used in several chronic diseases to improve outcomes. Treatment goals have also been suggested for psoriasis, but there is currently no consensus on targets, and guidance is needed to implement this strategy in clinical practice. The project 'Treat to Target Italia' was launched by a scientific board (SB) of 10 psoriasis experts to generate expert consensus recommendations. On the basis of the published literature, their clinical experience, and the results of a survey among Italian dermatologists, the SB identified four relevant topics: (1) clinical remission; (2) quality of life; (3) abrogation of systemic inflammation; (4) safety. They drafted 20 statements addressing these four topics and submitted them to a panel of 28 dermatologists, in a Delphi process, to achieve consensus (greater than 80% agreement). Consensus was reached on all statements. Treatment goals defining clinical remission should include a 90% improvement from baseline in the Psoriasis Area and Severity Index (PASI90 response) or an absolute PASI score of less than or equal to 3. Patient's quality of life and satisfaction are important targets. If PASI targets are achieved, there should be no or very low impact of psoriasis on quality of life [Dermatology Life Quality Index (DLQI) score less than or equal to 3]. If PASI or DLQI goals are not achieved within 3-4 months, treatment should be changed. Abrogation of systemic inflammation may be crucial for preventing or delaying inflammatory comorbidities. Safety is an equally important target as efficacy. These 20 consensus statements define the parameters of a treat-to-target strategy for psoriasis in Italy. It is hoped that use of these in the management of patients with psoriasis will improve treatment outcomes and patient health-related quality of life.

Identifiants

pubmed: 33426634
doi: 10.1007/s13555-020-00475-8
pii: 10.1007/s13555-020-00475-8
pmc: PMC7859133
doi:

Types de publication

Journal Article

Langues

eng

Pagination

235-252

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Auteurs

Paolo Gisondi (P)

Department of Medicine, Section of Dermatology and Venereology, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy. paolo.gisondi@univr.it.

Marina Talamonti (M)

Dermatology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy.

Andrea Chiricozzi (A)

Institute of Dermatology, Catholic University, Largo Francesco Vito, 1, 00168, Rome, Italy.
Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.

Stefano Piaserico (S)

Department of Dermatology, University of Padova, Via Vincenzo Gallucci, 4, 35121, Padova, Italy.

Paolo Amerio (P)

Department of Medicine and Aging Science and Dermatologic Clinic, University "G. d'Annunzio", Via dei Vestini, 31 66100, Chieti-Pescara, Chieti, Italy.

Anna Balato (A)

Department of Dermatology, University of Naples Federico II, Corso Umberto I, 40, 80138, Naples, Italy.

Federico Bardazzi (F)

Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy.

Piergiacomo Calzavara Pinton (P)

Dermatology Department, University of Brescia, ASST Spedali Civili, P.le Spedali Civili, 1, 25123, Brescia, Italy.

Anna Campanati (A)

Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, via Conca 71, 60126, Ancona, Italy.

Angelo Cattaneo (A)

Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, via Francesco Sforza 28, 20122, Milano, Italy.

Paolo Dapavo (P)

ASO City of Health and Science, University Dermatological Clinic, Corso Vittorio Emanuele II, 62, 10121, Torino, Italy.

Clara De Simone (C)

Institute of Dermatology, Catholic University, Largo Francesco Vito, 1, 00168, Rome, Italy.
Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.

Valentina Dini (V)

Dermatology Unit, Department of Clinical and Experimental Medicine Ospedale Santa Chiara, 11 Via Roma 67, 56126, Pisa, Italy.

Maria C Fargnoli (MC)

Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Coppito, 67100, L'Aquila, Italy.

Maria L Flori (ML)

Allergological Dermatology Unit Dermatology Section Department of Medical, Surgical and Neuro-Sciences, University of Siena, via Banchi di Sotto 55, 53100, Siena, Italy.

Marco Galluzzo (M)

Dermatology Unit, Fondazione Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Department of Experimental Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.

Claudio Guarneri (C)

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Piazza Pugliatti 1, 98122, Messina, Italy.

Claudia Lasagni (C)

Dermatological Clinic, Department of Specialized Medicine, University of Modena, Via Università 4, 41121, Modena, Italy.

Francesco Loconsole (F)

Department of Dermatology, University of Bari, Piazza Umberto I, 1, 70121, Bari, Italy.

Ada Lo Schiavo (A)

Dermatology Unit, University of Campania Luigi Vanvitelli, Viale Abramo Lincoln, 5, 81100, Naples, Italy.

Piergiorgio Malagoli (P)

Head Psocare Unit IRCCS Policlinico San Donato, Piazza Edmondo Malan, 2, 20097, San Donato, Milano, Italy.

Giovanna Malara (G)

UOC of Dermatology, Great Metropolitan Hospital "BMM", Via Giuseppe Melacrino 21, 89124, Reggio Calabria, Italy.

Santo R Mercuri (SR)

IRCCS Scientific Institute San Raffaele Vita-Salute University, Via Olgettina n. 60, 20132, Milano, Italy.

Maria L Musumeci (ML)

U.O.C. Dermatology, P.O.G. Rodolico, A.O.U. Policlnico-Vittorio Emanuele, Catania, Italy.

Luigi Naldi (L)

Department of Dermatology, AULSS8 Ospedale San Bortolo, viale Rodolfi 37, 36100, Vicenza, Italy.

Manuela Papini (M)

Dermatology Clinic of Terni, University of Perugia, Piazza dell'Università 1, 06123, Perugia, Italy.

Aurora Parodi (A)

DiSSal Section of Dermatology, University of Genoa, Policlinic-Hospital San Martino IRCCS, Largo R. Benzi 10, 16132, Genoa, Italy.

Concetta Potenza (C)

Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.

Francesca Prignano (F)

Unit of Dermatology, Department of Health Science, University of Florence, Viale Michelangiolo, 41 50125, Florence, Italy.

Franco Rongioletti (F)

Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Via Università 40, 09124, Cagliari, Italy.

Luca Stingeni (L)

Dermatology Section, Department of Medicine, University of Perugia, Piazza dell'Università 1, 06123, Perugia, Italy.

Rossana Tiberio (R)

Department of Health Science, Dermatologic Clinic, University of Eastern Piedmont, Corso Mazzini 18, 28100, Novara, Italy.

Marina Venturini (M)

Dermatology Department, University of Brescia, ASST Spedali Civili, P.le Spedali Civili, 1, 25123, Brescia, Italy.

Luca Bianchi (L)

Dermatology Unit, Department of Systems Medicine, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy.

Antonio Costanzo (A)

Dermatology Unit Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 20089, Pieve Emanuele, Milano, Italy.
Skin Pathology Laboratory, Humanitas Research Hospital IRCCS, Via Manzoni 56, 20089, Rozzano, Milano, Italy.

Francesco Cusano (F)

Dermatology Unit, "San Pio" General Hospital, Via Pacevecchia 53, 82100, Benevento, Italy.

Giampiero Girolomoni (G)

Department of Medicine, Section of Dermatology and Venereology, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy.

Anna M Offidani (AM)

Dermatology Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, via Conca 71, 60126, Ancona, Italy.

Ketty Peris (K)

Institute of Dermatology, Catholic University, Largo Francesco Vito, 1, 00168, Rome, Italy.
Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.

Classifications MeSH