More than 8 million people in the U.S. have psoriasis and current methods of managing the disease have resulted in patient frustration, largely due to the lack of a standardized treatment guideline for achieving clear skin. Determining the degree of skin clearance and how soon it should occur is paramount in the management of the disease.
For the first time in the United States, patients now have the ability to work with their health care provider to create a proactive treatment plan based on guidelines with a distinct set of measurable targets. Led by the National Psoriasis Foundation (NPF) Medical Board, these guidelines were created to develop treatment targets, which includes not only treatment goals, but guidelines on how long it should take to achieve each goal. A paper that outlines these guidelines is available online in the Journal of the American Academy of Dermatology.
“This is a pivotal, groundbreaking effort that defines treatment targets for psoriasis patients in the U.S.,” said Dr. April Armstrong, co-author of the paper, NPF Medical Board member and dermatologist at the University of Southern California. “The goal of these guidelines is to spark a dialogue between patients and health care providers about setting goals and to have a defined set of metrics to evaluate the current course of treatment.”
According to NPF surveys, as many as 18 percent of psoriasis patients experience moderate to severe psoriasis which covers more than 3 percent of a patient’s body surface area (BSA). The new guidelines establish an initial goal of reducing psoriasis BSA coverage to one percent or less within three months of starting treatment. If after three months a patient has seen some improvement, but not down to the one percent level, an “acceptable response” is defined as a 75 percent improvement in BSA. The guidelines recommend that six months after starting treatment, patients achieve a BSA of one percent or less and once that is achieved, patients should continue to check in with their health care provider every six months to maintain this target.
Given that there are many treatment options available to patients, there is no one-size-fits-all path to skin clearance. If patients do not meet the targets outlined in the new guidelines, then it is recommended that patients and their health care providers discuss treatment options and expectations. The decision for how to proceed is unique for each patient. These guidelines do not endorse or exclude any specific treatments, and final treatment decisions should be determined by the patient and their health care provider.
A unique consortium of doctors and psoriasis patients, including NPF Medical Board members and other leaders in the field of dermatology, developed these targets through a lengthy process of research, discussion and consensus-building.
“These guidelines are a very exciting step in empowering patients to understand what is possible in the treatment of their skin,” said Dr. Abby Van Voorhees, co-author of the paper, chair of the NPF Medical Board, and professor and chair of dermatology at Eastern Virginia Medical School. “These guidelines were developed by thought leaders in psoriasis with key input by both practicing dermatologists and patients. The voice of both of these groups was very important in finalizing the guidelines.”
Patients may receive more information about these new guidelines by contacting the NPF Patient Navigation Center at 800-723-9166, option 1 or visit www.psoriasis.org/navigationcenter.
