Division of Dermatology, Women's College Hospital, Department of Medicine, University of Toronto, Toronto, Canada.
Probity Medical Research, Inc., Waterloo, Canada.
Dermatol Ther. 2022 Oct;35(10):e15777. doi: 10.1111/dth.15777. Epub 2022 Aug 29.
Treat-to-target (T2T) recommendations for the use of systemic therapies (including biologics) in patients with moderate-to-severe plaque psoriasis have been published by a few groups of experts worldwide. However, there remains considerable variability in the choice of target severity measure and timing of milestones. To develop consensus recommendations for implementing T2T strategies for the management of moderate-to-severe plaque psoriasis using biologics. An expert group of Canadian dermatologists (the Committee) convened to develop a T2T consensus statement. They held a virtual meeting during which a preliminary set of criteria was created. These criteria were then reviewed, modified, and recirculated until unanimous agreement was achieved. The Committee agreed that defining treatment target is multidimensional and should reflect objective severity measures, as well as clinician and patient-reported outcomes. The Committee unanimously proposes a criterion-based system for determining the achievement of treatment target. The proposed T2T approach presented here provides a clinical framework for defining treatment success, measuring progress toward treatment success, recognizing when treatment modifications are warranted, and recommending treatment optimization strategies.
一些国际专家小组已经发布了针对中重度斑块型银屑病患者使用全身治疗(包括生物制剂)的靶向治疗(T2T)建议。然而,在选择目标严重程度衡量标准和里程碑时间方面仍然存在相当大的差异。为了制定使用生物制剂治疗中重度斑块型银屑病的 T2T 策略的共识建议。加拿大皮肤科专家(委员会)召开会议制定 T2T 共识声明。他们举行了一次虚拟会议,在此期间创建了一套初步标准。然后对这些标准进行了审查、修改和重新分发,直到达成一致意见。委员会一致认为,定义治疗目标是多方面的,应反映客观严重程度衡量标准,以及临床医生和患者报告的结果。委员会一致提议建立一个基于标准的系统来确定治疗目标的实现。这里提出的 T2T 方法为定义治疗成功、衡量治疗成功的进展、识别何时需要修改治疗以及推荐治疗优化策略提供了一个临床框架。