Meulewaeter Evelyn, Eylenbosch Anke, Verhaeghe Evelien, Soenen Rani, Lambert Jo
Department of Dermatology, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.
Dermatol Ther (Heidelb). 2024 Oct;14(10):2889-2903. doi: 10.1007/s13555-024-01277-y. Epub 2024 Oct 4.
Psoriasis is a chronic immune-mediated skin disease with several comorbidities and a considerable influence on quality of life. Many patients with moderate-to-severe psoriasis are undertreated and have a substantial disease duration before effective treatment is started. This study analyzed patient and disease characteristics and time to effective treatment of patients with psoriasis who consulted PsoPlus. It also examined whether a treat-to-target (T2T) approach, which is implemented in PsoPlus, has an impact on treatment choice and disease progression.
Through a single center, retrospective study, 170 patients in the PsoPlus dedicated clinic were compared at moment of enrollment in PsoPlus and at the last recorded consultation in 2021.
Median disease duration at the first PsoPlus consultation was 16.0 (interquartile range (IQR) 19.0) years. There was a significant difference in Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) between the first and the last recorded PsoPlus consultation (PASI 6.0 (IQR 6.4) vs. 0.6 (IQR 2.6); DLQI 11 (IQR 11) vs. 2 (IQR 6); p < 0.001). A weak positive Spearman correlation (r) was found between disease duration and PASI at the first PsoPlus consultation (r = 0.175; p = 0.034), while a weak negative correlation (r = - 0.2; p = 0.013) was found at the last registered PsoPlus consultation. Patients with a disease duration of more than 20 years had significantly more switches of treatment than those with a shorter disease duration (p < 0.001). Median time from psoriasis onset until PASI ≤ 2 was 16.0 years. Median time from the first PsoPlus consultation until PASI ≤ 2 was 7.0 months.
The PsoPlus program with its T2T approach effectively improves clinical outcomes and quality of life for patients with psoriasis in a relatively short period, emphasizing the value of a structured, personalized treatment plan for long-term management.
银屑病是一种慢性免疫介导的皮肤病，伴有多种合并症，对生活质量有相当大的影响。许多中度至重度银屑病患者治疗不足，在开始有效治疗前疾病持续时间很长。本研究分析了咨询PsoPlus的银屑病患者的患者和疾病特征以及达到有效治疗的时间。它还研究了PsoPlus实施的达标治疗（T2T）方法是否对治疗选择和疾病进展有影响。
通过一项单中心回顾性研究，对PsoPlus专科诊所的170名患者在加入PsoPlus时和2021年最后一次记录的会诊时进行比较。
首次PsoPlus会诊时的疾病中位持续时间为16.0（四分位间距（IQR）19.0）年。首次和最后一次记录的PsoPlus会诊之间的银屑病面积和严重程度指数（PASI）及皮肤病生活质量指数（DLQI）有显著差异（PASI 6.0（IQR 6.4）对0.6（IQR 2.6）；DLQI 11（IQR 11）对2（IQR 6）；p＜0.001）。在首次PsoPlus会诊时，疾病持续时间与PASI之间发现弱正Spearman相关性（r）（r = 0.175；p = 0.034），而在最后一次记录的PsoPlus会诊时发现弱负相关性（r = -0.2；p = 0.013）。疾病持续时间超过20年的患者的治疗转换次数明显多于疾病持续时间较短的患者（p＜0.001）。从银屑病发病到PASI≤2的中位时间为16.0年。从首次PsoPlus会诊到PASI≤2的中位时间为7.0个月。
采用T2T方法的PsoPlus项目在相对较短的时间内有效改善了银屑病患者的临床结局和生活质量，强调了结构化、个性化治疗计划对长期管理的价值。
