Strober Bruce, Zhong Yichen, Sima Adam, Beeghly Alicia, Eckmann Thomas, Balagula Eugene, Zhuo Joe, Lebwohl Mark
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.
Central Connecticut Dermatology Research, Cromwell, CT, USA.
J Psoriasis Psoriatic Arthritis. 2024 Nov 21:24755303241302070. doi: 10.1177/24755303241302070.
The International Psoriasis Council (IPC) updated the classification of psoriasis severity to guide clinical decision-making. According to IPC guidelines, patients are considered candidates for systemic therapy when body surface area (BSA) is >10%, when lesions affect special body areas (ie, face, palms, soles, genitals, scalp, or nails), or when topical therapy fails to control symptoms.
To evaluate patient candidacy for systemic therapy in real-world settings, according to disease severity criteria.
This cross-sectional study included systemic treatment-naive patients from the CorEvitas Psoriasis Registry who initiated systemic treatment at Registry visits between April 2015 and April 2023. Based on IPC criteria, systemic therapy candidates were identified, and data on demographics and clinical characteristics, including disease severity indicators (ie, BSA and Psoriasis Area Severity Index [PASI] scores) and patient-reported outcome measures, were collected and descriptively summarized.
The analysis included 2739 systemic therapy initiators with plaque psoriasis, of whom 82.7% met IPC criteria for systemic therapy. Of the 2265 systemic therapy candidates, 56.2% had a BSA >10%, 53.2% had a history of psoriasis affecting special areas, and 55.2% had prior but not current use of topical therapy. Notably, 71.0% of candidates for systemic therapy had PASI scores ≤12.
In this large real-world study, most patients with psoriasis who initiated systemic therapy met the IPC disease severity criteria to do so. Disease severity categorization based on PASI scores and BSA percentage alone may not adequately capture all patients who might be candidates for systemic psoriasis treatment.
NCT02707341.
国际银屑病理事会（IPC）更新了银屑病严重程度分类，以指导临床决策。根据IPC指南，当体表面积（BSA）>10%、病变累及特殊身体部位（即面部、手掌、脚底、生殖器、头皮或指甲）或局部治疗无法控制症状时，患者被视为全身治疗的候选者。
根据疾病严重程度标准，评估现实环境中患者进行全身治疗的候选资格。
这项横断面研究纳入了CorEvitas银屑病登记处未接受过全身治疗的患者，这些患者在2015年4月至2023年4月的登记访视中开始接受全身治疗。根据IPC标准确定全身治疗候选者，并收集人口统计学和临床特征数据，包括疾病严重程度指标（即BSA和银屑病面积严重程度指数[PASI]评分）以及患者报告的结局指标，并进行描述性总结。
分析包括2739例斑块状银屑病全身治疗起始者，其中82.7%符合IPC全身治疗标准。在2265例全身治疗候选者中，56.2%的患者BSA>10%，53.2%有银屑病累及特殊部位的病史，55.2%曾使用过但目前未使用局部治疗。值得注意的是，71.0%的全身治疗候选者PASI评分≤12。
在这项大型现实世界研究中，大多数开始接受全身治疗的银屑病患者符合IPC疾病严重程度标准。仅基于PASI评分和BSA百分比的疾病严重程度分类可能无法充分涵盖所有可能成为银屑病全身治疗候选者的患者。
NCT02707341。
