PSO-TARGET: a New Tool to Identify the Therapeutic Expectations of Psoriasis Patients Treated with Biologics.

INTRODUCTION

The effectiveness of psoriasis treatment is assessed by standardized tools such as the Dermatology life Quality Index (DLQI) and Psoriasis Area Severity Index (PASI). However, discrepancies between patients and physicians in terms of treatment success and goals, along with the growing importance of shared decision-making in healthcare, highlight the need for tools specifically designed for psoriasis. Such tools can enhance communication between patients and physicians, encouraging shared decision-making and improving the assessment of patient treatment expectations.

METHODS

Comparison of the new PSO-TARGET grid, which consists of 12 therapeutic goals evenly distributed across 4 major components commonly used in quality of life (QoL) studies for chronic diseases, with DLQI as a standard tool, was utilized.

RESULTS

A total of 143 adult patients with moderate-to-severe psoriasis and treated with brodalumab were included. On the basis of a blind assessment, dermatologists were not able to identify the patients' chosen PSO-TARGET goal in more than 50% of cases. The comparison after 12/16 weeks of treatment revealed some discrepancies between the two QoL tools. Compared with the rest of the population, the patients who achieved their PSO-TARGET goal, but still reported a DLQI > 1, had higher baseline PASI scores (18.6 versus 14.8; p = 0.067), higher DLQI scores (14.1 versus 10.1; p = 0.004), and a higher number of hard-to-treat locations (median of 2 versus 1; p = 0.004). In addition, patients who had not reached their PSO-TARGET goal but reported a DLQI ≤ 1, all had psoriasis on the scalp at the baseline and were generally younger (median of 31 versus 52 years, p = 0.001).

CONCLUSIONS

This study highlights the importance of considering patient characteristics of those with psoriasis and perspectives when evaluating treatment outcomes. Using shared decision-making tools such as the PSO-TARGET grid can improve communication and understanding between dermatologists and patients.

TRIAL REGISTRATION

ClinicalTrials.gov identifier, NCT04765332.