Armstrong April W, Gondo George C, Merola Joseph F, Roberts Alyssa M, Pérez-Chada Lourdes M, Balak Deepak M W, Eakin Guy S, Read Charlotte, Le Stephanie T, Gutierrez Yasmin, Bhutani Tina, Blauvelt Andrew, Duffin Kristina Callis, Fakharzadeh Steven, Feldman Steven R, Gelfand Joel M, Gladman Dafna D, Glick Brad, Green Lawrence J, Han George, Hawkes Jason E, Hwang Samuel T, Johnsen Nicole, Kalb Robert E, Kircik Leon, Langley Richard G, Lebwohl Mark G, Lewitt G Michael, Maverakis Emanual, Prussick Ronald, Reddy Soumya M, Rosen Cheryl F, Scher Jose U, Siegel Evan L, Wallace Elizabeth B, Weinberg Jeffrey M, Yamauchi Paul S, Yosipovitch Gil, Liao Wilson
Division of Dermatology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles.
National Psoriasis Foundation, Alexandria, Virginia.
JAMA Dermatol. 2025 Jun 18. doi: 10.1001/jamadermatol.2025.1625.
Defining on-treatment remission in plaque psoriasis is important for benchmarking patient responses to therapies. This also helps to facilitate shared understanding, align treatment expectations, and enable more effective psoriasis management.
To establish a consensus-based definition of on-treatment remission for plaque psoriasis through a multistage Delphi initiative.
The Remission Workgroup from the medical board and scientific advisory board of the National Psoriasis Foundation engaged various stakeholders, both US based and international, to participate in the consensus process. Following a working group meeting to determine the overall consensus approach, a systematic review of remission definitions in the current literature was performed. This review helped to inform the content of consensus materials. The consensus effort involved 2 stages: pre-Delphi interviews and surveys to inform the Delphi questions, followed by a Delphi exercise with physicians to define on-treatment remission for plaque psoriasis. Outcome measures considered included body surface area (BSA), Investigator Global Assessment (IGA), the product of the Physician Global Assessment and body surface area (PGA × BSA), and Psoriasis Area and Severity Index (PASI) score at various cutoff levels and time points.
The consensus process involved 92 stakeholders, including dermatologists, rheumatologists, researchers, patients, payers, and life sciences professionals. In the pre-Delphi interviews and surveys, patients emphasized that on-treatment remission meant the absence of psoriasis signs and symptoms while recieving therapy. Payers expressed that defining remission is important for long-term treatment coverage. Following the Delphi exercise and discussion with participating physicians specializing in psoriatic disease management, on-treatment remission in plaque psoriasis was defined as patients maintaining a BSA of 0% or IGA of 0 for at least 6 months while on treatment.
Through a Delphi consensus process, on-treatment remission for plaque psoriasis was defined as patients maintaining a BSA involvement of 0% or IGA of 0 for at least 6 months while on treatment. This clear and standardized benchmark is applicable to both research and practice settings.
定义斑块状银屑病治疗期间的缓解对于衡量患者对治疗的反应至关重要。这也有助于促进共同理解、调整治疗期望并实现更有效的银屑病管理。
通过多阶段德尔菲倡议建立基于共识的斑块状银屑病治疗期间缓解的定义。
国家银屑病基金会医学委员会和科学顾问委员会的缓解工作组邀请了美国和国际的各利益相关方参与共识过程。在确定总体共识方法的工作组会议之后，对当前文献中的缓解定义进行了系统回顾。该回顾有助于为共识材料的内容提供信息。共识工作包括两个阶段：德尔菲前访谈和调查以确定德尔菲问题，随后进行德尔菲练习，让医生定义斑块状银屑病治疗期间的缓解。考虑的结果指标包括体表面积（BSA）、研究者整体评估（IGA）、医生整体评估与体表面积的乘积（PGA×BSA）以及不同截断水平和时间点的银屑病面积和严重程度指数（PASI）评分。
共识过程涉及92名利益相关方，包括皮肤科医生、风湿病学家、研究人员、患者、支付方和生命科学专业人员。在德尔菲前访谈和调查中，患者强调治疗期间的缓解意味着在接受治疗时没有银屑病的体征和症状。支付方表示定义缓解对于长期治疗覆盖很重要。在德尔菲练习并与参与银屑病疾病管理的专科医生讨论之后，斑块状银屑病治疗期间的缓解被定义为患者在治疗期间至少6个月保持BSA为0%或IGA为0。
通过德尔菲共识过程，斑块状银屑病治疗期间的缓解被定义为患者在治疗期间至少6个月保持BSA受累为0%或IGA为0。这个清晰且标准化的基准适用于研究和实践环境。
