A Belgian consensus on the definition of a treat‐to‐target outcome set in psoriasis management

Abstract Objective Treat‐to‐target (T2T) is an algorithm to reach a predefined outcome. Here, we define a T2T outcome for moderate‐to‐severe psoriasis vulgaris. Methods Briefly, the study included a literature review, discussions with key opinion leaders, recruitment of additional dermatologists with experience in managing moderate‐to‐severe psoriasis, 3 eD elphi survey rounds and a patient focus group. Relevant topics were selected during discussions prior to the survey for the statements. Surveys were based on the eD elphi methodology for consensus‐building using a series of statements. Cons... Mehr ...

Verfasser: Grine, L.
de la Brassinne, M.
Ghislain, P.‐D.
Hillary, T.
Lambert, J.
Segaert, S.
Willaert, F.
Dokumenttyp: Artikel
Erscheinungsdatum: 2020
Reihe/Periodikum: Journal of the European Academy of Dermatology and Venereology ; volume 34, issue 4, page 676-684 ; ISSN 0926-9959 1468-3083
Verlag/Hrsg.: Wiley
Schlagwörter: Infectious Diseases / Dermatology
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-26498301
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1111/jdv.16104

Abstract Objective Treat‐to‐target (T2T) is an algorithm to reach a predefined outcome. Here, we define a T2T outcome for moderate‐to‐severe psoriasis vulgaris. Methods Briefly, the study included a literature review, discussions with key opinion leaders, recruitment of additional dermatologists with experience in managing moderate‐to‐severe psoriasis, 3 eD elphi survey rounds and a patient focus group. Relevant topics were selected during discussions prior to the survey for the statements. Surveys were based on the eD elphi methodology for consensus‐building using a series of statements. Consensus was defined as at least 80% of participants agreeing. A psoriasis patient focus group provided feedback on topic selection and outcome. Results A total of 5 discussions were held, and 3 eD elphi rounds were conducted with an average of 19 participants per round. The T2T outcome was set assuming shared decision between patient and dermatologist, awareness and referral for comorbidities by the dermatologist and appropriate treatment adherence by the patient. We defined ‘ideal’ and ‘acceptable’ targets; the latter referring to conditions restricting certain drugs. The T2T outcome was multidimensional, including ≥ Δ PASI 90/75 or PGA ≤ 1, itch VAS score ≤ 1, absence of disturbing lesions, DLQI ≤ 1/3, incapacity daily functioning VAS score ≤ 1, safety ≤ mild side‐effects and full/mild tolerability of treatment for the ideal and acceptable target, respectively. Finally, time to achieve the T2T outcome was set at 12 weeks after initiation for all treatments. At all times, safety should not exceed the presence of mild side‐effects. Conclusion With this novel T2T composite outcome for psoriasis, clinicians and patients can make shared decisions on the treatment goals they envisage, as a guidance for future treatment steps – leading to a tight control management of the disease.