The National Psoriasis Foundation Psoriasis Treatment Targets in Real World Patients: Prevalence and Association with Patient Reported Outcomes in the Corrona Psoriasis Registry
2020
INTRODUCTION: The National Psoriasis Foundation (NPF) published treat-to-target guidelines for psoriasis, yet their applicability in clinical practice remains unknown. OBJECTIVES: To estimate the proportion of psoriasis patients meeting the NPF's body surface area (BSA) 'target' (=1%) and 'acceptable' (=3%) response criteria and the cross-sectional associations of these criteria with patient-reported outcomes (PROs) in the Corrona Psoriasis Registry. METHODS: Separately for three independent cross-sectional cohorts of patients at the 1) enrollment, 2) 6-month and 3) 12-months visits, we calculated the proportion of patients with BSA=1% and =3%. Furthermore, we calculated odds ratios estimating the risk of PROs associated with not meeting criteria in the 6-month cohort. RESULTS: The enrollment, 6- and 12-month cohorts included 2,794, 1,310 and 629 patients, respectively. At enrollment, 24% of patients had a BSA=1% and 41% a BSA=3%. In the 6-month cohort, 43%/64% had BSA=1%/BSA=3%. In the 12-month cohort 46%/69% of patients BSA=1%/BSA=3%. Patients not at target/acceptable criteria had higher odds for worse quality of life compared to those who were. CONCLUSION: While most patients at 6 and 12-month visits were at the 'acceptable' response, less than half were at the 'target' response despite systemic therapy. There remain unmet needs to optimize psoriasis therapy and further validate current treat-to-target guidelines.
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