A series of critically challenging case scenarios in moderate to severe psoriasis: a Delphi consensus approach.
Clinical trials for systemic psoriasis therapy typically enroll healthy patients and exclude patients with cardiovascular disease, latent tuberculosis, liver disease, histories of malignancies, viral infections, children, and pregnant or breast-feeding women. Physicians often require guidance for optimum management of severe psoriasis in patients that have a combination of underlying disease states. To provide treatment recommendations for complex psoriasis scenarios, a consensus panel comprising 15 experts in psoriatic disease convened to review and discuss available evidence-based data and to arrive at a consensus for treatment options of difficult cases. An application of the Delphi Method was used to select case scenarios, provide medical treatment options, present the case study with existing medical evidence, and anonymously vote on treatment options. The top 10 treatment options were ranked and statistically analyzed to compare the differences between treatments. The final rankings and analysis provide guidance for practical, safe, and efficacious treatment options in a number of complex psoriasis scenarios.
Strober
Bruce
B
Department of Dermatology, New York University Medical Center, New York, NY, USA. b_strober@hotmail.com
Berger
Emily
E
Cather
Jennifer
J
Cohen
David
D
Crowley
Jeffrey J
JJ
Gordon
Kenneth B
KB
Gottlieb
Alice
A
Horn
Elizabeth J
EJ
Kavanaugh
Arthur F
AF
Korman
Neal J
NJ
Krueger
Gerald G
GG
Leonardi
Craig L
CL
Menter
Alan
A
Schwartzman
Sergio
S
Sobell
Jeffrey M
JM
Young
Melodie
M
D002648:Child; D015897:Comorbidity; D003697:Delphi Technique; D015658:HIV Infections / Q000150:complications; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy / Q000628:therapy*