title: From the Medical Board of the National Psoriasis Foundation: Treatment targets for plaque psoriasis.
abstract: BACKGROUND
  An urgent need exists in the United States to establish treatment goals in psoriasis.
  
  
  OBJECTIVE
  We aim to establish defined treatment targets toward which clinicians and patients with psoriasis can strive to inform treatment decisions, reduce disease burden, and improve outcomes in practice.
  
  
  METHODS
  The National Psoriasis Foundation conducted a consensus-building study among psoriasis experts using the Delphi method. The process consisted of: (1) literature review, (2) pre-Delphi question selection and input from general dermatologists and patients, and (3) 4 Delphi rounds.
  
  
  RESULTS
  A total of 25 psoriasis experts participated in the Delphi process. The most preferred instrument was body surface area (BSA). The most preferred time for evaluating patient response after starting new therapies was at 3 months. The acceptable response at 3 months postinitiation was either BSA 3% or less or BSA improvement 75% or more from baseline. The target response at 3 months postinitiation was BSA 1% or less. During the maintenance period, evaluation every 6 months was most preferred. The target response at every 6 months maintenance evaluation is BSA 1% or less.
  
  
  CONCLUSIONS
  Although BSA is feasible in practice, it does not encompass health-related quality of life, costs, and risks of side effects.
  
  
  CONCLUSIONS
  With defined treatment targets, clinicians and patients can regularly evaluate treatment responses and perform benefit-risk assessments of therapeutic options individualized to the patient.
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: aprilarmstrong@post.harvard.edu.
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
authors.affiliation: National Psoriasis Foundation, Portland, Oregon.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Siegel
authors.affiliation: Windsor Dermatology, East Windsor, New Jersey; University Medical Center of Princeton at Plainsboro, Plainsboro, New Jersey.
authors.forename: Jerry
authors.initials: J
authors.lastname: Bagel
authors.affiliation: Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Boh
authors.affiliation: National Psoriasis Foundation, Portland, Oregon.
authors.forename: Megan
authors.initials: M
authors.lastname: Buell
authors.affiliation: University Hospitals Case Medical Center, Cleveland, Ohio.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Cooper
authors.affiliation: University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Kristina
authors.initials: K
authors.lastname: Callis Duffin
authors.affiliation: University of California, San Diego School of Medicine, La Jolla, California.
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Eichenfield
authors.affiliation: Northwell Health and Hofstra North Shore University Hospital, Long Island Jewish Medical Center School of Medicine, Manhasset, New York.
authors.forename: Amit
authors.initials: A
authors.lastname: Garg
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gelfand
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Alice B
authors.initials: AB
authors.lastname: Gottlieb
authors.affiliation: University of California San Francisco Medical Center, San Francisco, California.
authors.forename: John Y M
authors.initials: JY
authors.lastname: Koo
authors.affiliation: University Hospitals Case Medical Center, Cleveland, Ohio.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Korman
authors.affiliation: University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Gerald G
authors.initials: GG
authors.lastname: Krueger
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Lebwohl
authors.affiliation: St Louis University Medical School, St Louis, Missouri.
authors.forename: Craig L
authors.initials: CL
authors.lastname: Leonardi
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Mandelin
authors.affiliation: Baylor University Medical Center and Texas A&M Health Science Center, Dallas, Texas.
authors.forename: M Alan
authors.initials: MA
authors.lastname: Menter
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Merola
authors.affiliation: Eastern Virginia Medical School, Norfolk, Virginia; Virginia Clinical Research Inc, Norfolk, Virginia.
authors.forename: David M
authors.initials: DM
authors.lastname: Pariser
authors.affiliation: George Washington University, Washington, District of Columbia.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Prussick
authors.affiliation: Baylor University Medical Center and Texas A&M Health Science Center, Dallas, Texas.
authors.forename: Caitriona
authors.initials: C
authors.lastname: Ryan
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Kara N
authors.initials: KN
authors.lastname: Shah
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Weinberg
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: MaryJane O U
authors.initials: MO
authors.lastname: Williams
authors.affiliation: Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
authors.forename: Jashin J
authors.initials: JJ
authors.lastname: Wu
authors.affiliation: Division of Dermatology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Yamauchi
authors.affiliation: Eastern Virginia Medical School, Norfolk, Virginia.
authors.forename: Abby S
authors.initials: AS
authors.lastname: Van Voorhees
mesh_terms: D001830:Body Surface Area; D005582:Foundations; D006801:Humans; D010347:Patient Care Planning; D017410:Practice Guidelines as Topic; D011565:Psoriasis / Q000628:therapy*; D013044:Specialty Boards; D014481:United States
keywords: Physician Global Assessment; biologics; body surface area; outcome measures; psoriasis; systemic therapies; treat to target; treatment; treatment goals