Disease severity criteria can significantly impact a psoriasis patient’s eligibility for treatment. While their disease may profoundly affect their quality of life, the current clinical definition of psoriasis severity is narrow. It does not account for the many potential challenges the disease may cause in a patient’s life.
In 2019, IPC began a project to redefine the criteria used for assessing disease severity that would better guide clinical decision-making to be more meaningful, practical, and better aligned with the actual severity of a patient’s disease. IPC is also working to strengthen psoriasis treatment guidelines and guide future clinical trials of drugs targeting various severities of psoriasis.
Reclassification would allow for more specific clinical severity criteria that can guide clinical decision-making to be more practical, meaningful, and better aligned with the severity of a patient’s disease.
PUBLICATIONS AND RESEARCH
International Psoriasis Councils’ Psoriasis Severity Reclassification Project aims to change the classification of psoriasis severity. IPC’s network of key opinion leaders agreed on a definition for each category of disease severity.
The IPC Disease Severity Working Group concluded that the objective measures of two commonly used clinical tools to determine psoriasis severity may not fully capture the impact of the disease on the individual in a new review published in the Journal of The Academy of Dermatology and Venerology (JEADV).
In moderate to severe psoriasis, there has been a long-lasting tradition to define outcome as a relative change from baseline PASI, with the classical PASI 75 being more recently replaced by PASI 90 or 100. However, this concept is dated, mainly due to the impressive development of anti-interleukin therapies and an increasing interest in real-world evidence.
Below are resources from other organizations that support IPC’s recategorization of psoriasis severity.
Evolution of Patient Perceptions of Psoriatic Disease: Results from the Understanding Psoriatic Disease Leveraging Insights for Treatment (UPLIFT) Survey.
Lebwohl M, Langley RG, Paul C, Puíg L, Reich K, van de Kerkhof P, Wu HL, Richter S, Jardon S, Gisondi P.Dermatol Ther (Heidelb). 2022 Jan;12(1):61-78. doi: 10.1007/s13555-021-00635-4. Epub 2021 Oct 25.PMID: 34704231
The proportion of patients with at least a moderate effect of psoriasis on quality of life was greater among patients with involvement in at least one special area versus no special area involvement. In this international population study, the impact of the various special areas on quality of life is reported.
Impact of Psoriatic Disease on Quality of Life: Interim Results of a Global Survey
April Armstrong 1, Barbra Bohannan 2, Sicily Mburu 3, Ivette Alarcon 4, Torben Kasparek 4, Jihen Toumi 5, Susan Frade 4, Silvia Fernandez Barrio 6, Matthias Augustin 7 Dermatol Ther (Heidelb). 2022 Apr;12(4):1055-1064. doi: 10.1007/s13555-022-00695-0.Epub 2022 Mar 14.
The IPC disease severity recategorization is not a data-driven but a practice-driven categorization. To a large extent, psoriasis is a systemic disease that requires dermatologists to look more than skin deep. As systemic treatment for psoriasis may be indicated in patients with mild skin involvement suffering from systemic comorbidity, the holistic approach in the IPC definition is crucial.
VIDEOS AND PODCASTS