25th EADV Congress day 3 highlight: Clinical assessment of disease severity in psoriasis

25th EADV Congress day 3 highlight: Clinical assessment of disease severity in psoriasis


You know, one of the challenges in psoriasis
is translating efficacy data and the metrics we use to measure efficacy in the clinical
studies—for example, PASI scores—to the clinic, to the real world. PASI scores are not practical, so a long-standing
effort is to develop measurement tools that the average clinician in the community can
utilize and make those tools valid. For example, the body surface area measurements. That obviously can be done in a clinic. It alone might not be enough to depict true
severity; so some companies are working on a combination of the BSA (Body Surface Area)
and the Physician Global Assessment (the PGA): they actually multiply these numbers together. And some of the posters at this meeting [presentations]
are ascribing value to the composite score of BSA times PGA and examining how it relates
to the PASI score. And it’s encouraging to see that the BSA times
the PGA is an excellent surrogate metric for disease severity. Now, another approach that’s being taken is
just simply asking patients to get to a target level of disease: a target PASI score is now
being examined. For example, if you get people to a PASI score
of 3 or less, or even better 2 or less, you essentially get them to what’s equivalent
of a PASI 90 most of the time. So you would just need to measure their raw
disease severity, and the problem with this is no one wants to do a PASI score. So again, we’re probably going to have a treat-to-target
approach, but perhaps a more accessible metric would be better and that’s left to be determined.

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