Definitions of Remission in Psoriasis: A Systematic Literature Review from the National Psoriasis Foundation

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• This systematic literature review seeks to compare the varied definitions of remission used in studies on psoriasis. There are different definitions, with some relying on the Psoriasis Area and Severity Index (PASI) measures or body surface area (BSA) percentages. There is much variation in criteria, for example, different studies use PASI75, PASI90, or PASI100 as a definition of remission.

• This study will aid the National Psoriasis Foundation in developing a consensus-based definition of psoriasis remission and cure.

–  Joshua R. Ortego, MD

Abstract 

Psoriasis studies increasingly employ outcomes that indicate complete disease resolution, yet remission and cure are poorly defined for psoriasis. We conducted a systematic literature review to identify definitions of psoriasis remission and cure reported in the literature. Medline, EMBASE, and The Cochrane Central Register of Controlled Trials databases were searched on July 22, 2020 for full-text studies providing definitions for psoriasis remission/cure. Definitions were analyzed descriptively for endpoint, time-frame, on/off treatment, patient-reported outcomes, and disease domains. We identified 106 studies that provided 41 unique remission definitions. Most definitions included endpoints based on Psoriasis Area and Severity Index (PASI), such as PASI75 (n=16 studies), PASI90 (n=10), PASI100 (n=10), and PASI of 0 (n=3), and descriptive endpoints related to 'skin clearance' (n=18). Few definitions specified time-frame, on/off treatment or other psoriasis-related disease domains. One small consensus-initiative defined drug-free remission for plaque psoriasis by BSA of 0 without any therapy for at least 12 months. While there is no cure for psoriasis, seven studies defined psoriasis cure using similar endpoints to those used to define remission. We identified a variety of definitions of psoriasis remission. These results will inform the development of consensus-based definitions for psoriasis remission to support efforts to improve research and clinical outcomes.

Journal of the European Academy of Dermatology and Venereology: JEADV

Definitions of Remission in Psoriasis: A Systematic Literature Review from the National Psoriasis Foundation

J Eur Acad Dermatol Venereol 2022 Aug 04;[EPub Ahead of Print], D Balak, LM Perez-Chada, LN Guo, C Mita, AW Armstrong, SJ Bell, GC Gondo, W Liao, JF Merola 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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