To the benefit of millions of people living with uncontrolled psoriasis worldwide, a global consortium of more than 100 physician leaders in dermatology led by the International Psoriasis Council (IPC) has developed a simplified method used to classify psoriasis severity and determine the appropriate course of treatment.
Psoriasis – a serious, inflammatory disease that appears on the skin – affects about 125 million people worldwide. Common symptoms of psoriasis include intense itch, pain and scaly skin lesions that crack and bleed. In addition, psoriasis brings related health issues such as psoriatic arthritis, depression, obesity and heart disease. In the U.S. alone, more than 50 percent of people with moderate to severe psoriasis are un- or undertreated, according to the National Psoriasis Foundation.
Bruce Strober, MD, PhD, assistant clinical professor at Yale University, head of Central Connecticut Dermatology Research and secretary-treasurer of the IPC Board of Directors, is the lead author on a consensus paper published recently in the Journal of the American Academy of Dermatology, which details the re-categorization of psoriasis severity initiative. “There’s a lot of unnecessary suffering among psoriasis patients due to ‘under-classifying’ the severity of the disease. This new approach to assess psoriasis severity developed by an IPC-led Delphi exercise aims to help providers everywhere start their patients on the appropriate treatment, and sooner,” said Dr. Strober.
Previous methods of determining psoriasis severity and subsequent treatment focused on identifying patients as mild, moderate or severe, depending on the percentage of body surface area (BSA) with active psoriasis or by using the Psoriasis Area Severity Index (PASI), which measures the body area of the disease and intensity of scaling, redness and induration. These approaches do not readily take into account the impact of psoriasis on special areas of the body such as face, nails, scalp, hands/feet and genitals, nor does it consider how patients have responded to topical therapies. As a result, people with psoriasis – especially those with certain mild to moderate (lower severity) forms of the condition – are denied access to critical systemic treatments to control symptoms.
The International Psoriasis Council method of assessing psoriasis severity is a treatment-first approach that significantly simplifies the process of getting psoriasis patients on the right medication for their disease level. Rejecting the mild, moderate and severe labels used to categorize psoriasis severity, the IPC method calls for classifying patients as candidates either for topical therapy or systemic therapy. To qualify for systemic therapy, patients must meet one or more of the following criteria:
Psoriasis lesions on 10% or more of their body surface; OR
Psoriasis lesions on sensitive areas of the body (i.e., hands/feet, face, genitals, scalp); OR
Topical therapy failed to control symptoms.
“So far patients with less involvement than PASI 10 or BSA 10 were not eligible for a treatment with a biologic in many countries, although they may suffer quite a bit from their disease. This new approach to classifying psoriasis severity furthers IPC’s work to help improve the health of psoriasis patients around the world,” said Peter van de Kerkhof, MD, PhD, chief medical officer of International Psoriasis Council.
From this consensus paper, IPC intends to work with health insurance entities, health care providers and with stakeholders involved in the drug development process to integrate this new method of assessing psoriasis severity into standards of care for psoriasis with the ultimate aim to increase access to care for patients worldwide.
About International Psoriasis Council
International Psoriasis Council (IPC) is a dermatology-led, voluntary, global, nonprofit organization with a network of more than 100 psoriasis experts, thought leaders, and professionals, dedicated to improving the health of people with psoriasis. IPC helps psoriasis patients get better care and treatment by conducting research into the disease and providing health care professionals with resources and education to best manage their psoriasis patients.