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Basic Therapeutic Approach for Patients with Plaque Psoriasis: Korean Expert Consensus Using the Modified Delphi Method

김정은|김태균|백유상|김병수|정기현|최용범|최유성|이은소|Seong Jin Jo|The Korean Society for Psoriasis
대한피부과학회 (Korean Dermalogical Association)|2023.06|Annals of Dermatology|제35권 제3호|pp. 173-182|DOI https://doi.org/10.5021/ad.22.216

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키워드

KoreaTreatmentPsoriasisConsensusTherapeutics
주제분류피부과학

초록

Background: Currently, there is no consensus on the treatment of psoriasis in Korean pa- tients. Objective: This study aimed to establish a consensus on the basic therapeutic principles for Korean patients with plaque psoriasis. Methods: Using the modified Delphi method, a steering committee proposed 53 statements for the first Delphi round, which covered five subjects: (1) the goal of treatment and evalu- ation of disease severity, (2) topical therapy, (3) phototherapy, (4) conventional systemic therapy, and (5) biologic therapy. The panel of dermatologists scored the level of agreement for each statement on a ten-point scale with scores ranging from 1 (strongly disagree) to 10 (strongly agree). After discussing the results of the first round, the committee reformulated 41 statements. Finally, consensus was defined as more than 70% of the second round scores being ≥7. Results: The panel participants strongly agreed that the ideal treatment goals for Korean pa- tients with plaque psoriasis should include complete skin clearance and high dermatological quality of life. A strong consensus was also reached on the use of topical agents for psoriasis of any severity, the consideration of phototherapy before biologics therapy, the conventional systemic agents for moderate-to-severe psoriasis, and the recommendation of biologic for retractable psoriasis to conventional systemic therapy and phototherapy. Conclusion: This modified Delphi panel established an expert consensus on the therapeutic approach for Korean patients with plaque psoriasis. This consensus may improve the treat- ment outcomes for psoriasis in Korea.

Abstract

Background: Currently, there is no consensus on the treatment of psoriasis in Korean pa- tients. Objective: This study aimed to establish a consensus on the basic therapeutic principles for Korean patients with plaque psoriasis. Methods: Using the modified Delphi method, a steering committee proposed 53 statements for the first Delphi round, which covered five subjects: (1) the goal of treatment and evalu- ation of disease severity, (2) topical therapy, (3) phototherapy, (4) conventional systemic therapy, and (5) biologic therapy. The panel of dermatologists scored the level of agreement for each statement on a ten-point scale with scores ranging from 1 (strongly disagree) to 10 (strongly agree). After discussing the results of the first round, the committee reformulated 41 statements. Finally, consensus was defined as more than 70% of the second round scores being ≥7. Results: The panel participants strongly agreed that the ideal treatment goals for Korean pa- tients with plaque psoriasis should include complete skin clearance and high dermatological quality of life. A strong consensus was also reached on the use of topical agents for psoriasis of any severity, the consideration of phototherapy before biologics therapy, the conventional systemic agents for moderate-to-severe psoriasis, and the recommendation of biologic for retractable psoriasis to conventional systemic therapy and phototherapy. Conclusion: This modified Delphi panel established an expert consensus on the therapeutic approach for Korean patients with plaque psoriasis. This consensus may improve the treat- ment outcomes for psoriasis in Korea.

참고문헌 (45)

  1. Griffiths CEM, "A multidimensional assessment of the burden of psoriasis : results from a multinational dermatologist and patient survey", Br J Dermatol, 179, pp.173~181 (2018)
  2. 한별, "한국인 건선 환자의 경제적 비용 부담", 대한피부과학회지, 59(5), pp.321~331 (2021), 대한피부과학회
  3. Nestle FO, "Psoriasis", N Engl J Med, 361, pp.496~509 (2009)
  4. Patrick MT, "Shared genetic risk factors and causal association between psoriasis and coronary artery disease", Nat Commun, 13, pp.6565~ (2022)
  5. 조수익, "Association of Metabolic Comorbidities with Pediatric Psoriasis: A Systematic Review and Meta-Analysis", Annals of Dermatology, 33(3), pp.203~213 (2021), 대한피부과학회[DOI]
  6. Jo SJ, "Calcipotriol", betamethasone aerosol foam(Enstilum)for the topical treatment of psoriasis vulgaris in routine practice in Korea : a prospective, noninterventional, multicenter study of treatment outcomes and patient satisfaction, 2022, pp.49, 1085~1095
  7. 권수현, "Secukinumab Response in Korean Patients with Moderate to Severe Plaque-Type Psoriasis Irrespective of Previous Biologic Use: 1-Year Experience at a Single Center", Annals of Dermatology, 32(3), pp.255~257 (2020), 대한피부과학회[DOI]
  8. 최성준, "Association Between Short-Term PASI90 Achievement and Drug Survival of Biologics in Patients with Psoriasis", Annals of Dermatology, 34(3), pp.173~181 (2022), 대한피부과학회[DOI]
  9. 손상욱, "Differences in Clinical Responses to Ustekinumab Treatment among Body Regions: Results from a Real-World Prospective, Observational, and Multi-Center Study in Korea", Annals of Dermatology, 34(1), pp.14~21 (2022), 대한피부과학회[DOI]
  10. Youn SW, "Efficacy and safety of guselkumab compared with placebo and adalimumab in Korean patients with moderate-to-severe psoriasis : posthoc analysis from the phase III, double-blind, placebo-and activecomparator-controlled VOYAGE 1", 2 trials, 2022, pp.33, 535~541
  11. 김정은, "2019 Consensus Korean Diagnostic Guidelines to Define Severity Classification and Treatment Refractoriness for Atopic Dermatitis: Objective and Subjective Assessment of Severity", Annals of Dermatology, 31(6), pp.654~661 (2019), 대한피부과학회[DOI]
  12. Elmets CA, "Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures", J Am Acad Dermatol, 84, pp.432~470 (2021)
  13. Menter A, "Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies", J Am Acad Dermatol, 82, pp.1445~1486 (2020)
  14. Nast A, "EuroGuiDerm guideline on the systemic treatment of psoriasis vulgaris-part 1 : treatment and monitoring recommendations", J Eur Acad Dermatol Venereol, 34, pp.2461~2498 (2020)
  15. Amatore F, "French guidelines on the use of systemic treatments for moderateto-severe psoriasis in adults", Ann Dermatol Venereol, 146, pp.429~439 (2019)
  16. Hart T, "Defining the treatment targets and active ingredients of rehabilitation : implications for rehabilitation psychology", Rehabil Psychol, 60, pp.126~135 (2015)
  17. Puzenat E, "What are the best outcome measures for assessing plaque psoriasis severity? A systematic review of the literature", J Eur Acad Dermatol Venereol, 24(Suppl 2), pp.10~16 (2010)
  18. Chalmers RJ, "Assessing psoriasis severity and outcomes for clinical trials and routine clinical practice", Dermatol Clin, 33, pp.57~71 (2015)
  19. Papp KA, "Psoriasis prevalence and severity by expert elicitation", Dermatol Ther(Heidelb), 11, pp.1053~1064 (2021)
  20. Zschocke I, "Non-adherence and measures to improve adherence in the topical treatment of psoriasis", J Eur Acad Dermatol Venereol, 28(Suppl 2), pp.4~9 (2014)
  21. Pariser DM, "National Psoriasis Foundation clinical consensus on disease severity", Arch Dermatol, 143, pp.239~242 (2007)
  22. Imafuku S, "Asian consensus on assessment and management of mild to moderate plaque psoriasis with topical therapy", J Dermatol, 45, pp.805~811 (2018)
  23. Lebwohl M, "Tacrolimus ointment is effective for facial and intertriginous psoriasis", J Am Acad Dermatol, 51, pp.723~730 (2004)
  24. Ito K, "Proactive treatment with calcipotriol reduces recurrence of plaque psoriasis", J Dermatol, 43, pp.402~405 (2016)
  25. Elmets CA, "Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy", J Am Acad Dermatol, 81, pp.775~804 (2019)
  26. Torres AE, "Role of phototherapy in the era of biologics", J Am Acad Dermatol, 84, pp.479~485 (2021)
  27. Strober B, "Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council", J Am Acad Dermatol, 82, pp.117~122 (2020)
  28. Kingsley GH, "A randomized placebo-controlled trial of methotrexate in psoriatic arthritis", Rheumatology(Oxford), 51, pp.1368~1377 (2012)
  29. Coates LC, "Methotrexate efficacy in the tight control in psoriatic arthritis study", J Rheumatol, 43, pp.356~361 (2016)
  30. Cline A, "Does daily folic acid supplementation reduce methotrexate efficacy?", Dermatol Online J, 23, pp.13030~ (2017)
  31. Chládek J, "The effect of folic acid supplementation on the pharmacokinetics and pharmacodynamics of oral methotrexate during the remission-induction period of treatment for moderate-to-severe plaque psoriasis", Eur J Clin Pharmacol, 64, pp.347~355 (2008)
  32. Kolios AG, "Swiss S1 guidelines on the systemic treatment of psoriasis vulgaris", Dermatology, 232, pp.385~406 (2016)
  33. Menter A, "Guidelines of care for the management of psoriasis and psoriatic arthritis : Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics", J Am Acad Dermatol, 58, pp.826~850 (2008)
  34. Smith CH, "British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020: a rapid update", Br J Dermatol, 183, pp.628~637 (2020)
  35. Smith CH, "British Association of Dermatologists guidelines for biologic therapy for psoriasis 2017", Br J Dermatol, 177, pp.628~636 (2017)
  36. Menter A, "Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics", J Am Acad Dermatol, 80, pp.1029~1072 (2019)
  37. Nast A, "German S3-guideline on the treatment of psoriasis vulgaris, adapted from EuroGuiDerm-part 1 : treatment goals and treatment recommendations", J Dtsch Dermatol Ges, 19, pp.934~150 (2021)
  38. Nast A, "German S3-guideline on the treatment of psoriasis vulgaris, adapted from EuroGuiDerm-part 2 : treatment monitoring and specific clinical or comorbid situations", J Dtsch Dermatol Ges, 19, pp.1092~1115 (2021)
  39. Poelman SM, "Practical guidelines for managing patients with psoriasis on biologics : an update", J Cutan Med Surg, 23(1 Suppl), pp.3~ (2019)
  40. Mrowietz U, "Strategies for improving the quality of care in psoriasis with the use of treatment goals--a report on an implementation meeting", J Eur Acad Dermatol Venereol, 25(Suppl 3), pp.1~13 (2011)
  41. Mrowietz U, "A consensus report on appropriate treatment optimization and transitioning in the management of moderate-to-severe plaque psoriasis", J Eur Acad Dermatol Venereol, 28, pp.438~453 (2014)
  42. Rajagopalan M, "Systemic management of psoriasis patients in Indian scenario : an expert consensus", Indian Dermatol Online J, 12, pp.674~682 (2021)
  43. Baker C, "Treatment goals for moderate to severe psoriasis : an Australian consensus", Australas J Dermatol, 54, pp.148~154 (2013)
  44. Daudén E, "Consensus document on the evaluation and treatment of moderate-to-severe psoriasis: Psoriasis Group of the Spanish Academy of Dermatology and Venereology", J Eur Acad Dermatol Venereol, 30(Suppl 2), pp.1~18 (2016)
  45. Okubo Y, "Comparison of treatment goals between users of biological and nonbiological therapies for treatment of psoriasis in Japan", J Clin Med, 10, pp.5732~ (2021)

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