Foley P

Gebauer K

Sullivan J

McMeniman E

Shumack S

Ng J

James A

Rawlin M

Sidhu S

Tilakaratne, Dev

Turner M

Radulski B

Nash P

Baker C

2023-07-28

BACKGROUND: Over the last decade, the treatment landscape for moderate-severe psoriasis has rapidly evolved. The Australasian College of Dermatologists sought to review and update previously published treatment goals for moderate-severe psoriasis. METHODS: A modified Delphi approach was used. Comprehensive literature review and guideline evaluation resulted in the development of statements and other questions to establish current clinical practices. Two rounds of anonymous voting were undertaken, with a collaborative meeting held in between to discuss areas of discordance. Overall, consensus was defined as achievement of ≥75% agreement in the range 7-9 on a 9-point scale (1 strongly disagree; 9 strongly agree). RESULTS: Consensus was achieved on 26/29 statements in round 1 and a further 20 statements in round 2. There was strong agreement to expanding the classification/definition of psoriasis severity by including a choice of metrics, incorporating quality of life measures, and widening the scope of high-impact sites. Consensus was also reached on revised treatment response criteria, which were then incorporated into a new treatment algorithm. There was discordance with the current requirement to undertake a trial with established systemic agents before accessing targeted therapy. CONCLUSION: The ability of new targeted treatment options to change the narrative in psoriasis patient care can only be properly realised if challenges to timely and equitable access are addressed. The proposed framework for the assessment, classification and management of moderate-severe psoriasis aligns with international recommendations. Its adoption into Australian clinical practice is hoped to improve treatment outcomes and patients' satisfaction with their care.

Skin Health Institute, Carlton, Victoria, Australia.

Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.

The University of Melbourne, Melbourne, Victoria, Australia.

Fremantle Dermatology, Fremantle, Western Australia, Australia.

The University of Western Australia, Nedlands, Western Australia, Australia.

Kareena Private Hospital, Ramsay Surgical Centre, Miranda, New South Wales, Australia.

Kingsway Dermatology & Aesthetics, Miranda, New South Wales, Australia.

Dermatology Research Centre, Princess Alexandra Hospital Southside Clinical Unit, University of Queensland, Brisbane, Queensland, Australia.

Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.

Department of Dermatology, Royal North Shore Hospital, Sydney, New South Wales, Australia.

Hobart Medical Specialists, Hobart, Tasmania, Australia.

General Practitioner, Lower Templestowe, Victoria, Australia.

Department of Dermatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Faculty of Health Sciences, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.

Department of Dermatology, Royal Darwin Hospital, Tiwi, Northwest Territories, Australia.

Darwin Dermatology, Tiwi, Northwest Territories, Australia.

Psoriasis Australia, Carlton, Victoria, Australia.

CNC Dermatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.

School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.

Department of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Rheumatology Research Unit, Sunshine Coast, Queensland, Australia.

Australas J Dermatol . 2023 Nov;64(4):476-487. doi: 10.1111/ajd.14138. Epub 2023 Jul 28.

0000-0001-5891-5607

0000-0002-8594-243X

0000-0002-1979-8978

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0000-0002-9121-7795

0009-0001-6070-7097

0000-0002-7822-1183

0000-0003-2128-2417

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0009-0006-5295-3585

0000-0002-2571-788X

0009-0003-0144-2927

https://pubmed.ncbi.nlm.nih.gov/37501636/?otool=iaurydwlib

https://hdl.handle.net/10137/12508

Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies - Adult patients.

Journal Article

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