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Decision points for the initiation of systemic treatment for psoriasis - 21/08/11

Doi : 10.1016/j.jaad.2005.03.050 
Steven R. Feldman, MD, PhD a, ⁎ , John Y.M. Koo, MD b, Alan Menter, MD c, Jerry Bagel, MD d
a From the Department of Dermatology, Wake Forest University School of Medicine 
b Department of Dermatology, University of California–San Francisco 
c Texas Dermatology Associates, Dallas 
d Psoriasis Treatment Center of Central New Jersey, East Windsor 

Correspondence to: Steven Feldman, MD, PhD, Department of Dermatology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157-1071.

Winston-Salem, North Carolina; San Francisco, California; Dallas, Texas; and East Windsor, New Jersey

Abstract

Psoriasis has a tremendous effect on health-related quality of life. Phototherapy and systemic treatments are used for patients with more debilitating (physically and emotionally) forms of the disease. These treatments can be extremely effective but can also have potentially significant adverse effects. The decision to undertake systemic treatment of psoriasis is a complex one that requires both experience and judgment. With the recent advent of new biologic systemic drugs for moderate to severe psoriasis, the need to clarify patient candidates for systemic therapy has become very important. Here, we present a diagnostic algorithm and a formal measure, the Koo–Menter Psoriasis Instrument (KMPI), to aid in identifying patients that would benefit from systemic therapy. In addition, the KMPI can be used to document and justify treatment decisions for health care payers. While the decision to undertake systemic treatment and the choice of specific treatment plan must ultimately be made mutually by the patient and physician, these tools are designed to provide information that will be valuable in these determinations.

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 Funding sources: None.
Disclosure: Dr Feldman has received grant and other support from Biogen, Amgen, Genentech, Roche, and Centocor. Dr Koo has received grant or other support from Allergan, Amgen, Biogen, Centocor, Fujisawa, Genentech, ICN, Novartis, and Roche. Dr Menter has received grant or other support from Abbott, Allergan, Amgen, Biogen, Centocor, Genentech, Novartis, Serona, and Xoma. Dr Bagel has received educational grants from Amgen, Biogen, Genentech and Novartis, and has been a speaker supported by Biogen.
Presented as a poster at the 2003 International Psoriasis Symposium, June 18/22, 2003, New York, NY, and at the 2003 Summer Meeting of the American Academy of Dermatology, July 25-29, 2003, Chicago, Ill.
This manuscript was reviewed by the Medical Board of the National Psoriasis Foundation and was endorsed by a majority vote.
Reprints not available from the authors.


© 2005  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 53 - N° 1

P. 101-107 - luglio 2005 Ritorno al numero
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