Recategorization of Psoriasis Severity

The current clinical definitions of psoriasis severity are narrowly defined and overlook the unique challenges faced by each patient, which may include localized lesions in specific areas and/or comorbidities. A more specific clinical severity classification is needed and would guide clinical decision-making to be more practical, meaningful, and better aligned with the true severity of a patient’s disease; strengthen psoriasis treatment guidelines and guide future clinical trials of drugs targeting various severities of psoriasis.

In Phase I of the project, the Delphi method was used to come to consensus, among IPC’s network of key opinion leaders, on a definition for each category of disease severity. As the result of the reclassification Delphi, IPC recommends that patients be considered a candidate for topical-only therapy or a candidate for systemic therapy.

Patients that meet one or more of the following criteria are candidates for systemic therapy:

• Psoriasis lesions on 10% or more of 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.

In Phase II of the project, the working group is focusing on implementing studies that quantify the statement in real-world practice.  In addition, significant work is being done to educate clinicians and patients on the new classification. Future work in Phase II will focus on educating regulatory bodies and developing additional activities to educate clinicians and patients.