Global Delphi consensus on treatment goals for generalized pustular psoriasis
Barker, Jonathan (King's College London)
Casanova, E.
Choon, Siew Eng (Monash University)
Foley, Peter (St Vincent's Hospital Melbourne)
Fujita, H. (Nihon University School of Medicine)
Gonzalez, C. (Clinica Universitaria Colombia)
Gooderham, Melinda (Queen's University)
Marrakchi, S. (Hedi Chaker University Hospital)
Puig Sanz, Lluís (Institut de Recerca Sant Pau)
Romiti, Ricardo (University of São Paulo)
Thaçi, Diamant (University of Lübeck)
Zheng, M. (Zhejiang University)
Strober, Bruce (Yale University)
Bhutani, T. (University of California)
Magariños, G. (University of Salvador)
Reich, Adam (University of Rzeszów)
Nakano, J. (Santa Casa de São Paulo)
Gao, X. (China Medical University)
Zhang, F. (Shandong Academy of Medical Science)
El Sayed, Mahira Hamdy (Ain Shams University (El Caire, Egipte))
Welzel, J. (Augsburg University Hospital)
Gisondi, Paolo (University of Verona)
Yaacob, Y.B.C.
Prignano, F. (Università degli Studi di Firenze)
Tada, Yayoi (Teikyo University School of Medicine)
Jo, S.J. (Seoul National University College of Medicine)
van der Kerkhof, P. (Radboud University)
Rivera, Raquel (Complutense University of Madrid)
Schmitt-Egenolf, M. (Umeå University)
Tsai, T. F. (National Taiwan University Hospital)
Baskan, E.B. (Bursa Uludag University)
Burden, D. (University of Glasgow)
Mostaghimi, A. (Harvard Medical School)
Reisner, D.
Eyerich, K. (Technical University of Munich)
Stratigos, A. (Andreas Syggros Hospital)
Pavlovsky, L. (Rabin Medical Center (Petah-Tikva, Israel))
Quintero, D.G.V. (Center for the Care of Inflammatory Diseases)
Imafuku, S. (Fukuoka University)
Becker, J. (University of Ottawa)
Affandi, A. (Hospital Kuala Lumpur)
Cortés, C. (Centro Medico Dali)
Carrascosa, José Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Wiseman, M. (University of Manitoba)
Viguier, M.A. (Hôpital Robert Debré)
Universitat Autònoma de Barcelona

Data:	2025
Resum:	Background: Generalized pustular psoriasis (GPP) is a chronic, systemic, neutrophilic inflammatory disease. A previous Delphi panel established areas of consensus on GPP, although patient perspectives were not included and aspects of treatment goals remained unclear. Objectives: To identify and achieve consensus on refined, specific treatment goals for GPP treatment via a Delphi panel with patient participation. Methods: Statements were generated based on a systematic literature review and revised by a Steering Committee. Statements were categorized into overarching principles, and short- and long-term treatment goals. A global panel of 30 dermatologists and 3 patient representatives voted in agreement or disagreement with each statement. Consensus was defined as ≥ 80% approval by the panellists. Results: Consensus was reached in the first round of voting and ≥ 90% agreement was reached for 23 of 26 statements. In summary, GPP requires a timely, tailored treatment plan, co-developed by patients and physicians, that involves a multidisciplinary approach and addresses the complexity, heterogeneity and chronicity of the disease. Short-term treatment goals should include pustule clearance within 7 days and prevention of pustule recurrence, reduction of cutaneous symptom burden (-4 or more points on the Itch and Skin Pain Numeric Rating Scale), improvement in systemic symptoms (e. g. resolution of fever within 3 days of treatment initiation and reduced fatigue), prevention of life-threatening complications and progressive improvement of inflammatory biomarkers. In patients with comorbid psoriatic diseases, treatment decisions should prioritize GPP. Long-term treatment goals should include minimizing disease activity through flare prevention and symptom control between flares, sustained disease control, management of comorbidities and improvement in quality of life (QoL). Small differences in perception between patients and physicians regarding the importance of certain treatment goals (e. g. avoiding hair and/or nail loss to improve QoL), reflect the complexity of assessing treatment goals and emphasize the need for a patient-centred approach. Conclusions: In the first global Delphi panel in GPP to include patient perspectives, consensus between dermatologists and patients was achieved on overarching principles of treatment, and short- and long-term treatment goals for GPP. These findings provide valuable insights for developing guidelines that consider the perspectives of patients and physicians in the treatment of GPP.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Consensus ; Delphi Technique ; Dermatologic Agents ; Humans ; Patient Care Planning ; Patient Participation ; Psoriasis ; Quality of Life
Publicat a:	British journal of dermatology, Vol. 192 Núm. 4 (january 2025) , p. 706-716, ISSN 1365-2133

DOI: 10.1093/bjd/ljae491
PMID: 39844356

11 p, 1000.1 KB

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