Remission Possible

Now, NPF is gathering input from the NPF Scientific Advisory Committee and Medical Board, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), International Dermatology Outcome Measures (IDEOM), and the Psoriasis & Psoriatic Arthritis Clinics Multicenter Advancement Network (PPACMAN). Using a methodology called a Delphi consensus, which also was used to generate the NPF COVID-19 guidelines, the project will result in a definition for psoriasis remission that is agreed upon by the majority of stakeholders.

With so many cooks in the kitchen, it is important to remember whom this project ultimately aims to benefit. “It’s hugely important for work like this to be driven by the patient advocacy organization because that really means that our focus is what’s best for the patient,” says George Gondo, associate director of research for NPF.

What’s in a Name?

After a consensus is reached, and the resulting definition of psoriasis remission is published, the real work begins. “We’ll start educating health care providers on what this definition of remission is, what it means for them and their practice, how they can incorporate it in their practice and talk with their patients about it,” says Gondo.

Since 2016, NPF has recommended a treat-to-target approach where an “acceptable response” to treatment results in psoriasis covering 3% or less BSA after three months. [3] With the new definition, remission will be the recommended target, says Gondo.

The goal is for clinical trials and patient registries to utilize these new recommendations, updating what success means across treatment options. Gondo explains that this could impact which treatments are prescribed by health care providers and possibly even the level of coverage by insurers.

“So that’s where the impact actually happens. We’re just trying to gather the evidence to allow us to have that greater impact,” says Gondo.

For those living with psoriasis, it means that at each step along the way, every person involved in creating your treatment, paying for your treatment, and prescribing your treatment is aiming to achieve remission – and this means better health outcomes.

Although all of the work so far has focused on psoriasis, the same process will be followed for PsA. “This is not the end,” says Gondo. “It’s actually the beginning.”

First Remission and Then a Cure?

“Although a psoriatic disease ‘cure’ has not been formally defined yet, most patients and providers I have talked with feel that a cure is a permanent, lifelong state of being free of a disease that does not require any ongoing treatment,” says Dr. Liao.

Without an agreed-upon definition of the goal, however, it is more difficult to know when it has been achieved. The strategy and process of defining remission for psoriatic disease will act as a framework for defining a cure, Gondo says.

In the past it may have seemed impossible, but today we get closer to a cure with each new discovery. “I am grateful that the National Psoriasis Foundation is committed to a cure, and I believe we will get there one day,” says Dr. Liao.