Treat to Target

When you start a new psoriasis treatment, it can be tough to know what to expect. And you may have questions, such as:

  • “How long before it starts to work?”
  • “How much improvement can I hope to see?”
  • “At what point should I try something different?”

To help answer these questions, NPF has issued a clear set of treatment targets for everyone with psoriasis and their health care providers. These targets were published in November 2016 by the Journal of the American Academy of Dermatology. If you’ve ever wondered how to talk to your health care provider about your treatment goals, these targets are the perfect conversation starter.

The idea behind the treatment targets is to get your psoriasis down to 1 percent of your body surface area (BSA) or less by the time you’ve been on a treatment for three months. The entire hand (the palm, fingers and thumb) is equal to about 1 percent of your body surface area. Once you’ve reached that 1 percent goal, you should check in with your health care provider every six months to make sure you’re still experiencing the same amount of improvement.

If you don’t meet the target after three months of treatment, a discussion with your health care provider is the key next step. (In addition to the treatment target, the recommendations also offer what can be considered an “acceptable response” after three months: either your psoriasis only covers 3 percent or less of your body, or you’ve experienced 75 percent improvement.)

If after three months you’re experiencing some improvement, one option is to wait and see. If you’re meeting the acceptable response, you may want to stay on your treatment for another three months to see if you can hit the treatment target.

If you don’t meet the target after six months — or if you’re not seeing an acceptable response after three months — talk to your health care provider about other options. Changing the dose, adding a new treatment to the one you’re already on or switching to a different treatment are all possibilities. There are more therapies available for psoriasis than ever before. It may take time to find the one that works for you, so keep working with your health care provider until you meet your treatment goal.

Remember, getting clear skin is a goal worth working toward! Improving your psoriasis can improve your overall health. Research tells us that psoriasis is associated with other diseases, such as diabetes and cardiovascular disease, and that reducing your psoriasis can reduce your risk for these conditions. Let these targets guide you on your path to clear skin.

FAQ for Patients

How long do I have to wait before my skin starts to improve?

In general, you should see a dramatic improvement after you’ve been on a treatment for six months. According to the targets, you should expect to see at least 75 percent improvement after three months. By the time six months have passed, you should expect to have clear or almost clear skin. If not, talk to your health care provider about your treatment options.

I don’t have clear skin yet, but my skin is getting better. Can I stick with my current treatment and see what happens?

In addition to the ultimate treatment target of 1 percent coverage or less, the targets also specify an acceptable response. That’s when your psoriasis covers 3 percent of your body or less. If you’re in the acceptable range after three months, you may want to take the wait-and-see approach. But if you’ve been on your treatment for six months and you haven’t hit your target — having clear or almost clear skin — it’s time to discuss your treatment options with your health care provider.

I’ve been on the same treatment for months, but I’m not seeing any improvement. How can I get better results?

Talk to your health care provider. Some treatment options you and your health care provider can consider are changing your treatment dose, adding a new treatment, or switching to a different treatment. Remember, after you’ve been on your treatment for six months, you should expect to have clear or almost clear skin.

Do these targets mean that every person with psoriasis has to use the same treatment?

No. The targets do not specify a specific treatment. Everyone is different. Your lifestyle, age, medical conditions or other factors may mean that certain treatments are better for you than others. Talk to your health care provider about your options, and remember that many people use a combination of different treatments for their psoriasis.

My health care provider and I agreed on a treatment. But I’m having trouble getting it. What should I do?

NPF’s Patient Navigation Center is here to help! Our patient navigators can help you get the treatment you and your health care provider have decided upon. From learning how to apply for prescription assistance to appealing insurance denials, contacting the Patient Navigation Center is the first step toward better treatment access.

Should these treatment targets be used by insurers to determine which treatments they will cover?

No. These targets should be used to guide you and your health care provider. They should not be used by insurers to deny coverage to any treatment.

Could you remind me again what the targets are?

  • After three months on a new treatment, the target is for you to have psoriasis on 1 percent or less of your body surface area (BSA).
  • An acceptable response after three months is 3 percent BSA or less, or 75 percent improvement.
  • If the acceptable response is met, you may decide to stay on your treatment for another three months. But if the target is not met after six months, or neither the target nor the acceptable response is met after three months, you should discuss other treatment options with your health care provider.

Have More Questions?

Contact a Patient Navigator to get information on treatments and to be connected with a health care provider in your area.

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