On-treatment remission in plaque psoriasis: NPF Remission Workgroup definition

In plaque psoriasis, defining remission is important for assessing patient responses to therapies, enabling understanding of treatment expectations and improved patient management. However, while there is consensus on the definition of off-treatment remission, on-treatment remission has yet to be completely clarified. The Remission Workgroup of the National Psoriasis Foundation (NPF) recently carried out a multistage consensus process, involving input from 92 stakeholders (dermatologists, rheumatologists, cardiologists, patients, US healthcare payers, and life sciences professionals), through interviews and a Delphi process, to clarify on-treatment remission. The resulting definition was published by Armstrong et al. in JAMA Dermatology.¹

Key learnings

The panel strongly agreed that the outcomes BSA and IGA should be used to determine on-treatment remission in plaque psoriasis and that these should measure 0 at the level of remission.

Furthermore, on-treatment remission should be defined as the maintenance of BSA = 0% or IGA = 0 for at least 6 months while receiving treatment.

Patients who maintained a BSA of 0% or an IGA score of 0 for ≥1 year and ≥2 years should be considered to be in 1-year or 2-year on-treatment remission, respectively.

The consensus-based definition of on-treatment remission in plaque psoriasis provides a standardized measure that applies to both clinical practice and trial settings, it and will have a deep and meaningful impact on patients.