PASI 100 response rates in moderate to severe psoriasis: a systematic literature review and analysis of clinical practice guidelines

Abstract

Background

Response to treatments in psoriasis can be assessed using the PASI response 50, 75, 90 or 100. Achieving a PASI 100 response would mean a complete resolution of the patient's basal lesions. Therefore, PASI 100 score has been increasingly used in the context of research, but its role in daily practice is currently controversial.

Objective

(1) To analyze PASI 100 response rates to pharmacological treatments; (2) To examine clinical practice guidelines (CPGs) recommendations/comments on PASI 100.

Methods

We conducted a systematic literature review (SLR). Selection criteria concerned patients with psoriasis, reporting PASI 100.

Results

Overall, 65 studies were included. Patients on methotrexate achieved at 16 weeks a PASI 100 of 7.3%. For TNF inhibitors rates were: 3.7–11.1% at 12 weeks, 13.7–20% at 16 weeks, 10.7–24% at 24 weeks and 21.8–34.8% at 1 year. IL-17 inhibitors achieved 23.3–44% at 12 weeks, 44.3–57.2% at 16 weeks, 39.7–67.5% at 24 weeks and 41.4–67.5% at 1 year. And the reported by IL-12/23 inhibitors were 12%/23.8% at 12 weeks, 32.7%/50% at 16 weeks, 44% at 24 weeks and 41.8%/56.3% at 1 year. PASI 100 response is scarcely commented in the CPGs.

Conclusions

PASI 100 response rate is an endpoint fundamentally restricted to research.

Keywords:

• Psoriasis
• Psoriasis Area Severity Index
• systematic literature review

Acknowledgments

We would like to thank Estíbaliz Loza from InMusc for her contributions in the systematic literature review. We also would like to thank to the following dermatologists their participation: Rubén del Río Gil, Eva Vilarrasa Rull, Anna Isabel Lázaro Simó, Amparo Pérez Ferriols, Servando E. Marron, Mar Llamas Velasco, Noemí Eiris Salvado, Laura Salgado Boquete, María Luisa Fernández Díaz, Rosario Fátima Lafuente Urrez, Javier Ruiz Martínez, María Caridad Soria Martínez, Rosa Taberner, Diana Ruiz Genao, Alberto Romero Maté, Jordi Mollet Sánchez, Laura García Fernández, Montse Salleras Redonnet, Beatriz Pérez Suárez, Miren Josune Michelena Eceiza, Anna López Ferrer, Susana Armesto, Pablo de la Cueva Dobao, Raquel Rivera, Mariano Ara Martín, Marta García Bustínduy, Mercedes Hospital Gil, José Manuel Fernández Armenteros, Conrad Pujol Marco, Estrella Simal Gil, Ricardo Ruiz-Villaverde, Lourdes Rodríguez Fernández Freire, Luis Puig, Pedro Herranz, Ferran Ballesca, Gregorio Carretero, Silvia Pérez Barrio, Miquel Rivera, Carmen Rodriguez Cerdeira, Alberto Conde Taboada, Jose Luis López Estebaranz.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This project was promoted and funded by the Spanish Academy of Dermatology and Venereology (AEDV) with unrestricted grant from Leo Pharma.