Most providers caring for patients with psoriasis are treating those patients appropriately, although they may not be following the treatment goal algorithm, according to data from the Netherlands.

Jeffrey Zweegers, MD, from the Radboud University Medical Center in The Netherlands, and colleagues reported in a recent issue of the British Journal of Dermatology that health-care providers “acted in accordance with treatment goals” in most patient visits, but should have modified therapy more frequently among patients who were not achieving treatment goals.

“Optimizing therapy and defining barriers in the latter group might increase treatment results in daily practice psoriasis care,” wrote the investigators.

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The researchers used data extracted from a prospective daily practice group of patients with psoriasis being treated with biologics. Effectiveness and quality of life were assessed using the Psoriasis Area and Severity Index (PASI) score and Dermatology Life Quality Index (DLQI) questionnaire, respectively. Treatment decisions such as dosage adjustments, combination treatments, or switching therapy were compared with the treatment goals algorithm.

Clinicians followed the treatment goals algorithm in 64% (253 of 395) of visits. The investigators suggested this can be explained by the high effectiveness of biologics in most visits, so providers did not feel it necessary to make changes to treatment strategies according to treatment goals.

There were 162 (41%) visits in which there should have been a treatment modification based on treatment goals and the physician modified treatment in 59 of these 162 visits (36%).

“This shows an urgent need for identification of barriers to using treatment goals and the need for implementation studies as this might increase the rate of treatment success and the number of patients with psoriasis with optimal quality of life on systemic therapies including biologics in daily clinical practice,” the authors wrote.


  1. Zweegers J. Br J Dermatol. 2014;171:1091–1098. doi: 10.1111/bjd.13137.


Zweegers reports a financial relationship with AbbVie, Janssen and Sciderm.