Global Delphi consensus on treatment goals for generalized pustular psoriasis

作者：Juliet N. Barker, Emmylou Casanova, Siew Eng Choon, Peter Foley, Hideki Fujita, César González‐González, Melinda Gooderham, Slaheddine Marrakchi, L. Puig, Ricardo Romiti, Diamant Thaçi, Min Zheng, Bruce Strober, Partnering for Innovation and Excellence in Rare Skin Diseases (PIONEERS®) Working Group and the DELPHI Panel, Gabriel Magariños, Adam Reich, Juliana Nakano, Xinghua Gao, Furen Zhang, Mahira El Sayed, Julia Welzel, Paolo Gisondi, Yuzlina Binti Che Yaacob, Francesca Prignano, Yayoi Tada, Seong Jin Jo, Peter van der Kerkhof, Emmylou Casanova, R. Rivera, Marcus Schmitt‐Egenolf, Tsen‐Fang Tsai, Emel Bülbül Başkan, David Burden, Arash Mostaghimi, Dale Reisner, Kilian Eyerich, Alexandros Stratigos, Lev Pavlovsky, Delfina Guadalupe Villanueva Quintero, Shinichi Imafuku, Jennifer Becker, Azura Mohd Affandi, Carolina Cortés, J.M. Carrascosa, Marni Wiseman, M. Viguier, Tina Bhutani · 发表于：British Journal of Dermatology · 年份：2025 · DOI：10.1093/bjd/ljae491 · 被引用次数：12 · 研究领域：Psoriasis: Treatment and Pathogenesis、Spondyloarthritis Studies and Treatments、Dermatology and Skin Diseases

BACKGROUND: Generalized pustular psoriasis (GPP) is a chronic, systemic, neutrophilic inflammatory disease. A previous Delphi panel established areas of consensus on GPP, although patient perspectives were not included and aspects of treatment goals remained unclear. OBJECTIVES: To identify and achieve consensus on refined, specific treatment goals for GPP treatment via a Delphi panel with patient participation. METHODS: Statements were generated based on a systematic literature review and revised by a Steering Committee. Statements were categorized into overarching principles, and short- and long-term treatment goals. A global panel of 30 dermatologists and 3 patient representatives voted in agreement or disagreement with each statement. Consensus was defined as ≥ 80% approval by the panellists. RESULTS: Consensus was reached in the first round of voting and ≥ 90% agreement was reached for 23 of 26 statements. In summary, GPP requires a timely, tailored treatment plan, co-developed by patients and physicians, that involves a multidisciplinary approach and addresses the complexity, heterogeneity and chronicity of the disease. Short-term treatment goals should include pustule clearance within 7 days and prevention of pustule recurrence, reduction of cutaneous symptom burden (-4 or more points on the Itch and Skin Pain Numeric Rating Scale), improvement in systemic symptoms (e.g. resolution of fever within 3 days of treatment initiation and reduced fatigue), prevention of life-...