Freedom From Disease Defined for Psoriasis

Freedom from disease in plaque psoriasis requires addressing 5 specific domains that will help reduce the psychosocial burden and improve patients’ quality of life and well-being, researchers reported in a study published in the Journal of the European Academy of Dermatology and Venereology.

A group of European nurses and dermatologists sought to define “freedom from disease” for patients with plaque psoriasis and provide an overarching consensus statement using a Delphi consensus methodology.

A Facilitating Consensus Panel was recruited to determine disease domains, and a larger Voting Consensus Panel provided consensus on the importance of different aspects of the domains. After an initial round of voting, the wording of some of the top 5 statements was improved by the Facilitating Consensus Panel before being included in the second round of voting, and some additional statements that were considered as highly important by the panel were included in round 2 voting.

The Facilitating Consensus Panel included 6 representatives from 4 different patient advocacy groups, 3 specialist nurses, and 6 physicians (dermatologists). The larger Voting Consensus Panel included participants from 15 European countries, with 166 and 130 respondents voting in rounds 1 and 2, respectively.

Among round 1 responders, 62% were aged 40 years of age or older, 63.3% were women, and 77.7% were patients. Among round 2 responders, 76.2% were aged 40 years of age or older, 55.4% were women, and 70% were patients.

The Facilitating Consensus Panel concluded that effective symptom control focused on clearing skin lesions will help reduce the psychosocial burden associated with psoriasis and that optimized treatment and health care team support are necessary to achieve control of skin symptoms and associated psychosocial burdens.

The final overarching consensus statement defined “freedom from disease” as multifaceted and includes the following 5 domains: management of clinical symptoms, psychosocial elements, quality of life and well-being, treatment, and health care team support. “Freedom from disease” requires sufficiently taking all of these aspects into account.

“Addressing all 5 offers individuals with psoriasis a restoration of normality: effective, lasting treatment to manage visible and nonvisible clinical symptoms, eliminating the anxiety and fear of losing control, and resulting in no impact of disease owing to treatment management, with treatment meeting the individual’s needs and expectations,” stated the investigators. “This reduces psychosocial burden, improving quality of life and well-being, and enabling life to be lived fully with the confidence that psoriasis will not disturb it.”

Disclosure: This study was sponsored by Janssen. Medical writing and editorial support were provided by Cello Health MedErgy, funded by Janssen. Several of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


van Ee I, Deprez E, Egeberg A, et al. Freedom from disease in psoriasis: a Delphi consensus definition by patients, nurses and physicians. J Eur Acad Dermatol Venereol. Published November 24, 2021. doi:10.1111/jdv.17829