Original articleProduct of the Physician Global Assessment and body surface area: A simple static measure of psoriasis severity in a longitudinal cohort
Section snippets
Methods
This cohort study was designed to assess the validity of PGAxBSA relative to PASI and SPASI. Data from the Utah Psoriasis Initiative were used. The Utah Psoriasis Initiative is a registry of over 1200 consecutively enrolled patients with psoriasis. Participants were evaluated at 6-month intervals between August 2008 and November 2010 by 3 dermatology investigators. Each investigator was trained by a psoriasis expert with extensive experience in educating investigators on psoriasis severity
Patient demographics
The analyses were performed on 435 patient evaluations from 226 participants. The static disease assessments were performed with 435 evaluations and the responsiveness to change analyses were performed with 240 evaluations. The average age of participants at entry to the study was 50 ± 15 years, and 113 (50%) were male (Table II). Caucasian race was reported in 206 (91%) participants. The average disease duration, at entry, was 23 ± 15 years. The median PASI score was 3.2 (interquartile range
Discussion
We explored the validity of PGAxBSA by comparing it with PASI, SPASI, and a patient-derived instrument (GPA) in the setting of a psoriasis registry. PGAxBSA correlated well with PASI and GPA and was sensitive in patients with mild disease. In addition, our data demonstrated that the PGAxBSA may function well as a measure of disease change.
Other instruments have previously been evaluated as alternatives to PASI. The Lattice Systemic PGA,12 the Psoriasis Exact Area and Severity Index,8 and the
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Cited by (65)
Efficacy and safety of apremilast in patients with mild-to-moderate plaque psoriasis: Results of a phase 3, multicenter, randomized, double-blind, placebo-controlled trial
2022, Journal of the American Academy of DermatologyCitation Excerpt :Greater proportions of patients achieved minimal to no impact of psoriasis on QOL with apremilast compared with placebo at week 16. Assessments of skin involvement, such as PASI, may not adequately assess disease severity or improvement in patients with mild psoriasis and can be difficult to use in clinical practice.21 Although patients in the ADVANCE study had mild-to-moderate psoriasis based on baseline sPGA, mean BSA (apremilast: 6.4%; placebo: 6.3%), and mean PASI (apremilast: 6.4; placebo: 6.5), rates of scalp involvement (apremilast: 71.4%; placebo: 66.8%), and mean DLQI scores (apremilast: 9.9; placebo: 9.8) reflected substantial disease burden.
Joint AAD–NPF Guidelines of care for the management and treatment of psoriasis with topical therapy and alternative medicine modalities for psoriasis severity measures
2021, Journal of the American Academy of DermatologyCitation Excerpt :As such, if a patient is satisfied with their results, they should be allowed to continue treatment even if it does not meet the target or recommended improvement. Recommendations on the use of PGA × BSA and its supporting evidence can be found in Tables XXXIV and XXXV.241-243 BSA can be overestimated, particularly by untrained providers.219-223
Initial validation of the product of the signs global assessment and body surface area in atopic dermatitis
2021, Journal of the American Academy of DermatologyCitation Excerpt :Furthermore, a recent international survey of 1,111 patients found the extent of atopic dermatitis involvement to be “quite important” or “very important” to the majority of patients.6 The product of a physician-derived SGA and BSA has been proposed as an instrument to quickly assess the severity of signs in psoriasis in clinical practice and has shown good validity.7-10 A similar outcome measure was recently proposed as a severity measure for pediatric atopic dermatitis, and correlated well with the EASI.11
Comment on “PGA×BSA composite versus PASI: Comparison across disease severities and as therapeutic response measure for Cal/BD foam in plaque psoriasis”
2020, Journal of the American Academy of DermatologyPGAxBSA composite versus PASI: Comparison across disease severities and as therapeutic response measure for Cal/BD foam in plaque psoriasis
2020, Journal of the American Academy of DermatologyCitation Excerpt :Spearman correlations between the PGA×BSA and mPASI for patients with moderate to severe disease were high (r = 0.72-0.89) and consistent with those reported for such patients in several other post hoc analyses (r = 0.74-0.9).3,6,18 However, some of the studies used in previous post hoc analyses did not assess therapeutic response7 or did not include patients with plaque psoriasis14 or with mild disease.3,6,18 Similarly, a recent post hoc analysis of 4 clinical studies (ERASURE, FEATURE, FIXTURE, and JUNCTURE) was restricted to data from a patient population with moderate to severe disease, whose baseline mean BSA was 33.3% and PASI score was 22.7.11
Product of Investigator Global Assessment and Body Surface Area (IGAxBSA): A practice-friendly alternative to the Eczema Area and Severity Index to assess atopic dermatitis severity in children
2020, Journal of the American Academy of Dermatology
Supported by the University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8UL1TR000105 (formerly UL1RR025764). Dr Gelfand received funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, through Grant K24AR064310. Dr Duffin received funding from the National Institutes of Health grant 1KM1CA156723.
Conflicts of interest: None declared.