How PASI Scores Redefine Psoriatic Arthritis Patient Care

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This is ReachMD, and you’re listening to Beyond Skin Deep: Impacts of Psoriatic Arthritis, sponsored by Lilly.

On this episode, titled, How PASI Scores Redefine Psoriatic Arthritis Patient Care, we will hear from Dr. Robin Dore, Clinical Professor of Medicine at the David Geffen School of Medicine, UCLA in Los Angeles, California.

Dr. Robin Dore:
PASI stands for Psoriasis Area Severity Index, and this is a way that is used to clinical trials of measuring the severity of a patient’s psoriasis.  It is not something that is used in clinical practice, but in clinical trials it is the standard way of measuring the skin involvement in a patient who has psoriasis.  It is independent of the joint measurements, which we usually use an ACR 20, 50 and a 70.  When we’re looking at PASI measurements, typically we look at a PASI 75, 90 and 100%, and so these are measurements of an improvement in the skin score from the original visit. 

So what this involves is, as mentioned by PASI, the area includes 4 regions of the body.  It looks at the head and neck, the arms and the hands, the trunk, which would be the abdomen, the chest, the upper back, and then the fourth region is the buttock, the lower extremities and the feet, so there are 4 different areas that you look at with regards to the PASI.  And then you look at the severity as the S in PASI, and this measures the severity of the skin lesions themselves and looks at redness, thickness and scaling. 

In the clinical trials, it’s always very important to have the same evaluator performing the PASI score because, obviously, this is very subjective, and what might be severe scaling to one patient or redness or thickness to one evaluator might not be the same for the other, so it’s very important in the clinical trial situation when we’re trying to measure the improvement of the skin score, that it’s always the same person that is doing that.  In the past, an excellent response would have been considered a PASI 75% improvement, and now we’re looking at a PASI 90 or 100% improvement.   

when the patients have improvement in their skin, they have less skin pain, they have less itching, they have less scaling, they’re able to sleep better at night because they’re not itching while they’re sleeping, the skin is not as painful, so improvement in the PASI score is associated with certainly a better quality of life as well. 

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