Table 1.

Treatment goals and response and/or failure definitions, with treatment changes in those with moderate to severe psoriasis [29,30,31].

Guideline	Moderate to Severe Psoriasis Treatment Aim Definitions	Treatment Response and/or Failure Definitions, with Changes in Those Suffering from Moderate to Severe Psoriasis
European guideline of systemic therapy	Any psoriasis treatment should aim at eliminating all symptoms of skin inflammation.Necessary: minimum improvement and particular drug analysis times.	Throughout the phases of induction and maintenance: ○PASI 75—achieved, with treatment maintenance ○PASI 50 improvement—not achieved, treatment change regimen should be modified ○PASI response is across 50 to 75%, therapy change(if DLQI>5), therapy maintenance (if DLQI ≤ 5).
French guideline of systemic therapy	Factors when establishing treatment goals for systemic therapy: ○Disease severity ○PsA/any comorbidity presence ○Physical, social and psychological patient disease impact ○The positive benefit-risk balance of ongoing systemic treatment ○Oppinion and satisfaction level of patient	An adequate treatment response: PASI 75 (from the baseline), or PASI 50 with DLQI ≤ 5.
British guideline of systemic therapy	Treatment choice according to the patient and other factors: ○Psoriasis features (therapeutic aim, disorder phenotype, activity pattern, impact and severity of disorder, PsA presence) ○Other factors (age, weight, comorbidities—past/present, pregnancy, views/preferences on treatmentfrequency and administration way, adherence).	○Assessment whether the minimal response have been met defined as: at least 50% decrease in baseline severity of disease (a response of PASI 50, otherwise percentage BSA) and improvement of physical, social or psychological performance (DLQI—4-point).
Spanish consensus of systemic therapy	The ideal outcome is to achieve: PASI 90 and a PGA ≤ 1, or as an alternative, a minimal, topical treatment controllable localized disease (PGA ≤ 2 and PASI < 5), DLQI ≤ 1, prolonged remissions without loss of efficacy, no worsening of comorbidities. Criteria for an appropriate response initially and in the long term (more than 6 months), 1 of: PASI 75, PASI < 5, PGA ≤ 1 and DLQI < 5. Criteria for the minimum efficacy required: PASI 50, PASI < 5.	Therapeutic failure during initiation of the treatment: ○a score is equal to or greater than those constituting the criteria for moderate-to-severe psoriasis at the end of the induction phase ○there is no adequate response according to the physician and the patient by the end of the induction phase, ○a decrease in 50% from the baseline PASI score has not been achieved (or this degree of response has been lost) after the induction phase.

Abbreviations. PsA—psoriatic arthritis; PASI—Psoriasis Area and Severity Index; BSA—Body Surface Area; DLQI—dermatology life quality index; RCT—randomized controlled trial; PGA—Physician’s Global Assessment.