Psoriasis — SCE Dermatology MCQ
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Correct answer: E — PASI 90 (clear or almost clear skin)
The BAD 2020 biologic guidelines have shifted toward higher treatment targets, reflecting the efficacy of newer biologics. While PASI 75 was the traditional clinical trial primary endpoint, PASI 90 (clear or almost clear skin) is now considered the optimal treatment target for biologic-treated psoriasis. This 'treat-to-target' approach recognises that residual disease (even PASI 75) can still significantly impact quality of life. If PASI 90 is not achieved, the treatment response should be assessed alongside DLQI and consideration given to dose optimisation or switching. PASI 100 (complete clearance) is achieved by many patients on newer biologics but is not mandated as the target.
Reference: BAD 2020 Biologic Psoriasis Guidelines