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Psoriasis Symposium Highlights

Redefining Treatment Success in Psoriasis: Moving Beyond PASI to Sustained Disease Control

At the 2026 EADV Congress, the Almirall-sponsored symposium "Redefining Treatment Success in Psoriasis: Moving Beyond PASI to Sustained Disease Control" brought together leading psoriasis experts to discuss how treatment goals in psoriasis are evolving beyond skin clearance alone, taking patients perspectives into account and considering their overall health as treatment goals. During the symposium, real world evidence was presented to support the role of tildrakizumab providing effectiveness across different patient profiles, including those of major complexity supporting a holistic approach to psoriasis management through favourable long-term safety profile and sustained treatment persistence. 

Beyond the Skin

Prof. Ulrich Mrowietz opened the session by highlighting how the burden of psoriasis translates into a chronic lifelong burden, and hence the limitations of focusing exclusively on traditional clinical efficacy scores. While psoriasis manifests on the skin, its impact extends into emotional, social, occupational, and physical domains, affecting patients beyond visible lesions. He emphasized the importance of moving from the traditional question, "What is the matter with you?" to a more patient-centred approach based on "What matters to you?"

The importance of sustained disease control was presented as a key concept for psoriasis treatment, together with drug survival, meaningful real-world indicator that reflects efficacy, safety, tolerability, and treatment suitability over time. Prof. Mrowietz finished his introduction highlighting that long-term persistence may represent one of the most comprehensive measures of treatment success in routine clinical practice.

Capturing What Matters to Patients: POSITIVE Study insights

Prof. Matthias Augustin then presented the POSITIVE study, a prospective real-world study evaluating patients with moderate-to-severe plaque psoriasis treated with tildrakizumab. Unlike traditional studies focused primarily on skin outcomes, POSITIVE incorporated patient-reported, physician-reported, and family-reported outcomes to provide a holistic assessment of disease burden and treatment benefit, being the first psoriasis study whose primary endpoint focuses on patient’s psychological well-being: the WHO-5 Well-Being Index.

Prof. Augustin highlighted that psychological well-being represents an often-overlooked component of psoriasis management and may not always improve at the same pace as skin clearance. This phenomenon, termed "psycholag", describes the delay between clinical improvement and recovery of psychological well-being, reinforcing the importance of assessing outcomes beyond PASI and BSA scores.

The study demonstrated sustained improvements across multiple dimensions, including psychological well-being, quality of life, symptoms, treatment satisfaction, work productivity, and family impact. Together, these findings demonstrated how treatment success extends beyond skin clearance to broader aspects of patient health and daily life.

Managing Psoriasis Where It Matters Most

Prof. Anna López-Ferrer focused on the management of psoriasis in high-impact areas and ageing populations.

Highlighting the substantial burden associated with involvement of the scalp, nails, palmoplantar and genital regions, the quality of life is significantly affected in these patients, being frequently associated with treatment challenges despite limited body surface area involvement, emphasizing the need for a holistic approach. Real world evidence data was presented to highlight how tildrakizumab provides meaningful clinical improvements in these high-impact areas. 

Ageing populations represented another area of focus, frequently presenting multiple comorbidities, polypharmacy, reduced mobility, and increased vulnerability to adverse events, making treatment selection more complex. Real-world data suggested that effective disease control can be achieved with tildrakizumab in older patients while maintaining a favourable safety profile, one of the main concerns in these patients.

Individualising Treatment for Complex Patients

In the final presentation, Prof. Paolo Gisondi explored how psoriasis care is increasingly moving towards individualised treatment approaches. He highlighted that contemporary treatment targets have evolved over the last decade, with international guidelines now expanding beyond PASI to include quality-of-life outcomes and patient-centred goals, aligning with the integration of a holistic management.

Factors such as high body weight, high baseline disease burden, high-impact area involvement, older age, and multiple comorbidities may influence treatment decisions and therapeutic outcomes, increasing the complexity presented by the patient in clinical practice.

During this session, the ability to tailor treatment strategies to treat specific patient profiles with tildrakizumab were discussed given the two commercially available doses, enabling dose selection based on individual patient characteristics per clinical discretion. Real world data supported the use of the higher dose in patients with a higher baseline clinical disease, as well as in patients with high body weight, achieving greater outcomes and enabling treatment individualization.

Evidence presented during the session demonstrated durable effectiveness, favourable long-term safety findings, and a robust drug survival, reinforcing the role of sustained disease management as a key treatment objective.