Canadian Treat-to-Target Practice Survey of Real-World Interventions and Strategies in Psoriasis (CAN TARGET PSORIASIS)

INTRODUCTION: Treat-to-target (T2T) strategies have been proposed to support decision-making in chronic plaque psoriasis care, but their use in Canadian clinical practice has not been well studied. METHODS: This retrospective chart review examined how Canadian T2T criteria are applied for adult patients with moderate-to-severe plaque psoriasis and whether treatment decisions reflect treatment target achievement in clinical practice. Charts from 438 adults who initiated or modified biologic therapy and completed two visits 3-8 months apart were included. Treatment target achievement at visit 2 was assessed using predefined major and minor criteria, which included Psoriasis Area and Severity Index (PASI), body surface area (BSA), Physician Global Assessment (PGA), and Dermatology Life Quality Index (DLQI) outcome measures. RESULTS: Of the 438 patients, 321 (73.3%) met the treatment target and 98.4% of these continued their current biologic therapy. Among the 117 patients who did not meet the treatment target, 48.7% of remained on their current biologic therapy. Treatment target achievement was associated with lower PASI, BSA, PGA, and DLQI scores. DLQI influenced treatment modification even when treatment targets were unmet. Switching between interleukin (IL)-17 and IL-23 inhibitors was the most frequent treatment modification strategy. CONCLUSION: Findings support the clinical value of Canadian T2T criteria, while highlighting the importance of shared decision-making. Many patients who did not meet treatment targets remained on their current biologic therapy, emphasizing the role of patient input, quality of life, and physician judgment. These results reinforce the importance of balancing treatment targets with individualized care in real-world plaque psoriasis management.