What is the GPPGA?

What is the Generalized Pustular Psoriasis Physician Global Assessment?

The Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) is a scoring system designed to evaluate the severity of Generalized Pustular Psoriasis (GPP)¹. GPP is a chronic, systemic, neutrophilic inflammatory disease^2-5. GPP has a heterogeneous and unpredictable clinical course, with chronic symptoms and periods of flaring⁵. The GPPGA, along with the GPPASI (Generalized Pustular Psoriasis Area and Severity Index), is used to measure disease severity, aiding clinicians and researchers in understanding the progression and impact of the condition¹.

Why is GPPGA Score Important?

The GPPGA score is vital for accurately diagnosing and assessing the severity of GPP. This measurement is essential for guiding treatment decisions, tracking disease progression, and evaluating the effectiveness of therapies¹. It also plays a crucial role in clinical trials and research, helping to standardize the assessment of GPP severity across different studies and populations^1,6.

Who Created the GPPGA?

The GPPGA was developed by a team of researchers including A. David Burden, Hervé Bachelez, Siew Eng Choon, Slaheddine Marrakchi, Tsen-Fang Tsai, and others. Their collective expertise in dermatology and psoriasis research contributed to the creation of this specialized tool^1,6.

Does the GPPGA Work?

Validation studies, such as those conducted using data from the EFFISAYIL(R)¹ study, have shown that the GPPGA is a valid, reliable, and responsive tool for assessing GPP disease severity⁶. These studies have supported its use in both clinical and research settings, affirming its effectiveness in measuring the severity of GPP⁶.

Is There a Better Alternative to GPPGA?

In 2019, a significant advancement was made with the development of the Automatic Generalized Pustular Psoriasis Physician Global Assessment (AGPPGA). This system, created by a multidisciplinary international team, utilizes image analysis to automatically assess the severity of GPP by analyzing a photo of the patient. The AGPPGA offers a quicker and more consistent alternative to the manual GPPGA, requiring only about 23 seconds for analysis compared to the 6-10 minutes needed for the manual approach. This speed and efficiency can encourage more physicians to use the scoring system, moving away from less precise "eyeball" estimates.

What is Automatic GPPGA (AGPPGA)?

The AGPPGA represents a technological leap in the assessment of GPP. By reducing the time required for assessment and minimizing inter-observer variability, the AGPPGA ensures more consistent and accurate evaluations. It outperforms traditional methods with a significantly lower margin of error (below 13% compared to the usual 20% in manual PASI). This advancement not only speeds up the assessment process but also enhances the reliability of GPP severity evaluations, potentially improving patient care and research outcomes in the field of dermatology.

References

1. Burden AD, et al. Am J Clin Dermatol. 2022;23(Suppl 1):39-50.
2. Armstrong AW, et al. J Am Acad Dermatol. 2024;90:727-730.
3. Fujita H, et al. J Dermatol. 2018;45:1235-1270.
4. Navarini AA, et al. J Eur Acad Dermatol Venereol. 2017;31:1792-1799.
5. Puig L, et al. J Eur Acad Dermatol Venereol. 2023;37:737-752.
6. Burden AD, et al. J Eur Acad Dermatol Venereol. 2023;37:1327-1335.