Spanish evidence-based guidelines on the treatment of psoriasis with biologic agents, 2013. Part 1: on efficacy and choice of treatment. Spanish Psoriasis Group of the Spanish Academy of Dermatology and Venereology

Actas Dermosifiliogr. 2013 Oct;104(8):694-709. doi: 10.1016/j.adengl.2013.04.013. Epub 2013 Sep 7.

Abstract

Biologic therapy is a well-established strategy for managing moderate and severe psoriasis. Nevertheless, the high cost of such therapy, the relatively short span of clinical experience with biologics, and the abundance of literature now available on these agents have made evidence-based and consensus-based clinical guidelines necessary. The ideal goal of psoriasis treatment is to achieve complete or nearly complete clearing of lesions and to maintain it over time. Failing that ideal, the goal would be to reduce involvement to localized lesions that can be controlled with topical therapy. Although current evidence allows us to directly or indirectly compare the efficacy or risk of primary or secondary failure of available biologics based on objective outcomes, clinical trial findings cannot be directly translated to routine practice. As a result, the prescribing physician must tailor the treatment regimen to the individual patient. This update of the clinical practice guidelines issued by the Spanish Academy of Dermatology and Venereology (AEDV) on biologic therapy for psoriasis incorporates information from the most recent publications on this topic.

Keywords: Adalimumab; Biologic agents; Biologic therapy; Biológicos; Clinical practice guidelines; Etanercept; Guía; Infliximab; Psoriasis; Terapia biológica; Tratamiento; Treatment; Ustekinumab.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • Acitretin / therapeutic use
  • Adult
  • Age Factors
  • Arthritis, Psoriatic / drug therapy
  • Biological Factors / adverse effects
  • Biological Factors / economics
  • Biological Factors / therapeutic use*
  • Child
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Cost-Benefit Analysis
  • Drug Substitution
  • Evidence-Based Medicine*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Meta-Analysis as Topic
  • Multicenter Studies as Topic
  • Photochemotherapy
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Psoriasis / drug therapy*
  • Severity of Illness Index
  • Sex Factors
  • Spain
  • Treatment Failure
  • Treatment Outcome

Substances

  • Biological Factors
  • Immunosuppressive Agents
  • Acitretin