Expert Recommendations on Topical Therapy for Psoriasis from the Spanish Psoriasis Working Group (GPS).

Abstract

Justification and objectives: Topical therapy is vital in the management of psoriasis. In recent years there have been multiple advances and changes in the management of psoriatic patients that justify a review and update of the use of topical therapy. Experts from the Spanish Psoriasis Working Group (GPS) of the Spanish Academy of Dermatology Venereology (AEDV) have developed a set of recommendations for the treatment of psoriasis based on the best available evidence and experts' opinion.

Methodology: We followed the methodology of nominal groups, with the help from a systematic review. A coordinator was designated, and a group of experts was selected based on their experience and knowledge on topical therapies for the management of psoriasis. Afterwards, the objectives and key points of the document were defined and agreed upon, and with help from a documentary specialist, a systematic review was conducted across Medline, Embase and Cochrane Library. Systematic reviews, meta-analyses, clinical trials, as well as observational studies were selected. Published clinical practice guidelines and related documents were also reviewed. With this information, the coordinator generated a series of recommendations that would be later evaluated and modified by the experts themselves. After several review processes and an external evaluation, the final document was drafted.

Results: Practical recommendations on the use of topical therapies for the management of psoriasis are presented in line with other documents of the AEDV, including the use of topical treatment as the main therapy, their adjuvant role when using systemic therapies, treatment selection, treatment strategies, their use in special locations and severe psoriasis, and the patients adherence and preferences to the topical therapy. The document critically evaluates the safety and efficacy profile of topical therapy.