Latin American consensus on tapering of biological therapy in psoriasis

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia Pub Date : 2025-06-18 DOI:10.1016/j.abd.2025.501134

Angela María Londoño-García , Juan Raúl Castro-Ayarza , Manuel Darío Franco Franco , Cesar Fernando González Ardila , Gabriel Magariños , Enrique Salvador Rivas Zaldívar , Susan Martínez , Linda Ibatá , Julieth Carolina Castillo , Paola Jimena Cárdenas Rojas , Evelyn Giuliana Castro Vargas , Claudia Romina Contreras , Claudia de la Cruz Fernández , Andrés Chavarriaga Restrepo , Cristina Mariela Echeverria , André Vicente Esteves de Carvalho , Benjamín Hidalgo Matlock , Enrique Loayza , Matías Rafael Maskin , Ricardo Romiti , Fernando Valenzuela

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Abstract

Background

Biologic therapy is an effective psoriasis treatment. However, its long-term use carries the risk of serious adverse effects and high costs for the healthcare system, which is particularly relevant in resource-limited Latin American countries. Therefore, there is scientific interest in exploring the feasibility of tapering therapy in low disease activity or clinical remission.

Objective

To provide expert consensus-based recommendations to guide personalized and efficient tapering of biologic agents in adult patients with cutaneous psoriasis.

Methods

Following an exhaustive systematic literature review, a consensus was developed using a modified Delphi methodology by a group of Latin American clinical dermatologists and an independent methodological team. The topics covered include treatment goals, tapering objectives and strategies, regimens, monitoring and tapering failure, and implementation considerations in patients with psoriasis treated with biological agents.

Results

The expert panel reached a consensus on five general principles and 13 recommendations for tapering biological therapy for psoriasis. These recommendations provide scientific support for dermatologists and healthcare providers regarding criteria for tapering, strategies and regimens, monitoring, failure management, and considerations for implementation.

Conclusion

Tapering of biologics appears to be effective and safe in psoriasis patients with low stable activity or clinical remission. This Latin American consensus was developed in recognition of the need for rational and optimal use of biologics, while individualizing cases to apply best clinical practices.

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拉丁美洲对银屑病逐渐减少生物治疗的共识

背景生物疗法是治疗银屑病的有效方法。然而，长期使用它会带来严重不良反应的风险和医疗保健系统的高成本，这在资源有限的拉丁美洲国家尤为重要。因此，在低疾病活动度或临床缓解期探索减量治疗的可行性具有科学意义。目的提供专家共识为指导成人皮肤银屑病患者个体化有效的生物制剂减量治疗提供建议。方法：一组拉丁美洲临床皮肤科医生和一个独立的方法学团队进行了详尽的系统文献综述，采用改进的德尔菲方法学达成共识。涵盖的主题包括治疗目标、减量目标和策略、方案、监测和减量失败，以及生物制剂治疗银屑病患者的实施考虑。结果专家小组就银屑病生物治疗的5项一般原则和13项建议达成共识。这些建议为皮肤科医生和医疗保健提供者提供了关于减量标准、策略和方案、监测、失败管理和实施考虑因素的科学支持。结论对于低稳定活动性或临床缓解的银屑病患者，减量使用生物制剂是安全有效的。这一拉丁美洲共识是认识到合理和最佳使用生物制剂的必要性，同时个体化病例以应用最佳临床实践而形成的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anais brasileiros de dermatologia DERMATOLOGY-

CiteScore

2.40

自引率

0.00%

发文量

184

审稿时长

32 days

期刊介绍： The journal is published bimonthly and is devoted to the dissemination of original, unpublished technical-scientific study, resulting from research or reviews of dermatological topics and related matters. Exchanges with other publications may be accepted.