Psoriasis guideline

Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics


 JAAD-icon.png  
Access the full psoriasis with biologics guideline from JAAD
   

Guideline highlights:

  • Psoriasis is a chronic, inflammatory, multisystem disease which affects up to 3.2 percent of the U.S population.
  • Based on current evidence, this guideline addresses important clinical questions regarding biologic agents used as monotherapy or in combination with other psoriasis therapies to treat moderate to severe psoriasis in adults, emphasizing treatment recommendations.
  • The guideline assesses the efficacy, effectiveness, effect of switching and adverse effects of all biologic agents that have been approved by the U.S. Food and Drug Administration for the treatment of psoriasis or are currently undergoing the FDA approval process:
    • TNF inhibition
      • etanercept (FDA approval 04/30/2004)
      • infliximab (FDA approval 09/27/2006)
      • adalimumab (FDA approval 01/22/2008)
      • certolizumab (FDA approval 05/27/2018)
    • IL-12/IL-23 inhibition
      • ustekinumab (FDA approval 09/25/2009)
    • IL-17 inhibition
      • secukinumab (FDA approval 01/21/2015)
      • ixekizumab (FDA approval 03/22/2016)
      • brodalumab (FDA approval 02/15/2017)
    • IL-23 inhibition
      • guselkumab (FDA approval 07/13/2017)
      • tildrakizumab (FDA approval 03/21/2018)
      • risankizumab (FDA approval pending)
  • This guideline also highlights the need to educate patients regarding the etiology, comorbidities and treatment options associated with psoriasis, as well as the dermatologist’s role in monitoring patients and educating them regarding the risks and benefits associated with biologic agents.
  • The guideline emphasizes the need for dermatologists to be up-to-date regarding biologic safety information, as well as the importance of multidisciplinary care to improve outcomes for patients.

Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities


 JAAD-icon.png  
Access the full psoriasis with awareness and attention to comorbidities guideline from JAAD
   

Guideline highlights:

  • Psoriasis is a chronic, inflammatory, multisystem disease which affects up to 3.2 percent of the U.S population.
  • Psoriasis is associated with several comorbidities, many of which first manifest as skin disease.
  • This guideline addresses the assessment and management of major comorbid conditions associated with psoriasis, including arthritis, heart disease, metabolic syndrome, smoking, excessive alcohol intake, inflammatory bowel disease and psychiatric disorders.
  • Identification of comorbidities may require the attention of the patient’s primary care provider and may impact management decisions for cutaneous disease.
  • The guideline also highlights the dermatologist’s role in identifying comorbidities by screening for them and/or alerting psoriasis patients’ primary care physicians about these associations.


Timeline for other psoriasis guidelines:

  • Joint AAD-NPF guidelines of care for the management of psoriasis with phototherapy: Expected in the second quarter of 2019
  • Joint AAD-NPF guidelines of care for the management of psoriasis in pediatric patients: Expected in the third quarter of 2019
  • Joint AAD-NPF guidelines of care for the management of psoriasis with non-biologics: Expected in the fourth quarter of 2019
  • Joint AAD-NPF guidelines of care for the management of psoriasis with topicals: Expected in the first quarter of 2020

Additional resources