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Vol. 100. Issue 4.
Pages 277-288 (May 2009)
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Vol. 100. Issue 4.
Pages 277-288 (May 2009)
Consensus statement
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Consensus Document on the Evaluation and Treatment of Moderate to Severe Psoriasis. Spanish Psoriasis Group of the Spanish Academy of Dermatology and Venereology
Documento de Consenso Sobre la Evaluación y el Tratamiento de la Psoriasis Moderada/Grave del Grupo Español de Psoriasis de la Academia Española de Dermatología y Venereología
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L. Puiga,
Corresponding author
lpuig@santpau.cat

Correspondence: Servicio de Dermatología Hospital de la Santa Creu i de Sant Pau, Sant Antoni Maria Claret, 167, 08025 Barcelona, Spain.
, X. Bordasb, J.M. Carrascosac, E. Daudénd, C. Ferrándizc, J.M. Hernanze, J.L. López-Estebaranzf, J.C. Morenog, J.L. Sánchez-Carazoh, F. Vanaclochai, H. Vázquez-Veigaj, for the Spanish Psoriasis Group of the Spanish Academy of Dermatology and Venereology
a Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona
b Servicio de Dermatología, Hospital Universitari de Bellvitge, Badalona, Barcelona
c Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona
d Servicio de Dermatología, Hospital de La Princesa, Madrid
e Servicio de Dermatología, Hospital Infanta Leonor, Madrid
f Servicio de Dermatología, Hospital Fundación de Alcorcón, Alcorcón, Madrid
g Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba
h Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia
i Servicio de Dermatología, Hospital 12 de Octubre, Madrid
j Servicio de Dermatología, Hospital de Conxo del Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña Spain
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Abstract

The treatment of psoriasis has been revolutionized by the introduction of biologic agents; these agents achieve skin clearance and long-term improvement without the risk of toxicity that has limited use of the traditional systemic treatments. The role of systemic treatment in the management of psoriasis is being reviewed on the basis of a large volume of scientific evidence on the efficacy and safety of biologic agents, and new therapeutic goals and strategies are being devised for patients with moderate to severe psoriasis. This has led to the need to establish severity criteria that will provide the rationale for the indication of the different systemic agents currently available for the treatment of moderate to severe psoriasis, as well as therapeutic goals, efficacy measures, therapeutic strategies, screening protocols, and choice of treatment based on the risk-benefit ratio of the different agents. These criteria must be established through consensus by experienced dermatologists and based on available scientific evidence. The present document reflects the consensus of the Spanish Psoriasis Group on these different issues in the management of moderate to severe psoriasis.

Key words:
psoriasis
treatment
consensus
criteria
biologic agents
Resumen

El tratamiento de la psoriasis se ha visto revolucionado por la introducción de los agentes biológicos, que permiten obtener blanqueamientos y mejorías a largo plazo sin el riesgo de toxicidad que ha venido limitando el tratamiento de estos pacientes con agentes sistémicos clásicos. Se ha acumulado abundante evidencia científica con respecto a la eficacia y seguridad de los agentes biológicos, que ha llevado a revisar el papel del tratamiento sistémico en general y ha permitido establecer nuevos objetivos y estrategias terapéuticas en los pacientes con psoriasis moderada a grave. En este contexto nuevo se hace necesario establecer, de forma consensuada por especialistas expertos y basada en la evidencia científica disponible, criterios de gravedad que justifiquen la indicación de los diferentes tratamientos sistémicos actualmente disponibles para la psoriasis, así como objetivos terapéuticos y parámetros de eficacia, estrategias de tratamiento, cribaje de los pacientes y selección del tratamiento basada en criterios de beneficio/riesgo. El presente documento recoge el consenso del Grupo Español de Psoriasis en estos diferentes aspectos del manejo de la psoriasis moderada a grave.

Palabras clave:
psoriasis
tratamiento
consenso
criterios
agentes biológicos
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The Spanish Psoriasis Group is a working group of the Spanish Academy of Dermatology and Venereology. The 50 members of the group are dermatologists working in hospital settings who have special expertise in the treatment of patients with psoriasis and are involved in clinical and therapeutic research in this specialized area.

Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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