Consensus Documents of the Spanish Psoriasis Group

2009/07/07 - News from medical groups

1: Actas Dermosifiliogr. 2009 Jun;100(5):386-413.

[Spanish Evidence-Based Guidelines on the Treatment of Moderate-to-Severe Psoriasis With Biologic Agents.]

[Article in Spanish]

Puig L, Carrascosa JM, Daudén E, Sánchez-Carazo JL, Ferrándiz C, Sánchez-Regaña M, García-Bustinduy M, Bordas X, Moreno JC, Hernanz JM, Laguarda S, García-Patos V; Grupo Español de Psoriasis de la Academia Española de Dermatología y Venereología.

Servicio de Dermatología. Hospital de la Santa Creu i Sant Pau. Barcelona. España. lpuig@santpau.cat.

Psoriasis vulgaris is an inflammatory skin disease that is generally chronic and that affects between 1 % and 2 % of the population in industrialized Western countries. It is associated with a marked decline in quality of life. A wide range of treatments are currently available, although surveys conducted before the advent of biologic agents reflected a strong degree of dissatisfaction with the treatments then available. Extensive scientific evidence has been gathered on the safety of biologic agents, and this has led to a review of the role of systemic treatment in general and has allowed new therapeutic goals and strategies to be contemplated in patients with moderate-to-severe psoriasis. In this new situation, there is a need for Spanish guidelines on the treatment of moderate-to-severe psoriasis with biologic agents, drafted by consensus among specialists and ratified by the Spanish Psoriasis Group of the Spanish Academy of Dermatology and Venereology (AEDV). These guidelines should be evidence-based with regard to the pharmacologic characteristics, mechanism of action, administration route and regimen, efficacy, contraindications, adverse effects, and cost estimates of biologic agents approved for the treatment of moderate-tosevere psoriasis in Spain.

Publication Types:

English Abstract

PMID: 19558918 [PubMed - in process]

2: Actas Dermosifiliogr. 2009 May;100(4):277-86.

[Consensus Document on the Evaluation and Treatment of Moderate-to-Severe Psoriasis. Spanish Psoriasis Group of the Spanish Academy of Dermatology and Venereology.]

[Article in Spanish]

Puig L, Bordas X, Carrascosa JM, Daudén E, Ferrándiz C, Hernanz JM, López-Estebaranz JL, Moreno JC, Sánchez-Carazo JL, Vanaclocha F, Vázquez-Veiga H; en representación del Grupo Español de Psoriasis de la Academia Española de Dermatología y Venereología.

Servicio de Dermatología. Hospital de la Santa Creu i Sant Pau. Barcelona. España. lpuig@santpau.cat.

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 classic 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.

Publication Types:

English Abstract

PMID: 19463230 [PubMed - in process]

3: Actas Dermosifiliogr. 2009 Mar;100(2):103-12.

[Reactions to infliximab infusions in dermatologic patients: consensus statement and treatment protocol]

[Article in Spanish]

Puig Sanz L, Sáez E, Lozano MJ, Bordas X, Carrascosa JM, Gallardo F, Luelmo J, Sánchez-Regaña M, Alsina M, García-Patos V; Grupo Español de Psoriasis de la Academia Española de Dermatología y Venereología.

Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Barcelona, España. Lpuig@santpau.cat

Infliximab is a chimeric monoclonal antibody that binds to and blocks tumor necrosis factor alpha and is the most effective biologic agent approved for the treatment of moderate-to-severe psoriasis. It is administered by intravenous infusion, usually in day hospitals on an outpatient basis. The main problem with the administration of infliximab is the possibility of infusion reactions, which may be immediate or delayed; these reactions are related to the immunogenicity of this monoclonal antibody, leading to the production of anti-infliximab antibodies. Infusion reactions to infliximab are not usually anaphylactic (ie, they are not mediated by immunoglobulin E), and re-exposure of the patient using specific protocols to prevent and treat these reactions is therefore possible. The extensive experience in the use of infliximab for the treatment of rheumatic conditions and chronic inflammatory bowel disease has made it possible to develop infusion reaction management protocols; these can be applied to dermatologic patients, who constitute a growing proportion of patients treated with intravenous biological agents. The aim of this review is to draw up a consensus protocol for the treatment of infusion reactions in dermatologic patients treated with infliximab.

Publication Types: