Article information
Abstract
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 to severe psoriasis in Spain.
Key words:
psoriasis
biologic agents
guidelines
treatment
etanercept
adalimumab
infliximab
efalizumab
biologic therapy
Resumen
La psoriasis vulgar es una enfermedad cutánea inflamatoria, de curso habitualmente crónico, que afecta a un 1-2% de la población en los países occidentales industrializados, y produce una reducción marcada de la calidad de vida de los pacientes. Pese a la diversidad de tratamientos disponibles, las encuestas efectuadas antes del advenimiento de los agentes biológicos demuestran un alto grado de insatisfacción con respecto a los tratamientos disponibles. 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 contemplar 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 ratificada por los integrantes del Grupo Español de Psoriasis de la Academia Española de Dermatología y Venereología (AEDV), unas directrices para el tratamiento de la psoriasis moderada a grave con agentes biológicos, que incluyan información basada en la evidencia científica disponible acerca de las características farmacológicas, mecanismo de acción, vía y pautas de administración, eficacia, contraindicaciones, efectos adversos y estimaciones del coste de los agentes biológicos aprobados para el tratamiento de la psoriasis moderada a grave en España
Palabras clave:
psoriasis
biológicos
directrices
tratamiento
etanercept
adalimumab
infliximab
efalizumab
terapia biológica
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