Guidelines of Polish Dermatological Society on the treatment of psoriasis vulgaris and arthropathic psoriasis (psoriatic arthritis) with biological drugs

Psoriasis is a chronic inflammatory skin disease affecting about 1-3% of the Caucasian population. Introduction of new biological drugs, that show good efficacy and a favourable safety profile, for the treatment of psoriasis has resulted in significant improvement of psoriatic patients’ daily life quality. Therefore, it is of great importance to enable Polish patients with psoriasis, especially those subjects who failed or were intolerant of other therapy modalities, to be treated with biologicals. The current guidelines were worked out to help Polish dermatologists in the selection of patients for this therapy and subsequent monitoring of individuals treated with biological drugs. We do hope that these guidelines will be a valuable support for those physicians who are just beginning their clinical practice with biologicals.
Taking into consideration the Polish economic situation it is suggested to qualify for biological treatment only those patients with moderate to severe psoriasis vulgaris who did not achieve a satisfactory response, were intolerant or have contraindications to at least two different types of classical systemic anti-psoriatic therapy. In addition, biological therapy is indicated in patients with active arthropathic psoriasis who did not achieve a satisfactory response, were intolerant or have contraindications to at least two different disease-modifying anti-rheumatic drugs, used in mono- or polytherapy. The authors do not recommend any of the available biological drugs as a first choice therapy. This decision should be made by physicians based on the specifics of the particular clinical patient’s situation and the current literature data on the efficacy and safety of these drugs.