Londoño-García Angela María, Castro-Ayarza Juan Raúl, Franco Franco Manuel Darío, González Ardila Cesar Fernando, Magariños Gabriel, Rivas Zaldívar Enrique Salvador, Martínez Susan, Ibatá Linda, Castillo Julieth Carolina, Cárdenas Rojas Paola Jimena, Castro Vargas Evelyn Giuliana, Contreras Claudia Romina, de la Cruz Fernández Claudia, Chavarriaga Restrepo Andrés, Echeverria Cristina Mariela, Esteves de Carvalho André Vicente, Hidalgo Matlock Benjamín, Loayza Enrique, Maskin Matías Rafael, Romiti Ricardo, Valenzuela Fernando
Dermatology Postgraduate Program, Faculty of Medicine, CES University, Medellin, Colombia.
Dermatology Postgraduate Program, Faculty of Medicine, National University of Colombia, Bogota, Colombia.
An Bras Dermatol. 2025 Jun 18;100(4):501134. doi: 10.1016/j.abd.2025.501134.
Biologic therapy is an effective psoriasis treatment. However, its long-term use carries the risk of serious adverse effects and high costs for the healthcare system, which is particularly relevant in resource-limited Latin American countries. Therefore, there is scientific interest in exploring the feasibility of tapering therapy in low disease activity or clinical remission.
To provide expert consensus-based recommendations to guide personalized and efficient tapering of biologic agents in adult patients with cutaneous psoriasis.
Following an exhaustive systematic literature review, a consensus was developed using a modified Delphi methodology by a group of Latin American clinical dermatologists and an independent methodological team. The topics covered include treatment goals, tapering objectives and strategies, regimens, monitoring and tapering failure, and implementation considerations in patients with psoriasis treated with biological agents.
The expert panel reached a consensus on five general principles and 13 recommendations for tapering biological therapy for psoriasis. These recommendations provide scientific support for dermatologists and healthcare providers regarding criteria for tapering, strategies and regimens, monitoring, failure management, and considerations for implementation.
Tapering of biologics appears to be effective and safe in psoriasis patients with low stable activity or clinical remission. This Latin American consensus was developed in recognition of the need for rational and optimal use of biologics, while individualizing cases to apply best clinical practices.
生物疗法是一种有效的银屑病治疗方法。然而,长期使用存在严重不良反应的风险,且给医疗系统带来高昂成本,这在资源有限的拉丁美洲国家尤为突出。因此,探索在疾病活动度低或临床缓解期逐渐减少治疗剂量的可行性具有科学意义。
提供基于专家共识的建议,以指导成年皮肤银屑病患者生物制剂的个性化和高效减量。
在进行详尽的系统文献综述之后,一组拉丁美洲临床皮肤科医生和一个独立的方法学团队采用改良的德尔菲法达成了共识。涵盖的主题包括治疗目标、减量目标和策略、方案、监测与减量失败,以及生物制剂治疗的银屑病患者的实施考量。
专家小组就银屑病生物疗法减量的五项一般原则和13项建议达成了共识。这些建议为皮肤科医生和医疗服务提供者在减量标准、策略和方案、监测、失败管理以及实施考量方面提供了科学支持。
对于疾病活动度低且稳定或处于临床缓解期的银屑病患者,逐渐减少生物制剂剂量似乎是有效且安全的。这份拉丁美洲共识的制定是为了认识到合理和优化使用生物制剂的必要性,同时针对具体病例采用最佳临床实践。