British Association of Dermatologists Guidelines for Biologic Therapy for Psoriasis 2017

C.H. Smith; Z.K. Jabbar-Lopez; Z.Z. Yiu; T. Bale; A.D. Burden; L.C. Coates; M. Cruickshank; T. Hadoke; E. MacMahon; R. Murphy; C. Nelson-Piercy; C.M. Owen; R. Parslew; E. Peleva; E. Pottinger; E.J. Samarasekera; J. Stoddart; C. Strudwicke; V. A. Venning; R.B. Warren; L.S. Exton; M.F. Mohd Mustapa


The British Journal of Dermatology. 2017;177(3):628-636. 

In This Article

Purpose and Scope of the Guideline

The overall aim of the guideline is to provide evidence-based recommendations on the use of biologic therapies (adalimumab, etanercept, infliximab, ixekizumab, secukinumab and ustekinumab) in adults, children and young people for the treatment of psoriasis; consideration is given to the specific needs of people with psoriasis and psoriatic arthritis. Biologic therapies have now been in use for over 10 years, and with accrued patient-year exposure and clinical experience, many areas that were covered in previous versions of the guideline are now part of the summary of product characteristics (SPC) and/or routine care so that specific recommendations are redundant. Therefore, in this update we focus on areas where there has been a major change in the evidence base or clinical practice, where practice is very varied and/or where clear recommendations are lacking.

This set of guidelines has been developed using the British Association of Dermatologists (BAD) recommended methodology[1] with reference to the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument ([2] and the Grading of Recommendations Assessment, Development and Evaluation (GRADE).[3] The recommendations were developed for implementation in the National Health Service (NHS) in the U.K. Note that the guideline recommendations will normally fall within licensed indications; exceptionally, and only if clearly supported by evidence, use outside a licensed indication may be recommended. The guideline assumes that prescribers cross-reference a drug's SPC to inform clinical decision making for individual patients. Where relevant, this guidance applies to biosimilars (similar biological medical products), subject to recommendations given within the BAD position statement[4] and the European Medicines Agency guidelines.[5] This guidance does not cover agents licensed outside the U.K. or use of biologic therapies for indications other than psoriasis or use when psoriatic arthritis is the main indication.