Current Approach to Modern Treatment of Psoriasis – Updated Guidelines of ČDS JEP for Targeted Treatment of Severe Chronic Psoriasis

Česká verzia

Authors: P. Cetkovská ¹; M. Kojanová ²; P. Arenberger ³; J. Fabianová ⁴
Authors place of work: Dermatovenerologická klinika FN a LF UK, Plzeň, přednosta prof. MUDr. Karel Pizinger, CSc. ¹; Dermatovenerologická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. Jiří Štork, CSc. ²; Dermatovenerologická klinika FNKV a 3. LF UK, Praha, přednosta prof. MUDr. Petr Arenberger, DrSc., MBA ³; Farmakoterapie, Praha ⁴
Published in the journal: Čes-slov Derm, 94, 2019, No. 4, p. 135-162
Category: Reviews (Continuing Medical Education)

Summary

Psoriasis is a chronic genetically determined immune mediated inflammatory skin disease associated with systemic comorbidities that contribute to shortening of patients’ lives. Local therapy and phototherapy are the foundation of mild psoriasis treatment. In case this treatment is not effective, not tolerated or contraindicated, as well as in patients with severe form of disease or significantly decreased quality of life, systemic therapy is indicated. Current possibilities of systemic therapy in the Czech Republic include non-biological agents (acitretin, cyclosporine, methotrexate, new small molecule apremilast) and biological agents (adalimumab, brodalumab, certolizumab, etanercept, guselkumab, infliximab, ixekizumab, secukinumab, ustekinumab; use of risankizumab and tildrakizumab is expected in near future). Presented recommendations for „targeted“ systemic therapy of adult patients with moderate to severe psoriasis are based on the Czech guidelines published in 2012, recent international guidelines and international consensus meetings taking into account national clinical practice in the Czech Republic and current summaries of product characteristics.

Keywords:

Psoriasis – guselkumab – infliximab – guidelines – biological therapy – anti-TNF-α – anti-IL-12/23 – anti-IL-17 – anti-IL-23 – adalimumab – brodalumab – certolizumab – etanercept – ixekizumab – risankizumab – secukinumab – tildrakizumab – ustekinumab – Small molecules – apremilast

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