Psoriasis Guidelines

EuroGuiDerm guidelines (2020/2021)

The EuroGuidDerm guidelines are supported by the European Dermatology Forum, and include a range of recommendations reached through a structured consensus process^1,2. Developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual, the guideline recommendations are based on the evaluation of efficacy and safety data, and on the practical experience obtained with different treatment modalities^1,2.

Part 1: Psoriasis treatment and monitoring recommendations

This evidence- and consensus-based guideline was released in 2020. It focuses on the treatment of psoriasis vulgaris and presents general treatment recommendations for management of psoriasis and monitoring recommendations for individual drugs¹.

Treatment options discussed are: acitretin, ciclosporin, fumarates, methotrexate, adalimumab, apremilast, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab, and ustekinumab¹.

View Part 1 of the EuroGuidDerm guideline (2020) on psoriasis treatment and monitoring

Part 2: Specific clinical and comorbid situations

This guideline was released in 2021, focusing on guidance for management of psoriasis in specific clinical and comorbid situations. These include psoriasis vulgaris with concomitant psoriatic arthritis, inflammatory bowel disease, a history of cancer, or a history of depression or suicidal ideation². It also addresses psoriasis in the presence of diabetes, viral hepatitis, cardiovascular disease, kidney disease and neurological disease².

Recommendations on screening for tuberculosis, and managing people with a positive tuberculosis test result, are given. It covers treatment for pregnant women or those planning pregnancy in the near future. Information on vaccination, immunogenicity and systemic treatment during the COVID-19 pandemic is also provided.

View Part 2 of the EuroGuiDerm guideline (2021), on specific clinical and comorbid situations in psoriasis

German S3 guidelines (2021)

Based on the EuroGuiDerm guidelines, the German S3 guidelines for treatment of psoriasis vulgaris were released in 2021^3,4. The authors developed the S3 guidelines by adapting, remixing, transforming, translating or building upon the pre-peer reviewed version of the EuroGuiDerm guidelines. The S3 guideline was approved by the German Dermatological Society and the Berufsverband der Deutschen Dermatologen e.V^3,4.

In addition to the English translation outlined below, a longer version of the guideline is also available in German.

Part 1: Treatment goals and treatment recommendations

Part 1 of the German S3 guidelines contains recommendations on treatment of psoriasis vulgaris, including treatment goals and consensus-based recommendations on treatment options based on characteristics of patients with psoriasis⁴.

View Part 1 of the German S3 guideline (2021) on psoriasis treatment goals and treatment recommendations (English version)

Part 2: Treatment monitoring and specific clinical or comorbid situations

Part 2 of the German S3 guidelines covers treatment monitoring for patients with psoriasis vulgaris, and specific clinical or comorbid situations³.

Similarly to the EuroGuiDerm guidelines, the specific clinical and comorbid situations addressed in the S3 guideline include psoriatic arthritis, inflammatory bowel disease, cancer, depression, conditions affecting the heart and kidneys, as well as neurological conditions such as multiple sclerosis, viral hepatitis and tuberculosis. Recommendations for management of women with psoriasis who are pregnancy or planning a pregnancy in the near future are also included³.

View Part 2 of the German S3 guideline (2021) on psoriasis treatment monitoring and specific clinical or comorbid situations (English version)

Spanish guidelines update from the Spanish Academy of Dermatology and Venereology (2022)

A practical, consensus-based update of the Spanish psoriasis guidelines was published by the Psoriasis Group (GPs) of the Spanish Academy of Dermatology and Venereology (AEDV) in 2022^5,6. It contains updates on treatment of moderate-to-severe psoriasis that have emerged following changes in the treatment paradigm and approval of a large number of new biologic agents in recent years^5,6.

This consensus document was developed using a structured approach, incorporating systematic reviews and meta-analyses as well as clinical trials and high-quality real-world studies^5,6.

Part 1: Concepts and general management of psoriasis with biologic therapy

Part 1 of this guideline include general principles for the treatment of patients with moderate-to-severe psoriasis, defining treatment goals and criteria for when biologic therapy is indicated, and for the selection of initial and subsequent therapies⁵. Practical issues, such as treatment failure and maintenance of response, are also addressed⁵.

View Part 1 of the Spanish AEDV guideline (2022) on concepts and general management of psoriasis with biologic therapy (English translation)

Part 2: Management of special populations, patients with comorbid conditions, and risk

Part 2 of this guideline covers management of special populations, comorbidities, and risk in the setting of moderate-to-severe psoriasis treated with biologic therapies⁶.

• It addresses management of psoriasis in patients older than 65 years, paediatric patients, and women who are pregnant, breastfeeding or planning a pregnancy⁶
• This guideline also addresses psoriasis management in the setting of patients with comorbidities such as obesity and metabolic syndrome, diabetes, psoriatic arthritis, inflammatory bowel disease, depression, cancer, and conditions affecting the heart, liver and kidneys, as well as neurological disease⁶ 

View Part 2 of the Spanish AEDV guideline (2022) on management of special populations, patients with comorbid conditions and risk (English translation)