Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis

Detalhes bibliográficos
Autor(a) principal: Marques Pinto, Gabriela
Data de Publicação: 2012
Outros Autores: Filipe, Paulo
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12
Resumo: Psoriasis is an inflammatory dermatosis, affecting approximately 2% of the population, with predominantly skin and joint involvement but also associated with considerable comorbidities. Approximately 20% to 30% of patients have moderate to severe disease uncontrollable with topical therapy. Traditional systemic therapy – oral PUVA, retinoids, cyclosporin and methotrexate – may induce organ specific toxicity and a significant number of patients are unresponsive, intolerant or have specific contraindications to its use. With the increased understanding of the pathogenesis of psoriasis, multiple biologic agents have been introduced. In the last years there has been an increased utilization of these agents and several studies were designed to evaluate their efficacy and safety. Currently, four biologics have been already approved by EMEA (European Medicines Agency) for the treatment of plaque psoriasis, 3 anti-TNFa (adalimumab, etanercept and infliximab) and one anti-IL12/23p40 (ustecinumab). In the present article we update the prior published guidelines (Trabalhos da SPDV 2010, 68(1): 47-68 and 2011, 69(4): 531-553) due to the recent progress in the knowledge and therapeutic options in these area. These recommendations should be used with caution and treatment should be tailored to meet individual patient’s needs and each specific clinical situation.
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spelling Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque PsoriasisNormas de Boa Prática Para o Tratamento da Psoríase em Placas em Idade Não Pediátrica com BiológicosPsoriasis is an inflammatory dermatosis, affecting approximately 2% of the population, with predominantly skin and joint involvement but also associated with considerable comorbidities. Approximately 20% to 30% of patients have moderate to severe disease uncontrollable with topical therapy. Traditional systemic therapy – oral PUVA, retinoids, cyclosporin and methotrexate – may induce organ specific toxicity and a significant number of patients are unresponsive, intolerant or have specific contraindications to its use. With the increased understanding of the pathogenesis of psoriasis, multiple biologic agents have been introduced. In the last years there has been an increased utilization of these agents and several studies were designed to evaluate their efficacy and safety. Currently, four biologics have been already approved by EMEA (European Medicines Agency) for the treatment of plaque psoriasis, 3 anti-TNFa (adalimumab, etanercept and infliximab) and one anti-IL12/23p40 (ustecinumab). In the present article we update the prior published guidelines (Trabalhos da SPDV 2010, 68(1): 47-68 and 2011, 69(4): 531-553) due to the recent progress in the knowledge and therapeutic options in these area. These recommendations should be used with caution and treatment should be tailored to meet individual patient’s needs and each specific clinical situation.A psoríase é uma dermatose inflamatória, que afecta cerca de 2% da população mundial, com envolvimento preferencial cutâneo e articular, mas frequentemente associada a co-morbilidades importantes. Cerca de 20-30% dos doentes têm formas moderadas a graves, não controláveis por tratamentos tópicos. As terapêuticas sistémicas clássicas – PUVAterapia oral, retinóides, ciclosporina e metotrexato – podem induzir toxicidade específica de órgão e uma percentagem considerável de doentes é resistente, intolerante ou tem contra-indicações para as iniciar. É neste contexto que surgem os agentes biológicos, especificamente direccionados aos mecanismos/vias envolvidos na patogénese da psoríase. Nos últimos anos a importância destes agentes como alternativas terapêuticas tem crescido, tendo-se desenvolvido vários estudos desenhados para avaliar a sua eficácia e segurança. Actualmente 4 agentes biológicos estão aprovados pela EMEA (agência europeia do medicamento) para o tratamento da psoríase em placas, três anti-TNFa (adalimumab, etanercept e infliximab) e um anti-IL12/23p40 (ustecinumab). Neste artigo pretende-se actualizar as recomendações anteriormente publicadas (Trabalhos da SPDV 2010, 68(1): 47-68 e 2011, 69(4): 531-553), dada a rápida evolução de conhecimentos científicos e de orientações terapêuticas nesta área. Estas Normas devem ser utilizadas criteriosamente, tendo em conta a especificidade de cada doente e de cada situação clínica.Ordem dos Médicos2012-06-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12oai:ojs.www.actamedicaportuguesa.com:article/12Acta Médica Portuguesa; Vol. 25 No. 2 (2012): March-April; 125-141Acta Médica Portuguesa; Vol. 25 N.º 2 (2012): Março-Abril; 125-1411646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12/26Marques Pinto, GabrielaFilipe, Pauloinfo:eu-repo/semantics/openAccess2022-12-20T10:55:39Zoai:ojs.www.actamedicaportuguesa.com:article/12Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:18.198007Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
Normas de Boa Prática Para o Tratamento da Psoríase em Placas em Idade Não Pediátrica com Biológicos
title Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
spellingShingle Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
Marques Pinto, Gabriela
title_short Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
title_full Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
title_fullStr Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
title_full_unstemmed Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
title_sort Recommendations for High-Quality Use of Biologic Therapies in Adults with Plaque Psoriasis
author Marques Pinto, Gabriela
author_facet Marques Pinto, Gabriela
Filipe, Paulo
author_role author
author2 Filipe, Paulo
author2_role author
dc.contributor.author.fl_str_mv Marques Pinto, Gabriela
Filipe, Paulo
description Psoriasis is an inflammatory dermatosis, affecting approximately 2% of the population, with predominantly skin and joint involvement but also associated with considerable comorbidities. Approximately 20% to 30% of patients have moderate to severe disease uncontrollable with topical therapy. Traditional systemic therapy – oral PUVA, retinoids, cyclosporin and methotrexate – may induce organ specific toxicity and a significant number of patients are unresponsive, intolerant or have specific contraindications to its use. With the increased understanding of the pathogenesis of psoriasis, multiple biologic agents have been introduced. In the last years there has been an increased utilization of these agents and several studies were designed to evaluate their efficacy and safety. Currently, four biologics have been already approved by EMEA (European Medicines Agency) for the treatment of plaque psoriasis, 3 anti-TNFa (adalimumab, etanercept and infliximab) and one anti-IL12/23p40 (ustecinumab). In the present article we update the prior published guidelines (Trabalhos da SPDV 2010, 68(1): 47-68 and 2011, 69(4): 531-553) due to the recent progress in the knowledge and therapeutic options in these area. These recommendations should be used with caution and treatment should be tailored to meet individual patient’s needs and each specific clinical situation.
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publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 25 No. 2 (2012): March-April; 125-141
Acta Médica Portuguesa; Vol. 25 N.º 2 (2012): Março-Abril; 125-141
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