GUIDELINES   Open access

Italian Journal of Dermatology and Venereology 2022 February;157(Suppl. 1 to No. 1):1-78

DOI: 10.23736/S2784-8671.21.07132-2

Copyright © 2021 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC 4.0 license which allows users to distribute, remix, adapt and build upon the manuscript, as long as this is not done for commercial purposes, the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI), provides a link to the license and indicates if changes were made.

language: English

Italian adaptation of EuroGuiDerm guideline on the systemic treatment of chronic plaque psoriasis

Paolo GISONDI ¹ ✉, Maria C. FARGNOLI ², Paolo AMERIO ³, Giuseppe ARGENZIANO ⁴, Federico BARDAZZI ^{5, 6}, Luca BIANCHI ⁷, Andrea CHIRICOZZI ⁸, Andrea CONTI ⁹, Monica CORAZZA ¹⁰, Antonio COSTANZO ¹¹, Paolo DAPAVO ¹², Clara DE SIMONE ⁸, Gabriella FABBROCINI ¹³, Claudio FELICIANI ¹⁴, Caterina FOTI ¹⁵, Giampiero GIROLOMONI ¹, Claudio GUARNERI ¹⁶, Angelo V. MARZANO ^{17, 18}, Giuseppe MICALI ¹⁹, Annamaria OFFIDANI ²⁰, Aurora PARODI ²¹, Giovanni PELLACANI ²², Stefano PIASERICO ²³, Francesca PRIGNANO ²⁴, Marco ROMANELLI ²⁵, Franco RONGIOLETTI ²⁶, Pietro RUBEGNI ²⁷, Giuseppe STINCO ²⁸, Luca STINGENI ²⁹, Carlo F. TOMASINI ³⁰, Marina VENTURINI ³¹, Ketty PERIS ⁸, Piergiacomo CALZAVARA-PINTON ³¹

¹ Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy; ² Section of Dermatology, Department of Biotechnological and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy; ³ Section of Dermatology, Department of Medicine and Aging Science, G. D’Annunzio University, Chieti, Italy; ⁴ Unit of Dermatology, Luigi Vanvitelli University of Campania, Naples, Italy; ⁵ Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; ⁶ Division of Dermatology, University Hospital of Bologna, Bologna, Italy; ⁷ Unit of Dermatology, Fondazione Policlinico Tor Vergata - PTV, Tor Vergata University, Rome, Italy; ⁸ Department of Translational Medicine and Surgery, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy; ⁹ Section of Dermatology, Department of Specialized Medicine, University of Modena and Reggio Emilia, Modena, Italy; ¹⁰ Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; ¹¹ Section of Dermatology, Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy; ¹² Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy; ¹³ Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; ¹⁴ Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy; ¹⁵ Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy; ¹⁶ Section of Dermatology, Department of Medicine, University Hospital G. Martino, Messina, Italy; ¹⁷ Unit of Dermatology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; ¹⁸ Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; ¹⁹ Section of Dermatology, Department of Medical and Surgical Specialties, University of Catania, Catania, Italy; ²⁰ Section of Dermatology, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy; ²¹ Section of Dermatology, Department of Health Sciences, IRCCS Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy; ²² Section of Dermatology, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy; ²³ Section of Dermatology, Department of Medicine, University of Padua, Padua, Italy; ²⁴ Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy; ²⁵ Section of Dermatology, Department of Medicine and Oncology, University of Pisa, Pisa, Italy; ²⁶ Section of Dermatology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy; ²⁷ Section of Dermatology, Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy; ²⁸ Section of Dermatology, Department of Medicine, University of Udine, Udine, Italy; ²⁹ Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; ³⁰ Section of Dermatology, Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, Foundation IRCCS Polyclinic San Matteo, University of Pavia, Pavia, Italy; ³¹ Section of Dermatology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by moderate to severe plaque psoriasis. The content of the guideline includes general information on the scope and purpose, health questions covered, target users and strength/limitations of the guideline, suggestions for disease severity grading and treatment goals. It presents the general treatment recommendations as well as detailed management and monitoring recommendations for the individual drugs including acitretin, cyclosporine, fumarates, methotrexate, adalimumab, apremilast, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab and ustekinumab. Moreover, the guideline provides guidance for specific clinical situations such as patient with concomitant psoriatic arthritis, inflammatory bowel disease, a history of malignancies, a history of depression, diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or those with childbearing potential. Information on vaccination, immunogenicity and systemic treatment during the COVID-19 pandemic is also provided.

KEY WORDS: Psoriasis; Guideline; Therapeutics; Biological products