European S3-guidelines on the systemic treatment of psoriasis vulgaris

D Pathirana, A D Ormerod, P Saiag, C Smith, P I Spuls, A Nast, J Barker, J D Bos, G-R Burmester, S Chimenti, L Dubertret, B Eberlein, R Erdmann, J Ferguson, G Girolomoni, P Gisondi, A Giunta, C Griffiths, H Hönigsmann, M HussainR Jobling, S-L Karvonen, L Kemeny, I Kopp, C Leonardi, M Maccarone, A Menter, U Mrowietz, L Naldi, T Nijsten, J-P Ortonne, H-D Orzechowski, T Rantanen, K Reich, N Reytan, H Richards, H B Thio, P van de Kerkhof, B Rzany

Research output: Contribution to journalArticle

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Abstract

Of the 131 studies on monotherapy or combination therapy assessed, 56 studies on the different forms of phototherapy fulfilled the criteria for inclusion in the guidelines. Approximately three-quarters of all patients treated with phototherapy attained at least a PASI 75 response after 4 to 6 weeks, and clearance was frequently achieved (levels of evidence 2 and 3). Phototherapy represents a safe and very effective treatment option for moderate to severe forms of psoriasis vulgaris. The onset of clinical effects occurs within 2 weeks. Of the unwanted side effects, UV erythema from overexposure is by far the most common and is observed frequently. With repeated or long-term use, the consequences of high, cumulative UV doses (such as premature aging of the skin) must be taken into consideration. In addition, carcinogenic risk is associated with oral PUVA and is probable for local PUVA and UVB. The practicability of the therapy is limited by spatial, financial, human, and time constraints on the part of the physician, as well as by the amount of time required by the patient. From the perspective of the cost-bearing institution, phototherapy has a good cost-benefit ratio. However, the potentially significant costs for, and time required of, the patient must be considered.
Original languageEnglish
Pages (from-to)1-70
Number of pages70
JournalJEADV: Journal of the European Academy of Dermatology and Venereology
Volume23
Issue numberSupplement s2
DOIs
Publication statusPublished - Oct 2009

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Phototherapy
Psoriasis
Guidelines
Premature Aging
Costs and Cost Analysis
Therapeutics
Erythema
Cost-Benefit Analysis
Physicians
Skin

Keywords

  • antibodies, monoclonal
  • cyclosporine
  • dermatologic agents
  • humans
  • immunoglobulin G
  • methotrexate
  • PUVA therapy
  • psoriasis
  • receptors, tumor necrosis factor
  • recombinant fusion proteins
  • retinoids

Cite this

Pathirana, D., Ormerod, A. D., Saiag, P., Smith, C., Spuls, P. I., Nast, A., ... Rzany, B. (2009). European S3-guidelines on the systemic treatment of psoriasis vulgaris. JEADV: Journal of the European Academy of Dermatology and Venereology, 23 (Supplement s2), 1-70. https://doi.org/10.1111/j.1468-3083.2009.03389.x

European S3-guidelines on the systemic treatment of psoriasis vulgaris. / Pathirana, D; Ormerod, A D; Saiag, P; Smith, C; Spuls, P I; Nast, A; Barker, J; Bos, J D; Burmester, G-R; Chimenti, S; Dubertret, L; Eberlein, B; Erdmann, R; Ferguson, J; Girolomoni, G; Gisondi, P; Giunta, A; Griffiths, C; Hönigsmann, H; Hussain, M; Jobling, R; Karvonen, S-L; Kemeny, L; Kopp, I; Leonardi, C; Maccarone, M; Menter, A; Mrowietz, U; Naldi, L; Nijsten, T; Ortonne, J-P; Orzechowski, H-D; Rantanen, T; Reich, K; Reytan, N; Richards, H; Thio, H B; van de Kerkhof, P; Rzany, B.

In: JEADV: Journal of the European Academy of Dermatology and Venereology, Vol. 23 , No. Supplement s2, 10.2009, p. 1-70.

Research output: Contribution to journalArticle

Pathirana, D, Ormerod, AD, Saiag, P, Smith, C, Spuls, PI, Nast, A, Barker, J, Bos, JD, Burmester, G-R, Chimenti, S, Dubertret, L, Eberlein, B, Erdmann, R, Ferguson, J, Girolomoni, G, Gisondi, P, Giunta, A, Griffiths, C, Hönigsmann, H, Hussain, M, Jobling, R, Karvonen, S-L, Kemeny, L, Kopp, I, Leonardi, C, Maccarone, M, Menter, A, Mrowietz, U, Naldi, L, Nijsten, T, Ortonne, J-P, Orzechowski, H-D, Rantanen, T, Reich, K, Reytan, N, Richards, H, Thio, HB, van de Kerkhof, P & Rzany, B 2009, 'European S3-guidelines on the systemic treatment of psoriasis vulgaris', JEADV: Journal of the European Academy of Dermatology and Venereology, vol. 23 , no. Supplement s2, pp. 1-70. https://doi.org/10.1111/j.1468-3083.2009.03389.x
Pathirana, D ; Ormerod, A D ; Saiag, P ; Smith, C ; Spuls, P I ; Nast, A ; Barker, J ; Bos, J D ; Burmester, G-R ; Chimenti, S ; Dubertret, L ; Eberlein, B ; Erdmann, R ; Ferguson, J ; Girolomoni, G ; Gisondi, P ; Giunta, A ; Griffiths, C ; Hönigsmann, H ; Hussain, M ; Jobling, R ; Karvonen, S-L ; Kemeny, L ; Kopp, I ; Leonardi, C ; Maccarone, M ; Menter, A ; Mrowietz, U ; Naldi, L ; Nijsten, T ; Ortonne, J-P ; Orzechowski, H-D ; Rantanen, T ; Reich, K ; Reytan, N ; Richards, H ; Thio, H B ; van de Kerkhof, P ; Rzany, B. / European S3-guidelines on the systemic treatment of psoriasis vulgaris. In: JEADV: Journal of the European Academy of Dermatology and Venereology. 2009 ; Vol. 23 , No. Supplement s2. pp. 1-70.
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abstract = "Of the 131 studies on monotherapy or combination therapy assessed, 56 studies on the different forms of phototherapy fulfilled the criteria for inclusion in the guidelines. Approximately three-quarters of all patients treated with phototherapy attained at least a PASI 75 response after 4 to 6 weeks, and clearance was frequently achieved (levels of evidence 2 and 3). Phototherapy represents a safe and very effective treatment option for moderate to severe forms of psoriasis vulgaris. The onset of clinical effects occurs within 2 weeks. Of the unwanted side effects, UV erythema from overexposure is by far the most common and is observed frequently. With repeated or long-term use, the consequences of high, cumulative UV doses (such as premature aging of the skin) must be taken into consideration. In addition, carcinogenic risk is associated with oral PUVA and is probable for local PUVA and UVB. The practicability of the therapy is limited by spatial, financial, human, and time constraints on the part of the physician, as well as by the amount of time required by the patient. From the perspective of the cost-bearing institution, phototherapy has a good cost-benefit ratio. However, the potentially significant costs for, and time required of, the patient must be considered.",
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AU - Ormerod, A D

AU - Saiag, P

AU - Smith, C

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AU - Nast, A

AU - Barker, J

AU - Bos, J D

AU - Burmester, G-R

AU - Chimenti, S

AU - Dubertret, L

AU - Eberlein, B

AU - Erdmann, R

AU - Ferguson, J

AU - Girolomoni, G

AU - Gisondi, P

AU - Giunta, A

AU - Griffiths, C

AU - Hönigsmann, H

AU - Hussain, M

AU - Jobling, R

AU - Karvonen, S-L

AU - Kemeny, L

AU - Kopp, I

AU - Leonardi, C

AU - Maccarone, M

AU - Menter, A

AU - Mrowietz, U

AU - Naldi, L

AU - Nijsten, T

AU - Ortonne, J-P

AU - Orzechowski, H-D

AU - Rantanen, T

AU - Reich, K

AU - Reytan, N

AU - Richards, H

AU - Thio, H B

AU - van de Kerkhof, P

AU - Rzany, B

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KW - antibodies, monoclonal

KW - cyclosporine

KW - dermatologic agents

KW - humans

KW - immunoglobulin G

KW - methotrexate

KW - PUVA therapy

KW - psoriasis

KW - receptors, tumor necrosis factor

KW - recombinant fusion proteins

KW - retinoids

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VL - 23

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JO - JEADV: Journal of the European Academy of Dermatology and Venereology

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SN - 0926-9959

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