Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodology
Introduction Psoriasis (PsO) is a common chronic, inflammatory, immune-mediated disease. In 2023, a 4.4% prevalence of PsO was reported in Portugal. Currently, Tumor Necrosis Factor inhibitors (TNFi) are the recommended first-line (1 L) biologic agents in Portugal given their lower cost. However, TN...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Journal of Dermatological Treatment |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/09546634.2025.2453601 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832583962888765440 |
|---|---|
| author | Tiago Torres Sofia Magina Maria João Paiva Lopes |
| author_facet | Tiago Torres Sofia Magina Maria João Paiva Lopes |
| author_sort | Tiago Torres |
| collection | DOAJ |
| description | Introduction Psoriasis (PsO) is a common chronic, inflammatory, immune-mediated disease. In 2023, a 4.4% prevalence of PsO was reported in Portugal. Currently, Tumor Necrosis Factor inhibitors (TNFi) are the recommended first-line (1 L) biologic agents in Portugal given their lower cost. However, TNFi may not be suitable for several patients. In these patients, interleukin inhibitors (ILi) should be considered as they provide more effective outcomes and a better safety profile.Methods Qualitative interviews with PsO experts were conducted to identify PsO biologic treatment needs, resulting in an online survey to explore clinical cases focused on subpopulations of PsO. A delphi study evaluated consensus on clinical criteria to initiate non-TNFi therapy in seven predefined subpopulations of patients.Results This study highlights the benefit of starting non-TNFi therapy in all PsO predefined subpopulations. Patients with infection risk, mild heart failure and associated comorbidities, autoimmune diseases and family history of demyelinating disease consensually benefit from starting non-TNFi therapy in 1 L. Several risks associated with latent tuberculosis, advanced age and oncological disease were also evaluated.Conclusion Given the existence of various risks associated with TNFi usage, this clinical perspective overview of Portuguese experts in PsO treatment emphasizes the need for a tailored therapeutic framework in the management of PsO. |
| format | Article |
| id | doaj-art-1ab5d20d0c824a5ba3be411db1406b01 |
| institution | Kabale University |
| issn | 0954-6634 1471-1753 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj-art-1ab5d20d0c824a5ba3be411db1406b012025-01-28T01:17:32ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532025-12-0136110.1080/09546634.2025.2453601Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodologyTiago Torres0Sofia Magina1Maria João Paiva Lopes2Department of Dermatology, Unidade Local de Saúde de Santo António, Porto, PortugalDepartment of Dermatology and Venereology, Centro Hospital Universitário São João, EPE, Portugal PortoDermatology Department, Hospital de S. José, Unidade Local de Saúde São José, Lisboa, PortugalIntroduction Psoriasis (PsO) is a common chronic, inflammatory, immune-mediated disease. In 2023, a 4.4% prevalence of PsO was reported in Portugal. Currently, Tumor Necrosis Factor inhibitors (TNFi) are the recommended first-line (1 L) biologic agents in Portugal given their lower cost. However, TNFi may not be suitable for several patients. In these patients, interleukin inhibitors (ILi) should be considered as they provide more effective outcomes and a better safety profile.Methods Qualitative interviews with PsO experts were conducted to identify PsO biologic treatment needs, resulting in an online survey to explore clinical cases focused on subpopulations of PsO. A delphi study evaluated consensus on clinical criteria to initiate non-TNFi therapy in seven predefined subpopulations of patients.Results This study highlights the benefit of starting non-TNFi therapy in all PsO predefined subpopulations. Patients with infection risk, mild heart failure and associated comorbidities, autoimmune diseases and family history of demyelinating disease consensually benefit from starting non-TNFi therapy in 1 L. Several risks associated with latent tuberculosis, advanced age and oncological disease were also evaluated.Conclusion Given the existence of various risks associated with TNFi usage, this clinical perspective overview of Portuguese experts in PsO treatment emphasizes the need for a tailored therapeutic framework in the management of PsO.https://www.tandfonline.com/doi/10.1080/09546634.2025.2453601Psoriasisbiologic therapyTNF inhibitorsinterleukin inhibitorsIL-23 |
| spellingShingle | Tiago Torres Sofia Magina Maria João Paiva Lopes Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodology Journal of Dermatological Treatment Psoriasis biologic therapy TNF inhibitors interleukin inhibitors IL-23 |
| title | Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodology |
| title_full | Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodology |
| title_fullStr | Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodology |
| title_full_unstemmed | Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodology |
| title_short | Portuguese consensus on first line treatment of moderate-to-severe psoriasis with a non-TNF inhibitor therapy – a delphi methodology |
| title_sort | portuguese consensus on first line treatment of moderate to severe psoriasis with a non tnf inhibitor therapy a delphi methodology |
| topic | Psoriasis biologic therapy TNF inhibitors interleukin inhibitors IL-23 |
| url | https://www.tandfonline.com/doi/10.1080/09546634.2025.2453601 |
| work_keys_str_mv | AT tiagotorres portugueseconsensusonfirstlinetreatmentofmoderatetoseverepsoriasiswithanontnfinhibitortherapyadelphimethodology AT sofiamagina portugueseconsensusonfirstlinetreatmentofmoderatetoseverepsoriasiswithanontnfinhibitortherapyadelphimethodology AT mariajoaopaivalopes portugueseconsensusonfirstlinetreatmentofmoderatetoseverepsoriasiswithanontnfinhibitortherapyadelphimethodology |