Psoriasis
ICD-10 L40 · ICD-11 EA90

First-Line Biologic Monotherapy for Moderate-to-Severe Plaque Psoriasis

When plaque psoriasis reaches moderate-to-severe extent, systemic biologic therapy becomes the recommended treatment approach. This protocol defines the first-line strategy and the measurable goals used to judge its success.

Clinical Scenario

Adults with moderate-to-severe plaque psoriasis in whom biologic monotherapy is appropriate as the initial systemic treatment.

Treatment Approach

The protocol initiates a biologic agent as monotherapy. Several interchangeable guideline-recommended options are available, each with a distinct dosing schedule.

Full agent selection, dosing schedules, and sequencing criteria are contained in the complete protocol.

Treatment Target

The primary goal is at least 75% improvement in the Psoriasis Area Severity Index (PASI 75). Definitive response is best assessed after 12 to 16 weeks of continuous therapy.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jaad.2018.11.057

Definitive response (positive or negative) to treatment with most TNF-α inhibitors is best ascertained after 12 to 16 weeks of continuous therapy, except for infliximab, for which the best time is after 8 to 10 weeks.

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