Question: When, who, and how to prescribe biological therapies for psoriasis in the United Kingdom?
Setting: British Association of Dermatologists (BAD) guideline working group.
Design: The BAD group developed guidelines for the use of biological interventions in psoriasis 2005. They used BAD-recommended methodology and the AGREE (Appraisal of Guidelines for Research and Evaluation) instrument. A literature review was performed by searching EMBASE and Medline (1990–early 2005) for clinical psoriasis trials involving efalizumab, etanercept, and infliximab using an agreed-on protocol. Included manuscripts were scored using the NICE (National Institute for Clinical Excellence) criteria for level of evidence and strength of recommendation. The pharmacology, clinical effectiveness, dosing regimens, and toxicity of the biological agents are reviewed. Three key questions (Which patients should be considered for biological therapy? Who should prescribe biological therapy? and How to prescribe biological therapies?) are answered.