Initiating and Monitoring Patients on Biologic Therapy for Psoriasis beyond the FDA: Our more Cautious Approach

Abstract

Biologics are offering new hope for patients with moderate to severe chronic plaque psoriasis and psoriatic arthritis, and every day more dermatologists are prescribing these medications for their patients. Prior to prescribing a biologic it is important to conduct the proper screening to determine if your patient is an appropriate candidate. While patients are being treated with biologics they need to be monitored carefully to maximize the benefit of the agent and minimize harmful side effects. Apart from the recommendations and requirements of the U.S. Food and Drug Administration (FDA), there are as yet no consensus statements or guidelines addressing the appropriate approach to initiating and monitoring patients being treated with biologics. In this article we will discuss our own approach to initiating and monitoring that we believe is appropriate for patients being treated with biologics. Our recommendations, which in many ways go beyond the recommendations and requirements of the FDA, should not be interpreted as the standard of care.