Latin American consensus on tapering of biological therapy in psoriasis

Angela María Londoño-García; Juan Raúl Castro-Ayarza; Manuel Darío Franco Franco; Cesar Fernando González Ardila; Gabriel Magariños; Enrique Salvador Rivas Zaldívar; Susan Martínez; Linda Ibatá; Julieth Carolina Castillo; Paola Jimena Cárdenas Rojas; Evelyn Giuliana Castro Vargas; Claudia Romina Contreras; Claudia de la Cruz Fernández; Andrés Chavarriaga Restrepo; Cristina Mariela Echeverria; André Vicente Esteves de Carvalho; Benjamín Hidalgo Matlock; Enrique Loayza; Matías Rafael Maskin; Ricardo Romiti; Fernando Valenzuela

doi:10.1016/j.abd.2025.501134

Latin American consensus on tapering of biological therapy in psoriasis

Angela María Londoño-García^*, Juan Raúl Castro-Ayarza, Manuel Darío Franco Franco, Cesar Fernando González Ardila, Gabriel Magariños, Enrique Salvador Rivas Zaldívar, Susan Martínez, Linda Ibatá, Julieth Carolina Castillo, Paola Jimena Cárdenas Rojas, Evelyn Giuliana Castro Vargas, Claudia Romina Contreras, Claudia de la Cruz Fernández, Andrés Chavarriaga Restrepo, Cristina Mariela Echeverria, André Vicente Esteves de Carvalho, Benjamín Hidalgo Matlock, Enrique Loayza, Matías Rafael Maskin, Ricardo RomitiFernando Valenzuela

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Biologic therapy is an effective psoriasis treatment. However, its long-term use carries the risk of serious adverse effects and high costs for the healthcare system, which is particularly relevant in resource-limited Latin American countries. Therefore, there is scientific interest in exploring the feasibility of tapering therapy in low disease activity or clinical remission. Objective: To provide expert consensus-based recommendations to guide personalized and efficient tapering of biologic agents in adult patients with cutaneous psoriasis. Methods: Following an exhaustive systematic literature review, a consensus was developed using a modified Delphi methodology by a group of Latin American clinical dermatologists and an independent methodological team. The topics covered include treatment goals, tapering objectives and strategies, regimens, monitoring and tapering failure, and implementation considerations in patients with psoriasis treated with biological agents. Results: The expert panel reached a consensus on five general principles and 13 recommendations for tapering biological therapy for psoriasis. These recommendations provide scientific support for dermatologists and healthcare providers regarding criteria for tapering, strategies and regimens, monitoring, failure management, and considerations for implementation. Conclusion: Tapering of biologics appears to be effective and safe in psoriasis patients with low stable activity or clinical remission. This Latin American consensus was developed in recognition of the need for rational and optimal use of biologics, while individualizing cases to apply best clinical practices.

Original language	English
Article number	501134
Journal	Anais Brasileiros de Dermatologia
Volume	100
Issue number	4
DOIs	https://doi.org/10.1016/j.abd.2025.501134
State	Published - 1 Jul 2025

Bibliographical note

Publisher Copyright:
© 2025 Sociedade Brasileira de Dermatologia

Keywords

Biological therapy
Consensus
Delphi technique
Drug tapering
Latin America
Psoriasis

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10.1016/j.abd.2025.501134

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Londoño-García, A. M., Castro-Ayarza, J. R., Franco Franco, M. D., González Ardila, C. F., Magariños, G., Rivas Zaldívar, E. S., Martínez, S., Ibatá, L., Castillo, J. C., Cárdenas Rojas, P. J., Castro Vargas, E. G., Contreras, C. R., de la Cruz Fernández, C., Chavarriaga Restrepo, A., Echeverria, C. M., Esteves de Carvalho, A. V., Hidalgo Matlock, B., Loayza, E., Maskin, M. R., ... Valenzuela, F. (2025). Latin American consensus on tapering of biological therapy in psoriasis. Anais Brasileiros de Dermatologia, 100(4), Article 501134. https://doi.org/10.1016/j.abd.2025.501134

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title = "Latin American consensus on tapering of biological therapy in psoriasis",

abstract = "Background: Biologic therapy is an effective psoriasis treatment. However, its long-term use carries the risk of serious adverse effects and high costs for the healthcare system, which is particularly relevant in resource-limited Latin American countries. Therefore, there is scientific interest in exploring the feasibility of tapering therapy in low disease activity or clinical remission. Objective: To provide expert consensus-based recommendations to guide personalized and efficient tapering of biologic agents in adult patients with cutaneous psoriasis. Methods: Following an exhaustive systematic literature review, a consensus was developed using a modified Delphi methodology by a group of Latin American clinical dermatologists and an independent methodological team. The topics covered include treatment goals, tapering objectives and strategies, regimens, monitoring and tapering failure, and implementation considerations in patients with psoriasis treated with biological agents. Results: The expert panel reached a consensus on five general principles and 13 recommendations for tapering biological therapy for psoriasis. These recommendations provide scientific support for dermatologists and healthcare providers regarding criteria for tapering, strategies and regimens, monitoring, failure management, and considerations for implementation. Conclusion: Tapering of biologics appears to be effective and safe in psoriasis patients with low stable activity or clinical remission. This Latin American consensus was developed in recognition of the need for rational and optimal use of biologics, while individualizing cases to apply best clinical practices.",

keywords = "Biological therapy, Consensus, Delphi technique, Drug tapering, Latin America, Psoriasis",

author = "Londo{\~n}o-Garc{\'i}a, \{Angela Mar{\'i}a\} and Castro-Ayarza, \{Juan Ra{\'u}l\} and \{Franco Franco\}, \{Manuel Dar{\'i}o\} and \{Gonz{\'a}lez Ardila\}, \{Cesar Fernando\} and Gabriel Magari{\~n}os and \{Rivas Zald{\'i}var\}, \{Enrique Salvador\} and Susan Mart{\'i}nez and Linda Ibat{\'a} and Castillo, \{Julieth Carolina\} and \{C{\'a}rdenas Rojas\}, \{Paola Jimena\} and \{Castro Vargas\}, \{Evelyn Giuliana\} and Contreras, \{Claudia Romina\} and \{de la Cruz Fern{\'a}ndez\}, Claudia and \{Chavarriaga Restrepo\}, Andr{\'e}s and Echeverria, \{Cristina Mariela\} and \{Esteves de Carvalho\}, \{Andr{\'e} Vicente\} and \{Hidalgo Matlock\}, Benjam{\'i}n and Enrique Loayza and Maskin, \{Mat{\'i}as Rafael\} and Ricardo Romiti and Fernando Valenzuela",

note = "Publisher Copyright: {\textcopyright} 2025 Sociedade Brasileira de Dermatologia",

year = "2025",

month = jul,

day = "1",

doi = "10.1016/j.abd.2025.501134",

language = "English",

volume = "100",

journal = "Anais Brasileiros de Dermatologia",

issn = "0365-0596",

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Londoño-García, AM, Castro-Ayarza, JR, Franco Franco, MD, González Ardila, CF, Magariños, G, Rivas Zaldívar, ES, Martínez, S, Ibatá, L, Castillo, JC, Cárdenas Rojas, PJ, Castro Vargas, EG, Contreras, CR, de la Cruz Fernández, C, Chavarriaga Restrepo, A, Echeverria, CM, Esteves de Carvalho, AV, Hidalgo Matlock, B, Loayza, E, Maskin, MR, Romiti, R & Valenzuela, F 2025, 'Latin American consensus on tapering of biological therapy in psoriasis', Anais Brasileiros de Dermatologia, vol. 100, no. 4, 501134. https://doi.org/10.1016/j.abd.2025.501134

TY - JOUR

T1 - Latin American consensus on tapering of biological therapy in psoriasis

AU - Londoño-García, Angela María

AU - Castro-Ayarza, Juan Raúl

AU - Franco Franco, Manuel Darío

AU - González Ardila, Cesar Fernando

AU - Magariños, Gabriel

AU - Rivas Zaldívar, Enrique Salvador

AU - Martínez, Susan

AU - Ibatá, Linda

AU - Castillo, Julieth Carolina

AU - Cárdenas Rojas, Paola Jimena

AU - Castro Vargas, Evelyn Giuliana

AU - Contreras, Claudia Romina

AU - de la Cruz Fernández, Claudia

AU - Chavarriaga Restrepo, Andrés

AU - Echeverria, Cristina Mariela

AU - Esteves de Carvalho, André Vicente

AU - Hidalgo Matlock, Benjamín

AU - Loayza, Enrique

AU - Maskin, Matías Rafael

AU - Romiti, Ricardo

AU - Valenzuela, Fernando

PY - 2025/7/1

Y1 - 2025/7/1

N2 - Background: Biologic therapy is an effective psoriasis treatment. However, its long-term use carries the risk of serious adverse effects and high costs for the healthcare system, which is particularly relevant in resource-limited Latin American countries. Therefore, there is scientific interest in exploring the feasibility of tapering therapy in low disease activity or clinical remission. Objective: To provide expert consensus-based recommendations to guide personalized and efficient tapering of biologic agents in adult patients with cutaneous psoriasis. Methods: Following an exhaustive systematic literature review, a consensus was developed using a modified Delphi methodology by a group of Latin American clinical dermatologists and an independent methodological team. The topics covered include treatment goals, tapering objectives and strategies, regimens, monitoring and tapering failure, and implementation considerations in patients with psoriasis treated with biological agents. Results: The expert panel reached a consensus on five general principles and 13 recommendations for tapering biological therapy for psoriasis. These recommendations provide scientific support for dermatologists and healthcare providers regarding criteria for tapering, strategies and regimens, monitoring, failure management, and considerations for implementation. Conclusion: Tapering of biologics appears to be effective and safe in psoriasis patients with low stable activity or clinical remission. This Latin American consensus was developed in recognition of the need for rational and optimal use of biologics, while individualizing cases to apply best clinical practices.

AB - Background: Biologic therapy is an effective psoriasis treatment. However, its long-term use carries the risk of serious adverse effects and high costs for the healthcare system, which is particularly relevant in resource-limited Latin American countries. Therefore, there is scientific interest in exploring the feasibility of tapering therapy in low disease activity or clinical remission. Objective: To provide expert consensus-based recommendations to guide personalized and efficient tapering of biologic agents in adult patients with cutaneous psoriasis. Methods: Following an exhaustive systematic literature review, a consensus was developed using a modified Delphi methodology by a group of Latin American clinical dermatologists and an independent methodological team. The topics covered include treatment goals, tapering objectives and strategies, regimens, monitoring and tapering failure, and implementation considerations in patients with psoriasis treated with biological agents. Results: The expert panel reached a consensus on five general principles and 13 recommendations for tapering biological therapy for psoriasis. These recommendations provide scientific support for dermatologists and healthcare providers regarding criteria for tapering, strategies and regimens, monitoring, failure management, and considerations for implementation. Conclusion: Tapering of biologics appears to be effective and safe in psoriasis patients with low stable activity or clinical remission. This Latin American consensus was developed in recognition of the need for rational and optimal use of biologics, while individualizing cases to apply best clinical practices.

KW - Biological therapy

KW - Consensus

KW - Delphi technique

KW - Drug tapering

KW - Latin America

KW - Psoriasis

UR - https://www.scopus.com/pages/publications/105008245809

U2 - 10.1016/j.abd.2025.501134

DO - 10.1016/j.abd.2025.501134

M3 - Article

C2 - 40554355

AN - SCOPUS:105008245809

SN - 0365-0596

VL - 100

JO - Anais Brasileiros de Dermatologia

JF - Anais Brasileiros de Dermatologia

IS - 4

M1 - 501134

ER -

Latin American consensus on tapering of biological therapy in psoriasis

Abstract

Bibliographical note

Keywords

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