Latin American consensus on tapering of biological therapy in psoriasis

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.