title: Optimization of systemic treatments for chronic plaque psoriasis. Recommendations for switching and transitioning.
abstract: OBJECTIVE
  The aim of this study was to provide practical recommendations for optimizing the use of conventional and biological systemic treatments for moderate-severe chronic plaque psoriasis, particularly in case of transitioning and switching.
  
  
  METHODS
  A total number of 147 dermatologists from 33 different countries including Italy achieved consensus in providing practical recommendations for the use of conventional and biological treatments for moderate to severe psoriasis based on systematic literature review and/or expert opinion.
  
  
  RESULTS
  In general, the continuous treatment regimen should be preferred in order to achieve a complete and long-term control of psoriasis. However, the treatment could be stopped or the dose reduced in case of complete disease clearance. A conventional drug could be associated to biological treatment in selected cases. Transitioning and/or switching could be considered in case of inefficacy or intolerance. A period of wash up is required if transitioning or switching is due to safety issues.
  
  
  CONCLUSIONS
  This study provides practical suggestions for the optimal use of conventional and biological treatments for chronic plaque psoriasis.
authors.affiliation: Clinica Dermatologica, Università degli Studi di Verona, Verona, Italia - paolo.gisondi@univr.it.
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