title: Experience and challenges for biologic use in the treatment of moderate-to-severe psoriasis in Africa and the Middle East region.
abstract: The incidence of psoriasis in Africa and the Middle East (AfME) is high as in other regions and represents a significant problem for both dermatologists and patients. Psoriasis co-morbidities such as obesity, cardiovascular disease and psoriatic arthritis (PsA) are also particularly common in these regions and may be under-recognized and under-treated. Despite this, regional guidelines to aid physicians on the appropriate use of biologic agents in their clinical practice are limited. A group of expert dermatologists from across the AfME region were surveyed to help establish best practice across the region, alongside supporting data from the literature. Although biologics have significantly improved patient outcomes since their introduction, the results of this survey identified several unmet needs, including the lack of consensus regarding their use in clinical practice. Discrepancy also exists among AfME physicians concerning the clinical relevance of immunogenicity to biologics, despite increasing data across inflammatory diseases. Significant treatment and management of challenges for psoriasis patients remain, and a move towards individualized, tailored care may help to address these issues. The development of specific local guidelines for the treatment of both psoriasis and PsA could also be a step towards understanding the distinct patient profiles in these regions.
authors.affiliation: a Department of Dermatology , Rashid Hospital , Dubai , UAE.
authors.forename: Anwar
authors.initials: A
authors.lastname: Al Hammadi
authors.affiliation: b Department of Dermatology , King Abdulaziz Medical City , Riyadh , Saudi Arabia.
authors.forename: Afaf
authors.initials: A
authors.lastname: Al-Sheikh
authors.affiliation: c Department of Dermatology , St George Hospital University Medical Center , Beirut , Lebanon.
authors.forename: Alfred
authors.initials: A
authors.lastname: Ammoury
authors.affiliation: d Department of Dermatology , American University of Beirut Medical Center , Lebanon.
authors.forename: Samer
authors.initials: S
authors.lastname: Ghosn
authors.affiliation: e Department of Dermatology , University Hospital of Verona , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gisondi
authors.affiliation: f Department of Dermatology , King Faisal Hospital and Research Centre , Riyadh , Saudi Arabia.
authors.forename: Issam
authors.initials: I
authors.lastname: Hamadah
authors.affiliation: d Department of Dermatology , American University of Beirut Medical Center , Lebanon.
authors.forename: Abdul-Ghani
authors.initials: AG
authors.lastname: Kibbi
authors.affiliation: g Pfizer Inc , Dubai , UAE.
authors.forename: Khalid
authors.initials: K
authors.lastname: Shirazy
mesh_terms: D000349:Africa; D015535:Arthritis, Psoriatic / Q000188:drug therapy; D001291:Attitude of Health Personnel; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D000066491:Clinical Decision-Making; D003362:Cost-Benefit Analysis; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019468:Disease Management; D019538:Health Care Surveys; D006801:Humans; D008877:Middle East; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011565:Psoriasis / Q000188:drug therapy*
chemical_list: D001688:Biological Products; D003879:Dermatologic Agents
keywords: Biologics; co-morbidities; guidelines; screening; treatment