Joint American Academy of Dermatology–National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies

• DOI: 10.1016/j.jaad.2020.02.044
• Publication Date: 2020-02-28T14:40:21Z
• Authors: Alan Menter; Joel M. Gelfand; Cody Connor; April W. Armstrong; Kelly M. Cordoro; Dawn M.R. Davis; Boni E. Elewski; Kenneth B. Gordon; Alice B. Gottlieb; Daniel H. Kaplan; Arthur Kavanaugh; Matthew Kiselica; Dario Kivelevitch; Neil J. Korman; Daniela Kroshinsky; Mark Lebwohl; Craig L. Leonardi; Jason Lichten; Henry W. Lim; Nehal N. Mehta; Amy S. Paller; Sylvia L. Parra; Arun L. Pathy; Elizabeth Farley ...; Robert S. Rahimi; Reena N. Rupani; Michael Siegel; Benjamin Stoff; Bruce E. Strober; Elliot B. Tapper; Emily B. Wong; Jashin J. Wu; Vidhya Hariharan; Craig A. Elmets
• Keywords: Acitretin; Thalidomide; 3. Good health; 03 medical and health sciences; Methotrexate; Pyrimidines; 0302 clinical medicine; Piperidines; Cyclosporine; Humans; Psoriasis; Drug Monitoring

Psoriasis is a chronic inflammatory disease involving multiple organ systems and affecting approximately 2% of the world's population. In this guideline, we focus the discussion on systemic, nonbiologic medications for the treatment of this disease. We provide detailed discussion of efficacy and safety for the most commonly used medications, including methotrexate, cyclosporine, and acitretin, and provide recommendations to assist prescribers in initiating and managing patients on these treatments. Additionally, we discuss newer therapies, including tofacitinib and apremilast, and briefly touch on a number of other medications, including fumaric acid esters (used outside the United States) and therapies that are no longer widely used for the treatment of psoriasis (ie, hydroxyurea, leflunomide, mycophenolate mofetil, thioguanine, and tacrolimus).