Project

www.psoriasis-guideline.com

Development of an evidence based (S3-) guideline for the therapy of Psoriasis

In February 2004 the project for developing an evidence based guideline for the therapy of Psoriasis started whereas the dEBM was assigned by the DDG (Deutschen Dermatologischen Gesellschaft) and the BVDD (Berufsverband der Deutschen Dermatologen). Meanwhile, the S3 – guideline for the therapy of Psoriasis is finished. A publication in the German language as well as a translation into English is planned for the end of July 2006.

The aim of preparing this high level S3-guideline was to create a guideline that is not only based on profound scientific, evidence but also takes into consideration other issues as quality of life, applicability doctor and patient and costs. The purpose of the guidelines is to provide help to the dermatologist in their treatment decisions for individual patients.

The guideline was designed based on the methodological guidelines of the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften) and the ÄZQ (Ärztliches Zentrum für Qualität in der Medizin). The German guideline orientates itself at the results of the Dutch S3 – guideline called “ Richtlijn Foto(Chemo-) Therapie en systemische Therapie bij ernstige chronische Plaque Psoriasis“ which was published in the year 2003 and focuses on the systemic treatment of psoriasis. The Dutch guideline served as a structural basis, however, the contents were updated and the spectrum of therapies was extended including topical therapies, combination therapies, and the new biologicals

 

Procedural steps in the year 2004

In 2004 the Dutch guideline was translated and evaluated within the study group based on the AGREE (Appraisal of Guidelines for Research & Evaluation) instrument.

For the guideline group the BVDD nominated 5 dermatologists from private practice and the DDG nominated 5 dermatologists from the departments of dermatology. This „5 + 5 group“ formed the content of the guideline. During their work the „5+5 group“ was supported methodologically and logistically by the guideline coordination team of the dEBM.

The dEBM carried out an extensive and complete literary search for all published clinical controlled trials focusing on plaque type psoriasis. For this purpose the databases of the Cochrane Collaboration, MedLine and Embase were used. Then the literature was critically judged with the help of provided evidence tables and evaluation criteria of the „5+5 group“. Based on the evaluated literature as well as other sources the formulation of therapy recommendations was carried out.

After two further meetings in the year 2004 first proposals were formulated regarding the guideline.

 

Procedural steps in the year 2005

An extended group besides the dermatologists was created which consists of a multi-disciplined team of patients with psoriasis, nurses, rheumatologists, psychosomatic specialists.

The first consensus conference took place in June 2005 under the moderation of Dr. I. Kopp, MD from the AWMF. Here, the initial proposals were developed and judged together. Thanks to the cooperation of all participants it was possible to create a first version of the guideline in another consensus conference which took place at the end of August 2005.

At the end of the year 2005 the guideline was given to a peer review by another group of experts, nominated from the DDG, BVDD und and the Psoriasis Bund e.V (Psoriasis alliance e.V.). A methodological review was also carried out by two experts nominated from the dEBM.

 

Working steps in the year 2006:

At the final consensus conference in January 2006 the final version of the guideline was agreed upon in consideration of the results from the expert review. After the editorial revision of the dEBM and final authorization of the authors of the individual chapters now the publication of the German S 3 – guideline for the therapy of Psoriasis is planned for Summer 2006. In addition, a translation into English and a special version for patients are under work.

read more : www.psoriasis-leitlinie.de (in german)