DERMATOLOGY SOCIETY OF SOUTH AFRICA

Guidelines

General Information

  • All Dermatological patients who wish to use biologic therapies must be registered with the DSSA Biologics Registry. Any changes in biologic therapy, adverse events during the course of treatment and 6 monthly clinical updates are to be added to the registry.
  • All patients must be tested for active or latent tuberculosis before starting biologic therapy. Latent tuberculosis must be treated according to DSSA recommendations before treatment is started. (see TB guidelines)
  • Testing for chronic hepatitis B and C is advised before commencing biologic treatment.
  • The PASI scoring system is used for activity of disease scoring and monitoring of response to treatment ( PASI score sheet available under Downloads)
  • The use of biologic therapies is restricted to registered dermatologists. Accreditation for the use of biologics may be sought from DSSA Executive Committee providing the physician or paediatrician can prove sufficient clinical experience in dermatology and regular attendance of appropriate conferences.
  • Standard systemic therapy (with the exception of methotrexate) should be discontinued for 4 weeks prior to initiation of biologic therapy whenever possible to minimize risk of infection and establish baseline disease severity. When necessary, methotrexate co-therapy may be continued at the minimal required dose
  • Where discontinuing standard systemic therapy is associated with risk of severe or unstable disease, use of concomitant systemic therapy should be rationalized during the transition period and stopped as soon as therapeutic efficacy of the biologic therapy is established
  • The DSSA subscribes to the British Association of Dermatologist Guidelines of 2009 ( see under downloads)