Criteria and procedure for starting biological treatment

If you're primarily interested in what biological treatment for psoriasis entails (or biological drugs in general), we recommend reading these subsections first.

• Biological treatment of psoriasis
• What is biological treatment ? (Basic explanation) 

In the following lines, we will explore the standard procedure and criteria for starting biological treatment.

While biological drugs represent an innovative and effective medical advancement in psoriasis treatment, they cannot be administered to everyone.

This is because it is a relatively new treatment, and its cost is relatively high. Therefore, from a public finance perspective, it is necessary for it to be administered only to patients who absolutely need it and have no other treatment options

The following criteria are necessary for you to qualify for biological treatment.

Severity

Biological treatment is intended for individuals with moderate to severe forms of psoriasis. The severity of the condition is determined by a dermatologist through physical examination based on:

• Psoriasis Area and Severity Index (PASI),
• Percentage of Body Surface Area affected (BSA),
• Dermatology Life Quality Index (DLQI).

Failure of previous treatment

Biological treatment can be administered to patients who do not respond to conventional systemic therapy (methotrexate, cyclosporine, acitretin, phototherapy), or for whom it is contraindicated.

This means that before applying for biological treatment, you must undergo at least two types of conventional systemic treatment – each for 3 months. If the medications were ineffective, adverse effects occurred during their use, or they could not be prescribed to you at all (for example, for health reasons), you meet another criterion.

In summary – you are a suitable candidate for biological treatment if:

• you meet the criteria based on PASI, BSA, or DLQI indices, and
• conventional systemic treatment has failed or is contraindicated.

If you meet the criteria, there are still a few examinations awaiting you that are an essential part of the application process for biological treatment.

You should undergo:

• blood tests (among other things, the presence of syphilis, hepatitis, or HIV is determined),
• urine analysis,
• lung examination.

If the examinations do not reveal anything preventing the initiation of biological treatment, the doctor at the clinic specializing in biological treatment will issue a request and send it to your health insurance company. The insurer typically has 30 days to approve it.

If you are approved for biological treatment, the first dose will be administered under medical supervision. In addition to injections given at the clinic, the doctor may also prescribe an injection pen. With it, you can administer the medication at home.

An advantage of biological treatment is its infrequent dosing – once every 4 to 12 weeks depending on the medication.

After a certain period, the effectiveness of the treatment must be evaluated. If the desired effect is not achieved, treatment with the particular biological drug is discontinued, and alternative biological treatment may be considered.

Therefore, the first step towards biological treatment is a visit to a clinic specializing in biological treatment.