Practical Saudi Guidelines on management of moderate-to-severe psoriasis: 2026 update.

Authors

Mohammed Ibrahim Fatani, Yousef Binamer, Dana Alessa, Hajer Y Almudaiheem, Mohammed Abdulaziz Alajlan, Issam Hamadah, Bedor A Al-Omari, Fahad Alzuriqan, Haifa F Alotaibi, Waleed Alhazzani, Ahmed Aljedai, Maysa Tariq Eshmawi

Published in

The Journal of dermatological treatment. Volume 37. Issue 1. Pages 2724623. Epub Sep 07, 2026.

Abstract

Psoriasis is a chronic, immune-mediated inflammatory skin disease that affects approximately 5.3% of the population in the Kingdom of Saudi Arabia (KSA). Thus, we aim to develop updated evidence-based clinical practice guidelines for the management of adults and pediatric patients with moderate-to-severe plaque psoriasis in the KSA.
These guidelines followed the "Grading of Recommendations, Assessment, Development, and Evaluation" (GRADE) methodology. We conducted a systematic literature review of PubMed, EMBASE, and the Cochrane Library for high-quality evidence published between 2020 and 2026. The panel developed 31 PICO questions that address key treatment considerations for moderate-to-severe psoriasis.
We established 27 evidence-based recommendations and 4 good-practice statements addressing key aspects of moderate-to-severe psoriasis management. These guidelines strongly recommend adopting the Psoriasis Area and Severity Index (PASI) 90 as the primary treatment goal over PASI 75. For adult patients, the guidelines recommend biologic therapies, including interleukin (IL)-17 inhibitors, IL-23 inhibitors, IL-12/23 inhibitors, and tumor necrosis factor (TNF)-α inhibitors, for better disease control. For pediatric patients, the guidelines recommend early initiation of biologic therapy, with etanercept, secukinumab, ixekizumab, and adalimumab as preferred options.
These Saudi national guidelines offer a comprehensive, evidence-based framework for managing moderate-to-severe psoriasis in adults and pediatric patients.

PMID:
42704198
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.

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