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Biologic Continuation — SCE Dermatology MCQ

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EasyDermatopharmacologyBiologic ContinuationSCE Dermatology

A 60-year-old man with plaque psoriasis has excellent skin clearance on Risankizumab (PASI 100) at his 6-month review. His DLQI is 0. He remains well with no adverse effects. According to BAD continuation criteria, can he continue the biologic?

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Correct answer: E — Yes — he meets continuation criteria (maintained adequate response defined as PASI 75 or PASI 50 + DLQI improvement ≥5 points)

BAD/NICE continuation criteria for biologic therapy in psoriasis require demonstration of adequate response at regular review intervals (typically 3-6 monthly). Adequate response is defined as: PASI 75 (75% reduction from baseline) OR PASI 50 (50% reduction) with ≥5 point improvement in DLQI. A patient with PASI 100 and DLQI 0 clearly meets continuation criteria. Treatment should continue as long as the response is maintained and no safety concerns arise. Periodic re-assessment ensures appropriate resource use. If response is lost, dose optimisation, addition of topical therapy, or biologic switching should be considered.

Reference: BAD 2020 Biologic Guidelines; NICE CG153