Methods Report: Update of the German S3 Guideline for the Treatment of Psoriasis vulgaris

Background: This report describes the methods and processes used to develop the 2017 update of the German Evidence-and Consensus-based (S3) Guideline for the Treatment of Psoriasis vulgaris (Deutsche S3-Leitlinie zur Therapie der Psoriasis vulgaris - Update 2017). Methods: The methods used to search for, assess and grade the evidence on the systemic treatment of psoriasis followed the recommendations given in the Cochrane Handbook for Systematic Reviews, as well as those of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group and the German Association of Scientific Medical Societies (AWMF). The nominal group technique was used during the guideline consensus conference to generate draft recommendations, discuss alternatives and reach final consensus. Results: The systematic literature search considered studies published up to and including 1 December 2016 and identified 1655 records. After two screening phases, 15 records reporting 12 new studies that satisfied the inclusion criteria remained. In total, evidence from 87 studies was graded, producing 52 individual GRADE summary of findings (SoF) tables. Draft recommendations were prepared by experts for all consensus-based recommendations. All draft recommendations were discussed and voted on in two consensus conferences attended by the experts from the guideline development group. Conclusion: The field of psoriasis therapy is in constant transition. A lack of head-to-head trials makes direct comparisons challenging. Continuous updating will be necessary to respond to the further changes expected in the field. Updates on newly approved medications such as ixekizumab are expected to take place before the present guideline expires.