2026 Saudi guideline updates for the management of moderate-to-severe PsO

Updated evidence-based clinical practice guidelines for the management of moderate-to-severe psoriasis (PsO) in the Kingdom of Saudi Arabia were published in the Journal of Dermatological Treatment by Fatani et al. Recommendations were developed by a 12-member multidisciplinary panel using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. 

Key data: Overall, 27 evidence-based recommendations and 4 good-practice statements addressing 31 population, intervention, comparator, and outcome (PICO) questions were developed. Recommendations include the adoption of ≥90% improvement in Psoriasis Area and Severity Index (PASI90) as the primary treatment goal over PASI75 for patients who are candidates for systemic or biologic therapy; the use of dose-escalated biologics, such as interleukin (IL)-17, IL-23, IL-12/23, and tumor necrosis factor (TNF)-alfa inhibitors, for the treatment of adults; and early biologic initiation for pediatric patients. Interclass switching is suggested for adult patients with minimal response. It is recommended that patients receiving biologic therapy are closely monitored for adverse events (AEs); patients receiving TNF-alfa inhibitors should also be regularly screened for cardiovascular complications and hepatitis B virus (HBV) infection. Additional recommendations are provided for patients with comorbidities, pregnancy, and difficult-to-treat PsO. 

Key learning: The 2026 Saudi national guideline updates provide a comprehensive, evidence-based framework to support clinical decision-making in the management of moderate-to-severe PsO.