OBJECTIVES: To describe the results of a program of rational use of biological drugs in an integrated clinic of immune-mediated skin diseases (CLIPSO).

METHODS: Descriptive, cross-sectional study, conducted in July-December 2022, in a cohort of patients diagnosed with immune-mediated dermatologic diseases. Patients were evaluated by a team of physicians, dermatology specialists, and pharmacists, who performed a clinical and pharmacological follow-up of patients and according to their evolution established optimization strategies or avoidable initiation of biological therapies. A univariate analysis was performed, with summary measures of central tendency, and relative and cumulative frequencies. The statistical package R Core Team Version 4.2 (2022) was used.

RESULTS: During the period evaluated, 1043 patients were identified on treatment with biological therapy of which 86 patients (8.2%) had their therapy optimized according to their clinical evolution. These patients had a mean age of 46 years (SD: 16), 57% (49 persons) were female and mainly with diagnoses of psoriasis 65.1%, urticaria 17.4%, atopic dermatitis 12.8% and hidradenitis suppurativa 4.7%. Therapy optimization strategies were 41.9% spacing of biologic administration frequency (ixekizumab 22.2%, adalimumab 19.4%, and ustekinumab 19.4%), 19.8% discontinuation of biologic therapy (omalizumab 52.9% and adalimumab 23.5%), 17.4% avoidability of biologic therapy initiation (dupilumab 40%, adalimumab 26.7%, guselkumab 26.7% and omalizumab 6.7%); 10.5% dose reduction (secukinumab 44.4%, omalizumab 44.4% and ixekizumab 11.1%); 9.3% chance of treatment (ustekinumab to guselkumab) and 1.2% switch to a biosimilar drug (adalimumab). All patients maintained satisfactory clinical results and a total saving of 84535.30 USD (14089.22 USD/month) was generated.

CONCLUSIONS: A biological therapy rationalization program based on an adequate approach and follow-up of patients with immune-mediated skin diseases allows for obtaining satisfactory clinical results and a significant economic impact on the health system.