Background: In recent years, the approval of newer biological therapies for the management of moderate-to-severe plaque psoriasis has enabled the achievement of higher treatment goals. On the other hand, these therapies are associated with substantially higher costs, creating increasing pressure from healthcare payers to reduce overall expenditure and influencing prescribing practices. To support clinicians in navigating these challenges, the first Slovenian guidelines for the management of moderate-to-severe plaque psoriasis in adult patients have been developed. Their purpose is to provide evidence-based guidance that empowers dermatovenerologists to prescribe, at any given time, the therapy they consider most appropriate for the individual patient. Methods: The guidelines were developed using a structured, consensus-based Delphi approach. A working group of six Slovenian dermatovenereology specialists was convened and formally approved by the Association of Slovenian Dermatovenereologists. Following a review of existing national and international guidelines, the group drafted initial recommendation statements, which were iteratively revised and voted on until 100% consensus was reached. The finalized statements were subsequently distributed for voting to members of the Association of Slovenian Dermatovenereologists prescribing biological therapies for psoriasis. Results and conclusion: This process resulted in a robust, consensus-driven set of recommendations for Slovenian dermatovenerologists, providing evidence-based guidance on selecting systemic therapies, initiating and sequencing biological drugs, defining moderate-to-severe disease, establishing treatment goals, and determining treatment failure.
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