Choosing the right biologic treatment for moderate-to-severe plaque psoriasis: the impact of comorbidities

Expert Rev Clin Pharmacol. 2024 Apr;17(4):363-379. doi: 10.1080/17512433.2024.2340552. Epub 2024 Apr 11.

Abstract

Introduction: Psoriasis is a chronic inflammatory skin disease often associated with several comorbidities, such as psoriatic arthritis, inflammatory bowel disease, obesity, diabetes mellitus or cardiovascular diseases, infections, or cancer, among others. With the progressive aging of the population, a growing number of patients with psoriasis can be expected to present multiple comorbidities. Currently, there is a wide range of biological treatments available for moderate to severe psoriasis, including tumor necrosis alpha (TNF) inhibitors, IL12/23 inhibitor, IL17 inhibitors, and IL23 inhibitors.

Areas covered: This review aims to describe the specific characteristics of these drugs in relation to psoriasis comorbidities, in order to facilitate decision-making in clinical practice.

Expert opinion: Some of the biological treatments can influence comorbidities, in some cases even improving them. Therefore, comorbidities are a key factor when deciding on one biological treatment over another. The development of new drugs is expanding the therapeutic arsenal for psoriasis. A high level of expertise in the field with a detailed knowledge of the characteristics of every drug is imperative to provide personalized medicine.

Keywords: IL17 inhibitors; IL23 inhibitors; Psoriasis; TNF inhibitors; biologic treatment; comorbidities; ustekinumab.

Publication types

  • Review

MeSH terms

  • Arthritis, Psoriatic* / drug therapy
  • Biological Products* / adverse effects
  • Comorbidity
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Psoriasis* / drug therapy

Substances

  • Biological Products