BIOLOGIC THERAPIES FOR PSORIASIS

Psoriasis is a chronic, immune-mediated inflammatory skin disease affecting 2–3% of global population, with significant impacts on quality of life and comorbid health conditions. Recent advances in understanding the IL-23/IL-17 axis have led to the development of targeted biologic therapies that offer superior efficacy and safety compared to traditional treatments. Biologic agents—including TNF-? inhibitors, IL-12/23 inhibitors, IL-17 inhibitors, and IL-23 inhibitors—have demonstrated high rates of skin clearance (PASI90/100),durable long-term responses, and favorable safety profiles. IL-17 inhibitors provide rapid onset, while IL-23 inhibitors offer sustained disease control and drug survival. Biosimilars enhance cost effectiveness and access to care. Clinical guidelines now endorse biologics as first-line systemic therapies for moderate-to-severe psoriasis. Personalized prescribing, monitoring, and screening strategies are essential to optimize outcomes, especially in special populations. This review provides an in-depth analysis of biologic mechanisms, comparative efficacy, long-term safety, and clinical application in the evolving management of psoriasis.

KEYWORDS: Psoriasis, Biologics, IL-23, IL-17, TNF-?, IL-12/23, PASI (Psoriasis Area & Severity Index), Efficacy, Safety, Onset, Drug survival, Biosimilars.