Advances in biologic therapy for the treatment of moderate to severe psoriasis: a systematic review

Abstract

We summarize that biologic therapies for moderate to severe psoriasis development has advanced enough as these therapies encompass biologic factors such as TNF-α inhibitors, IL-12/IL-23 inhibitors, and IL-17/IL-23 pathway inhibitors for psoriasis. First-generation biologics like etanercept, infliximab, and adalimumab offer substantial clinical improvements but carry risks of infections and malignancies. Second-generation agents, such as ustekinumab, provide targeted efficacy with fewer adverse effects. Third-generation biologics, including secukinumab, ixekizumab, brodalumab, guselkumab, and tildrakizumab, present highly specific mechanisms, achieving remarkable efficacy with manageable safety profiles. Despite challenges such as cost and long-term monitoring, these biologics represent a paradigm shift in psoriasis management, enhancing patient outcomes and quality of life.