Systemic Pharmacological Treatments for Chronic Plaque Psoriasis.

CLINICAL QUESTION: Among adults with moderate to severe plaque psoriasis, how do systemic treatments compare in attaining a Psoriasis Area and Severity Index 90 (PASI 90) response and the occurrence of serious adverse events?

BOTTOM LINE: Biologic therapies, particularly interleukin (IL)-17 and IL-23 inhibitors, provide the highest short-term likelihood of achieving PASI 90, while existing oral agents offer more modest efficacy but remain important options for patients who prefer noninjectable treatments. Severe adverse events were uncommon across all therapies and similar to placebo in the short term.