The role of biologics in the treatment of moderate-to-severe plaque psoriasis.

Psoriasis is a chronic, relapsing, inflammatory skin disease requiring long-term treatment and in many cases involving a reduction in the quality of life. Treatment with biologics is indicated in patients with moderate-to-severe psoriasis who do not respond or cannot be treated with conventional systemic drugs, and the therapeutic goal is an improvement of 90% (or at least 75%) with respect to baseline PASi at the end of the induction phase, which should be maintained long-term in the mainternance phase of treatment. Before starting treatment with a biological agent it is necessary to review the contraindications and precautions, rule out latent tuberculosis infection and complete the pending immunizations. Biological agents have a more favorable safety profile than classical systemic treatments; the most common side effects are mild and rarely involve the discontinuation of treatment. The treatment decision will be based on individual characteristics and patient preferences, functional limitation, expected speed of onset of effect, adverse reactions, availability and cost of treatment.