TREATMENTS

Goals of therapy for psoriasis include the following:

  • Pursue clearance of skin symptoms.
    • PASI 75 has been the gold standard, but with some of the newer biologics, PASI 90/100 is possible
  • Enhance quality of life and minimize day-to-day psoriasis burden.
  • Minimize adverse events through individualization of therapy.
  • Minimize comorbid disease burden.
  • Maintain patient involvement.

Psoriasis Treatments

Psoriasis treatments include:

  • Biologics
    • TNF-alpha blockers
      • Certolizumab pegol (psoriatic arthritis)
      • Etanercept
      • Adalimumab
      • Infliximab
      • Golimumab (psoriatic arthritis)
    • IL 12/23 blocker
      • Ustekinumab
    • IL-17A blockers
      • Ixekizumab
      • Secukinumab
    • IL-17 receptor blockers
      • Brodalumab
    • Systemics
    • Acitretin
    • Apremilast
    • Cyclosporine
    • Methotrexate
  • Phototherapy
    • Ultraviolet light B (UVB)
    • Sunlight
    • Psoralen + UVA (PUVA)
    • Laser treatments
    • Tanning beds
  • Topicals (for mild psoriasis)
    • Over-the-counter agents
    • Topical steroids
    • Calcipotriene with or without betamethasone
    • Tazarotene
    • Calcitriol
    • Anthralin
  • Complementary and alternative therapies
    • Diet and nutrition
    • Herbal remedies
    • Mind/body therapies
    • Alternative therapies
    • Exercise/yoga/tai chi

Biologic agents are typically targeted to moderate-to-severe psoriasis and are given by injection or intravenous (IV) infusion. These agents are protein-based molecules derived from cell culture and in contract to systemic agents, target specific parts of the immune system such as tumor necrosis factor-alpha (TNF-alpha), IL-17A, or IL-12/IL-23. Each of these cytokines plays a significant role in developing psoriasis and psoriatic arthritis.

biological & commonly

Biologic-AEs

REFERENCES

Please see product labels of individual agents for further information.

Epidemiology

Challenges

Diagnosis

Cardiovascular Disease

Treatments

Additional Reading