Psoriasis: Which therapy for which patient: Psoriasis comorbidities and preferred systemic agents

Abstract

Psoriasis is a systemic inflammatory disease associated with increased risk of comorbidities, such as psoriatic arthritis, Crohn's disease, malignancy, obesity, and cardiovascular diseases. These factors have a significant impact on the decision to use one therapy over another. The past decade has seen a paradigm shift in our understanding of the pathogenesis of psoriasis that has led to identification of new therapeutic targets. Several new drugs have gained approval by the US Food and Drug Administration, expanding the psoriasis armamentarium, but still a large number of patients continue to be untreated or undertreated. Treatment regimens for psoriasis patients should be tailored to meet the specific needs based on disease severity, the impact on quality of life, the response to previous therapies, and the presence of comorbidities. The first article in this continuing medical education series focuses on specific comorbidities and provides insights to choose appropriate systemic treatment in patients with moderate to severe psoriasis.

Keywords: IL-17; IL-23; TNF-α; acitretin; adalimumab; apremilast; biologic; brodalumab; certolizumab; comorbidities; cyclosporine; etanercept; golimumab; infliximab; ixekizumab; methotrexate; psoriasis; psoriatic arthritis; secukinumab; ustekinumab.