In this installment of “Discourses in Dermatology,” George Han, MD, PhD, and Jason Hawkes, MD, MS, explore treatment options for psoriasis, focusing on the evolving role of biologics versus traditional systemic immunosuppressants. Dr. Han discusses how the precision of biologics in targeting specific components of the immune system, such as TNF alpha and cytokines like IL-23 and IL-17, means biologics are more effective for psoriasis without affecting the broader immune system. He further explains the benefits of newer biologics over older medications, like TNF alpha inhibitors, which have more contraindications.

Dr. Han addresses safety concerns surrounding biologics, contrasting them with the side effects of broad-acting medications like methotrexate. He points out that biologics have a strong safety track record, with most having 3-5 years of data available. However, he notes the challenge of balancing medical economics with the efficacy of newer treatments. The discussion concludes with the need for further exploration of targeted therapies in psoriasis, particularly for patients with psoriatic arthritis, emphasizing a more nuanced approach to treatment selection.

Reference: Hawkes J, Han G. Psoriasis mechanism of disease: Insights on treatment options. Updated November 16, 2023. Accessed March 29, 2024. https://dermsquared.com/videos/discourses-in-dermatology/psoriasis-mechanism-of-disease-treatment