Biologic Therapy Selection Guide for Psoriasis

TNF Inhibitors Adalimumab, etanercept, infliximab Well-established safety profile, long-term data Good for concurrent psoriatic arthritis PASI 75 rates: 50-80% IL-17 Inhibitors Secukinumab, ixekizumab, brodalumab Rapid onset, high efficacy Consider for severe, widespread disease PASI 90 rates: 60-75% Caution in IBD IL-23 Inhibitors Guselkumab, risankizumab, tildrakizumab Convenient dosing (every 8-12 weeks maintenance) High sustained efficacy PASI 90 rates: 65-75% Favorable safety profile IL-12/23 Inhibitor Ustekinumab Weight-based dosing Longest safety data among newer biologics Good for concurrent psoriatic arthritis Selection Considerations Comorbidities, dosing preference, prior biologic exposure, concurrent psoriatic arthritis, IBD history, infection risk, pregnancy planning.