This review focuses on the emerging concepts concerning the efficacy profile of biological
drugs in psoriasis ranging from moderate to severe, and attempts to provide the most recent individual
positioning of biologics in treating psoriasis.
Biologic agents targeting towards specific immune mediators have emerged as treatment options for
patients with moderate to-severe plaque psoriasis unresponsive or intolerant to traditional systemic
Data on the safety of biologics are available for up to 5 years in psoriasis and are on the whole reassuring. National
registries are still evolving and will provide data on safety, to help the long-term monitoring of patients with psoriasis
ongoing biological treatment.
Although several biologics have demonstrated good efficacy and tolerability in short-term trials, treatment guidelines
recommend them as third line therapies due to relative lack of long-term safety data, especially for those who have been
Here, we have reviewed the long-term safety data obtained from National Registries, randomized controlled trials, openlabel
extension studies and meta-analyses on etanercept, infliximab, adalimumab, and ustekinumab in the treatment of
adults with moderate to severe plaque psoriasis.