Biologics and Psoriasis: Treatment Selection with a Focus on Patient Comorbidities

Psoriasis is a chronic, multisystemic, inflammatory disease that exhibits a wide array of clinical presentations and is associated with high disease burden. Advancements in our understanding of the pathophysiology of psoriasis have led to the development of novel therapeutic modalities known as biologics that inhibit the action of pro-inflammatory cytokines, offering a more targeted therapeutic approach and improved safety profile compared to traditional systemic agents. Psoriasis disease severity is usually the main driver when it comes to selecting the appropriate biologic for any given patient; however, with an increasing number of biologics from which to choose, one pressing question that is increasingly more common in clinical practice is, “How do we select the ‘right’ treatment for each patient?” We performed a review of the literature on biologic use in patients with psoriasis with a focus on specific systemic comorbidities. Here, we summarize currently available recommendations based on available studies.