title: Biological therapies for psoriasis.
abstract: BACKGROUND
  Biological therapies have revolutionized moderate-to-severe psoriasis treatment. Increased understanding of disease pathogenesis has yielded multiple therapeutic targets involving the IL-23/Th17 pathway, while current therapies continue to be monitored for long-term efficacy and safety.
  
  
  METHODS
  This review details current understanding of psoriasis immunopathogenesis specifically related to therapeutic targets. Approved and emerging biological psoriasis therapies targeting TNF-α, IL-12/23p40, IL-17 and IL-23p19 are covered. Biological agent uses in special circumstances are reviewed together with the emerging debate on biosimilar therapies and their potential future role in psoriasis and other inflammatory diseases.
  
  
  CONCLUSIONS
  Psoriasis treatment has expanded and has become more effective due to increased understanding of disease pathogenesis. However, lack of efficacy in select psoriasis patients, safety concerns and limited treatment efficacy in psoriasis variants (e.g., pustular) are areas which still need improvement. As such, pharmacogenomics will be of vital importance in future for individualized psoriasis care. Further, a better understanding of the multiple psoriasis comorbidities, especially cardiovascular disease, continues to be of significant interest in the psoriasis community. Last, the emergence of biosimilar agents has the potential to change psoriasis treatment, especially as it relates to better access for the psoriasis community worldwide.
authors.affiliation: Dermatology Research FellowBaylor University Medical Center, Division of Dermatology , 3900 Junius Street, Suite 125, Dallas, TX 75204 , USA.
authors.forename: Bobbak
authors.initials: B
authors.lastname: Mansouri
authors.forename: Mahir
authors.initials: M
authors.lastname: Patel
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
mesh_terms: D001685:Biological Factors / Q000627:therapeutic use*; D001691:Biological Therapy; D006801:Humans; D011565:Psoriasis / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D001685:Biological Factors