Advances in Monoclonal Antibody Therapy for Moderate to Severe Psoriasis: Targeting TNF, IL-17, And IL-23 Pathways for Optimal Disease Management

Abstract

Psoriasis, a chronic immune-mediated dermatological disorder, significantly impacts patients' quality of life, particularly in its moderate to severe forms. The advent of biologic therapies, specifically monoclonal antibodies (mAbs), has revolutionized the treatment landscape. This article provides an in-depth analysis of the efficacy, safety, and mechanistic insights of anti-TNF (e.g., adalimumab, infliximab), anti-IL-17 (e.g., secukinumab, ixekizumab), and anti-IL-23 (e.g., guselkumab, risankizumab) agents in the management of moderate to severe psoriasis. Clinical trials and real-world evidence demonstrate that these biologics achieve substantial improvements in Psoriasis Area and Severity Index (PASI) scores, Dermatology Life Quality Index (DLQI), and long-term remission rates. However, their use is not without risks, including potential adverse effects such as infections, immunogenicity, and rare paradoxical reactions. This review underscores the importance of personalized treatment strategies, considering patient-specific factors such as comorbidities, disease severity, and treatment history. By synthesizing current evidence, this article aims to guide clinicians in optimizing therapeutic outcomes while mitigating risks associated with monoclonal antibody therapy in psoriasis management.