Psoriasis

Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.

Sbidian E, Chaimani A, Guelimi R, Tai CC, Beytout Q, Choudhary C · The Cochrane database of systematic reviews · 2025

Psoriasis is an immune-mediated disease with either skin or joints manifestations, or both, and it has a major impact on quality of life. Although there is currently no cure for psoriasis, various treatment strategies allow sustained control of disease signs and symptoms. Despite multiple available treatments, their comparative efficacies and safety remain unclear due to the limited number of direct comparisons. We conducted a network meta-analysis to comprehensively compare systemic treatments. To compare the benefits and harms of non-targeted systemic agents, targeted synthetic agents, and biologic targeted treatments for people with moderate-to-severe psoriasis using a network meta-analysis, and to rank these treatments according to their benefits and harms. For this update of the living systematic review, we updated our searches monthly up to July 2024 in the following databases and trial registers: CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and WHO ICTRP. Randomised controll

GWAS meta-analysis of psoriasis identifies new susceptibility alleles impacting disease mechanisms and therapeutic targets.

Dand N, Stuart PE, Bowes J, Ellinghaus D, Nititham J, Saklatvala JR · Nature communications · 2025

Psoriasis is a common, debilitating immune-mediated skin disease. Genetic studies have identified biological mechanisms of psoriasis risk, including those targeted by effective therapies. However, the genetic liability to psoriasis is not fully explained by variation at robustly identified risk loci. To refine the genetic map of psoriasis susceptibility we meta-analysed 18 GWAS comprising 36,466 cases and 458,078 controls and identified 109 distinct psoriasis susceptibility loci, including 46 that have not been previously reported. These include susceptibility variants at loci in which the therapeutic targets IL17RA and AHR are encoded, and deleterious coding variants supporting potential new drug targets (including in STAP2, CPVL and POU2F3). We conducted a transcriptome-wide association study to identify regulatory effects of psoriasis susceptibility variants and cross-referenced these against single cell expression profiles in psoriasis-affected skin, highlighting roles for the tran

Indirect comparison of deucravacitinib and other systemic treatments for moderate to severe plaque psoriasis in Asian populations: A systematic literature review and network meta-analysis.

Tsai TF, Tada Y, Kung C, Zhong Y, Cichewicz A, Borkowska K · The Journal of dermatology · 2024

Expanding the systemic treatment options for patients with psoriasis, deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor is approved in the United States, European Union, China, Japan, Taiwan, Korea, and other countries for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. Evidence suggests the comparative efficacy of systemic therapies may be different in Asian versus White patients. This systematic review and network meta-analysis (NMA) evaluated the clinical efficacy associated with deucravacitinib and other biologic or non-biologic systemic treatments for moderate to severe plaque psoriasis in Asian populations. Electronic databases were searched to identify randomized trials of the interventions of interest. Multinomial random effects models adjusting for baseline placebo risk were used to estimate Psoriasis Area and Severity Index (PASI) responses at weeks 10-16. Of 8596 studies identified, 20 were i

Integrating network pharmacology and experimental validation to advance psoriasis treatment: Multi-target mechanistic elucidation of medicinal herbs and natural compounds.

Jo HG, Seo J, Jang B, Kim Y, Kim H, Baek E · Autoimmunity reviews · 2025

Psoriasis, a chronic immune-mediated inflammatory disease (IMID), presents significant therapeutic challenges, necessitating exploration of alternative treatments like medicinal herbs (MH) and natural compounds (NC). Network pharmacology offers predictive insights, yet a systematic evaluation connecting these predictions with experimental validation outcomes specifically for MH/NC in psoriasis is lacking. This review specifically fills this gap by comprehensively integrating and analyzing studies that combine network pharmacology predictions with subsequent experimental validation. A systematic literature search identified 44 studies employing both network pharmacology and in vitro or in vivo experimental methods for MH/NC targeting psoriasis. This review provides a systematic analysis of the specific network pharmacology platforms, predicted targets/pathways, in vivo and in vitro experimental validation models, and key biomarker changes reported across these integrated studies. Metho

Evidence-based dietary recommendations for patients with psoriasis: A systematic review.

Wang Q, Wang J, Sun X, Liu L, Zhang M, Yu Y · Clinical nutrition (Edinburgh, Scotland) · 2025

Psoriasis is a chronic recurrent inflammatory skin disease mediated by immune, genetic, and environmental factors. Numerous studies have demonstrated that the excessive consumption of certain pro-inflammatory foods, including alcohol, dairy products, high-sugar foods, and gluten, can exacerbate psoriasis. Thus, modifying one's dietary habits can alleviate psoriasis symptoms. However, high-quality evidence regarding the relationship between diet and psoriasis is currently lacking. This review provides insight into the dietary management of psoriasis by reviewing previous dietary therapies. An extensive search of the PubMed, Embase, and Cochrane databases for clinical studies of psoriasis and diet revealed that diets meeting Mediterranean, gluten-free, or calorie-restricted principles, dietary fiber, probiotic, prebiotic, and n-3 fatty acid contents may be associated with improved psoriasis outcomes. Additionally, patients with psoriasis should avoid consuming alcohol and high amounts of

Complementary and Alternative Therapies for Psoriasis.

Chalupczak NV, Lio PA · Archives of dermatological research · 2024

Despite recent advancements in psoriasis treatment, challenges in management persist. Recently, there has been a rising interest amongst patients in complementary and alternative medicines (CAM), driven by the desire for more natural, holistic approaches and dissatisfaction with conventional treatments. Up to 41% of patients with psoriasis reported using alternative therapies and 39.5% use complementary therapies (Murphy EC, Nussbaum D, Prussick R, Friedman AJ (2019) Use of complementary and alternative medicine by patients with psoriasis. J Am Acad Dermatol 81:280-283). Despite their rapidly growing prevalence, literature on CAM therapies for psoriasis is lacking, making their recommendation difficult. Since the last systematic review on this topic published in 2018, evidence for new alternative therapies has emerged, promoting a further investigation of their efficacy (Gamret AC, Price A, Fertig RM, Lev-Tov H, Nichols AJ (2018) Complementary and Alternative Medicine Therapies for Pso

French guidelines on systemic treatments for moderate-to-severe psoriasis in adults: Update 2025.

Masson Regnault M, Brenaut E, Marniquet ME, Berthault C, Canoen L, Marcombes C · Journal of the European Academy of Dermatology and Venereology : JEADV · 2026

The current French guidelines for the treatment of psoriasis date from 2019 and do not include the most up-to-date interventions. The Psoriasis Research Group of the French Society of Dermatology has developed new guidelines to provide updated decision-making algorithms for the systemic treatment of adult patients with moderate-to-severe psoriasis. The algorithms were created following a thorough review of existing psoriasis treatment guidelines and recent publications on new systemic therapies not included in previous recommendations. They propose updated treatment strategies that combine established and emerging systemic therapies for patients with plaque psoriasis and psoriatic arthritis. The working group recommends methotrexate, adalimumab or ustekinumab as the primary systemic treatment for patients with psoriasis without symptomatic comorbidities. Additionally, the guidelines include specific recommendations for long-term management in cases of insufficient response or low disea

Joint position statement from the National Psoriasis Foundation Medical Board and the International Psoriasis Council on routine testing for latent tuberculosis infection prior to and during treatment of psoriasis patients with interleukin 17 or interleukin 23 inhibitors.

Blauvelt A, Strober BE, Eakin GS, McCormick Howard L, Langan C, van de Kerkhof PCM · Journal of the American Academy of Dermatology · 2026

Although testing for latent tuberculosis (TB) infection has been standard practice for psoriasis patients being treated with interleukin (IL) 17 or IL-23 inhibitors, evidence for this practice is weak. To review evidence on safety of IL-17 and IL-23 inhibitors in the setting of latent TB infection and to provide a new Joint Position Statement on this topic. Experts from the National Psoriasis Foundation and the International Psoriasis Council reviewed evidence regarding progression of latent TB infection to active disease in psoriasis patients receiving IL-17 or IL-23 blockers. A Joint Position Statement was formulated and approved to provide updated guidance to clinicians. 87.5% of the members from the National Psoriasis Foundation Medical Board and International Psoriasis Council approved a new Joint Position Statement regarding psoriasis patients being treated with IL-17 or IL-23 inhibitors, stating that testing for latent TB infection is not required. This position statement al

S3 Guideline for the treatment of psoriasis vulgaris, adapted from EuroGuiDerm - part 1: Treatment recommendations and monitoring.

Nast A, Altenburg A, Augustin M, Bachmann F, Boehncke WH, Cornberg M · Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2026

This first part of the updated German S3 guideline on the treatment of psoriasis vulgaris covers the sections on treatment recommendations, treatment goals, and monitoring of therapies. The recommendations are based on the current Cochrane network meta-analysis, the results of which are also summarized. When selecting systemic therapies for psoriasis vulgaris, the guideline emphasizes consideration of efficacy, safety, comorbidities, and individual patient factors. The decision framework is presented in the treatment options overview, and in this updated version, the possibility of first-line therapy with biologics or novel targeted small molecules is more prominently highlighted. Standardized instruments for assessing disease severity, as well as patient-centered treatment goals, are underscored. A Psoriasis Area and Severity Index (PASI) 75 response is defined as the minimum therapeutic target, while PASI 90 or an absolute PASI <2 are considered desirable goals. Since the last ver

Mediterranean Diet and Patients With Psoriasis: The MEDIPSO Randomized Clinical Trial.

Perez-Bootello J, Berna-Rico E, Abbad-Jaime de Aragon C, Goni L, Vazquez-Ruiz Z, Neria F · JAMA dermatology · 2025 · n=38

Despite growing interest on the role of diet in the prevention and treatment of psoriasis, randomized clinical trials are lacking. The Mediterranean diet is known for its anti-inflammatory and cardiometabolic benefits, which may be relevant to psoriasis pathophysiology. To assess whether a 16-week Mediterranean diet intervention would improve psoriasis severity in patients with mild to moderate disease. MEDIPSO (Impact of the Mediterranean Diet on Patients With Psoriasis), an open-label, single-center, single-blinded (evaluator) randomized clinical trial, was conducted from February 2024 to March 2025 at a dermatology referral clinic in Madrid, Spain. Participants were adults with mild to moderate psoriasis (Psoriasis Area and Severity Index [PASI] of 2-10, with higher scores indicating maximal disease) receiving stable topical therapy. Participants were randomized 1:1 to the intervention or control group. The intervention group received a 16-week, dietitian-guided Mediterranean die

The Effect of a Ketogenic Diet versus Mediterranean Diet on Clinical and Biochemical Markers of Inflammation in Patients with Obesity and Psoriatic Arthritis: A Randomized Crossover Trial.

Lambadiari V, Katsimbri P, Kountouri A, Korakas E, Papathanasi A, Maratou E · International journal of molecular sciences · 2024

The effect of different diet patterns on psoriasis (PSO) and psoriatic arthritis (PSA) is unknown. Τhe aim of our study was to evaluate the effectiveness of a Mediterranean diet (MD) and Ketogenic diet (KD), in patients with PSO and PSA. Twenty-six patients were randomly assigned to start either with MD or KD for a period of 8 weeks. After a 6-week washout interval, the two groups were crossed over to the other type of diet for 8 weeks. At the end of this study, MD and KD resulted in significant reduction in weight (p = 0.002, p < 0.001, respectively), in BMI (p = 0.006, p < 0.001, respectively), in waist circumference (WC) (p = 0.001, p < 0.001, respectively), in total fat mass (p = 0.007, p < 0.001, respectively), and in visceral fat (p = 0.01, p < 0.001, respectively), in comparison with baseline. After KD, patients displayed a significant reduction in the Psoriasis Area and Severity Index (PASI) (p = 0.04), Disease Activity Index of Psoriatic Arthritis (DAPSA)

Transforming Psoriasis Care: Probiotics and Prebiotics as Novel Therapeutic Approaches.

Buhaș MC, Candrea R, Gavrilaș LI, Miere D, Tătaru A, Boca A · International journal of molecular sciences · 2023 · n=63

Psoriasis is a chronic inflammatory skin disease with autoimmune pathological characteristics. Recent research has found a link between psoriasis, inflammation, and gut microbiota dysbiosis, and that probiotics and prebiotics provide benefits to patients. This 12-week open-label, single-center clinical trial evaluated the efficacy of probiotics (Bacillus indicus (HU36), Bacillus subtilis (HU58), Bacillus coagulans (SC208), Bacillus licheniformis (SL307), and Bacillus clausii (SC109)) and precision prebiotics (fructooligosaccharides, xylooligosaccharides, and galactooligosaccharides) in patients with psoriasis receiving topical therapy, with an emphasis on potential metabolic, immunological, and gut microbiota changes. In total, 63 patients were evaluated, with the first 42 enrolled patients assigned to the intervention group and the next 21 assigned to the control group (2:1 ratio; non-randomized). There were between-group differences in several patient characteristics at baseline, inc

Switching biologic agent in patients with psoriasis: a systematic review and meta-analysis.

Zhang L, Zhao X, Li W, Sun Y, Liu H · The Journal of dermatological treatment · 2025 · n=679

Multiple biologics are available for psoriasis treatment, but switching treatments is often necessary at some point. The choice between intraclass or interclass biologic switching has not been extensively investigated. Two independent authors searched the databases PubMed and EMBASE for studies reporting on biologic switching in psoriasis patients. Our study was performed in line with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. A total of 19 publications, comprising 679 patients, were included. The intraclass switching group consisted of 519 patients, while the interclass switching group included 139 patients. For intraclass switching, there are respectively 160, 326 and 33 patients switched of TNF-α, IL-17, IL-23. For interclass switching, 11 patients switched from TNF-α to IL-17, 6 from IL-17 to IL-23, 41 from IL-17 to IL-12/23, 29 from IL-17 to TNF-α, 15 from IL-12/23 to IL-17, 8 from IL-12/23 to IL-23. After 12&#x2

INDIVIDUAL ARTICLE: Psoriasis and Obesity: Optimizing Pharmacologic Treatment and Lifestyle Interventions.

Guo L, Kircik L, Armstrong AW · Journal of drugs in dermatology : JDD · 2025

Obesity is a metabolic disease that is marked by excessive fat accumulation and is objectively defined as a body mass index (BMI) ≥30 kg/m2. Obesity is associated with several other comorbidities, including psoriasis, which is a chronic autoimmune skin disease. Adipocytes produce pro-inflammatory signaling molecules, namely adipokines and classic cytokines, that drive increased inflammation axnd may contribute to the pro-inflammatory pathways driving psoriasis disease pathogenesis. Optimizing dermatologic management of obese patients with psoriasis may be challenging due to the effect of comorbid obesity on the pharmacokinetics of systemic therapies. Biologic therapy is a mainstay of psoriasis treatment in these patients. The IL-17 and IL-23 inhibitor classes, including those targeting the IL-17 receptor (brodalumab), IL-17 cytokine antagonists (secukinumab, ixekizumab, bimekizumab), and IL-23 cytokine antagonists (guselkumab, risankizumab, tildrakizumab). In general, the most e

Ultra-Processed Food Consumption and the Risk of Psoriasis: A Large Prospective Cohort Study.

Peng X, Li X, He J, He M, Ning N, Chen L · Nutrients · 2025 · n=19

Background: The sales of ultra-processed food (UPF) are rapidly increasing worldwide, and there have been reports linking UPF consumption to several chronic diseases. However, there is limited prospective evidence exploring the impact of UPF on inflammatory skin diseases. Objectives: This study investigates the association between UPF intake and the incidence of psoriasis using data from the UK Biobank. Methods: UPFs were assessed based on the NOVA classification in this large prospective study. Cox proportional hazards regression was employed to estimate the association between UPF intake and the incident risk of psoriasis. Inflammation score (INFLA-score) and body mass index (BMI) were chosen as mediators to examine the mediation effect. Substitution analysis was performed to estimate the psoriasis risk when replacing the absolute amount of UPF with an equivalent weight of unprocessed or minimally processed food. Results: This study enrolled 121,019 participants aged 40-69 years from

A Randomized, Double-Blind, , Placebo Controlled, 18 Week Study To Evaluate the Efficacy of Adjuvant 9-cis-β-Carotene Rich Powder of the Alga Dunaliella Bardawil in Subjects With Plaque Type Psoriasis.

n=46 · NCT01628081 · UNKNOWN · UNKNOWN

This is a double blind, parallel group, randomized study with 12 weeks of daily oral administration of Dunaliella or placebo in psoriasis patients.

The Effects of Audio-Based Therapy on Anxiety in Psoriasis

n=120 · NCT07390487 · NOT_YET_RECRUITING · NOT_YET_RECRUITING

Anxiety in psoriasis is associated with impaired quality of life, and the prevalence of anxiety symptoms in psoriatic populations is approximately 34% and anxiety disorders up to 16%. Many experts recommend routine screening, referral, and interventions for anxiety in psoriasis; however, many barriers inhibit access to mental health resources and proper management. To our knowledge, there is a lack of easily accessible interventions that manage anxiety. Audio-based therapy offers convenient and effective interventions that show reduced anxiety in published, randomized studies and is a promising management for psoriasis patients. This study will evaluate the effects of audio therapy in patients with psoriasis and measure changes in overall symptoms.

Dendritic Cell-Specific Transmembrane Protein (DC-STAMP) as a Severity and Response Biomarker in Psoriatic Arthritis

n=22 · NCT01123265 · COMPLETED · COMPLETED

The purpose of this study is to determine whether DC-STAMP, a protein on the surface of osteoclast precursors (OCPs), can be used as a biologic marker in Psoriatic Arthritis (PsA). With this marker the investigators hope to learn more about how OCPs develop as well as find out if DC-STAMP predicts PsA severity and how well treatment works in PsA.

Cochrane Reviews: Psoriasis

Cochrane

The Cochrane Library provides a collection of high-quality, independent evidence to inform healthcare decision-making, including systematic reviews related to psoriasis treatments and interventions.

Psoriasis

TRIP Database

TRIP is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice, including extensive results for psoriasis.