Speed of Response in Biologic Treatments for Moderate-to-Severe Plaque Psoriasis: Bayesian Network Meta-Analysis

Psoriasis is a chronic, immune-mediated inflammatory condition that affects approximately 3% of the adult population in the United States (US) and is characterized by the rapid proliferation of keratinocytes, resulting in thick, scaly plaques on extensor surfaces of the body.¹ Aside from its cutaneous manifestations, psoriasis can significantly negatively impact a patient’s quality of life and is associated with increased risk for comorbid conditions, including obesity, metabolic syndrome, cardiovascular disease, psoriatic arthritis, and psychiatric comorbidities, including depression and anxiety.^2,3

Its pathogenesis is thought to involve immune system dysregulations through the activation of Th1-mediated T-cell pathways, resulting in the overproduction of proinflammatory cytokines, including tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-17, and IL-23.^4,5 Understanding the specific mechanisms underlying the disease has led to the development of targeted biologic therapies that specifically inhibit these cytokines, offering more effective and precise treatment options than traditional immunosuppressive systemic therapies.⁶ While biologics have revolutionized the paradigm of treating moderate-to-severe psoriasis, there remains variability in patient response regarding the onset of action and sustainability of response.⁵ Thus, this systematic review and meta-analysis aims to analyze the rate of response and efficacy of biologic therapies within the first 8 weeks of initiation in individuals with plaque psoriasis. By comparing the early response rates of various biologics, this study aims to identify which biologics offer the most rapid and effective control of psoriasis symptoms. Understanding these early efficacy differences is critical for optimizing treatment strategies and improving patient outcomes in clinical practice.⁷