Biological therapies in moderate to severe psoriasis: efficacy and safety in long-term treatment

Abstract Psoriasis is a chronic inflammatory disease with a significant impact on quality of life. In recent years, biological treatments have changed the therapeutic landscape, providing alternatives targeting specific immunopathogenic mechanisms. IL-17 inhibitors (secukinumab, ixekizumab) and IL-23 inhibitors (guselkumab, risankizumab) have demonstrated greater efficacy in the remission of skin lesions compared to TNF-α antagonists. However, the safety profile remains a topic of study, since prolonged use of these agents may increase the risk of opportunistic infections and cardiovascular adverse events. In addition, individual response varies according to patient genetics and the coexistence of comorbidities. This review analyzes advances in biological therapy, assessing their long-term impact and the need for therapeutic strategies that minimize risks without compromising efficacy. The importance of long-term comparative studies to establish optimal protocols for the personalized management of psoriasis is highlighted. Keywords: Psoriasis, biological therapies, IL-17, IL-23, long-term safety.