LAUSR

Personalized medicine is the new frontier in psoriasis as it may allow a patient-tailored management with treatment optimization and reduction of side effects as well as health costs [1]. Thanks to the growing advances in understanding psoriasis pathogenesis, a great number of new molecules have been discovered and developed to increase clinical outcome and improve patients’ quality of life. The so-called target therapies have then revolutionized psoriasis treatment, ensuring selectivity, high efficacy and safety, and allowing reach clear or almost clear skin manifestations. To date, eleven biologics, belonging to four pharmacological classes according to the target cytokine (tumor-necrosis factor [TNF], interleukins [IL] 12/23, 17, and 23), are available for psoriasis treatment with different peculiarities. Despite the great therapeutic armamentarium, treatment selection is still based on clinical factors (patients and psoriasis’ characteristics) and not on genetic ones. Indeed, the vast spectrum of psoriasis phenotypes together with the occurrence of primary and secondary lack of efficacy also with the new biologics are expression of a highly patient-dependent treatment response thus suggesting the need to identify individual genotype [2]. Hence, the identification and the introduction in daily clinical practice of biomarkers predictive of response to biological treatments may help clinicians in the therapeutic choice, optimizing clinical outcomes and minimizing the risk of side effects and treatment failure with related huge health costs and reduced patients’ quality of life. Herein we present and discuss the recent advances in personalized biological treatment for psoriasis.