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Updated: Aug 29, 2025

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Towards Personalized Medicine in Psoriasis: Current Progress.

Elisa Camela1, Luca Potestio1, Angelo Ruggiero1

  • 1Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Psoriasis (Auckland, N.Z.)
|September 8, 2022
PubMed
Summary

Identifying biomarkers for psoriasis treatment response is crucial for personalized medicine. While HLA-C*02:06 shows promise, a comprehensive panel is needed for optimal treatment selection and improved patient outcomes.

Keywords:
DMFMTXSMacitretinapremilastbiologicalsbiomarkersciclosporinconventional systemic treatmentsdimethyl fumaratemethotrexatepharmacogeneticspharmacogenomicsphototherapyprecision medicinesmall moleculesstratification medicine

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Area of Science:

  • Dermatology
  • Immunology
  • Pharmacogenomics

Background:

  • Psoriasis treatment has advanced with targeted therapies, aiming for complete skin clearance.
  • However, primary or secondary lack of efficacy remains a challenge.
  • Personalized medicine requires biomarkers to stratify patients and tailor treatments.

Purpose of the Study:

  • To review current evidence on biomarkers predicting response to psoriasis treatments.
  • Focus on phototherapy, conventional systemic agents, and biologicals.
  • Assess the potential of biomarkers for precision medicine in psoriasis.

Main Methods:

  • Systematic literature review of studies published in English within the last five years (up to March 20, 2022).
  • Databases searched include PubMed, Embase, Google Scholar, EBSCO, MEDLINE, and Cochrane library.
  • Focus on biomarkers for anti-TNF, IL-12/23, IL-17 (secukinumab), and phototherapy.

Main Results:

  • More evidence exists for biomarkers predicting response to expensive biologicals compared to other treatments.
  • HLA-C*02:06 is a discussed biomarker, associated with psoriasis and differential response to biologicals.
  • HLA-C*02:06 positivity correlates with methotrexate response, but results for anti-TNF and IL-12/23 are debated; it does not appear to affect secukinumab response.

Conclusions:

  • Personalized psoriasis treatment can improve outcomes and minimize side effects.
  • Current evidence is insufficient to identify a gold-standard biomarker due to scarcity and heterogeneity.
  • A comprehensive biomarker panel is likely necessary for reliable treatment decisions in psoriasis.