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Updated: Sep 16, 2025

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Systemic Biologic Treatment for Psoriasis in Elderly Patients.

Sapir Glazer Levavi1, Ronny Maman2, Shany Sherman1,2

  • 1Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva 49100, Israel.

Journal of Clinical Medicine
|July 12, 2025
PubMed
Summary

Biologic drugs are effective and safe for treating psoriasis in elderly patients. Some treatments, like adalimumab and guselkumab, showed better drug survival when started after age 65.

Keywords:
biologic treatmentelderlypsoriasis

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Area of Science:

  • Dermatology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Psoriasis affects a notable percentage of individuals over 60.
  • Elderly patients are often excluded from clinical trials, limiting data on biologic efficacy and safety in this demographic.

Purpose of the Study:

  • To evaluate the efficacy and safety of biologic drugs for psoriasis treatment in elderly patients.
  • To compare outcomes between patients initiating biologic treatment before and after age 65.

Main Methods:

  • Retrospective cohort study involving 149 elderly psoriasis patients.
  • Patients were stratified into two groups: <65 years (adult-start) and >65 years (elderly-start).
  • Analysis included patient characteristics, drug survival, and safety outcomes (hospitalizations for infection, death).

Main Results:

  • Demographics, comorbidities, and treatment turnover were comparable between groups.
  • Adalimumab (first-line) and guselkumab (any sequence) demonstrated significantly better drug survival in the elderly-start group.
  • No significant differences in drug safety, including hospitalizations for infection or mortality, were observed between groups.

Conclusions:

  • Biologic therapies are both efficacious and safe for managing psoriasis in the elderly population.
  • Certain biologic agents, specifically adalimumab and guselkumab, may offer improved drug survival when initiated in patients over 65.