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Updated: Mar 27, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
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Systemic Pharmacological Treatments for Chronic Plaque Psoriasis
April W Armstrong1, Yvonne Nong1, Joseph F Merola2
1Division of Dermatology, University of California Los Angeles, Los Angeles.
JAMA Dermatology
|March 25, 2026
Summary
For moderate to severe plaque psoriasis, biologic therapies like IL-17 and IL-23 inhibitors offer the best chance for a PASI 90 response. Oral agents provide modest benefits, and serious side effects are rare for all treatments.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Plaque psoriasis is a chronic inflammatory skin condition affecting adults.
- Systemic treatments are used for moderate to severe cases.
- Psoriasis Area and Severity Index 90 (PASI 90) is a key efficacy endpoint.
Purpose of the Study:
- To compare the efficacy of systemic treatments for plaque psoriasis.
- To evaluate the rate of serious adverse events associated with these treatments.
Main Methods:
- Systematic review and meta-analysis of clinical trials.
- Comparison of biologic therapies (IL-17, IL-23 inhibitors) and oral agents.
- Assessment of PASI 90 response rates and safety profiles.
Main Results:
- Biologic therapies, especially IL-17 and IL-23 inhibitors, demonstrated the highest likelihood of achieving PASI 90 in the short term.
- Oral agents showed more modest efficacy but are viable non-injectable options.
- Serious adverse events were infrequent and comparable to placebo across all evaluated therapies.
Conclusions:
- Interleukin inhibitors are highly effective for achieving rapid PASI 90 response in plaque psoriasis.
- Oral systemic treatments remain valuable alternatives for patients preferring non-injectable options.
- Current systemic therapies for plaque psoriasis exhibit favorable short-term safety profiles.
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