Targeted Therapies and Biomarkers for Personalized Treatment of Psoriasis

Four decades of clinical, translational, and basic psoriasis research have greatly advanced our understanding of psoriasis pathogenesis. Psoriasis is a complex disease resulting from the interaction of genetic, environmental, and immunological factors. Several psoriasis susceptibility genes and critical immunological drivers have been identified, and some of these findings have resulted in novel target therapies which have increased the number of effective therapeutic options available to clinicians and patients. Nonetheless, biologic therapies are expensive, associated with side effects, and there is still a sizable fraction of nonresponder patients, thus calling for increasingly effective and safe therapies, as well as biomarkers for patients’ stratification to maximize the chances of therapy success. A continuous effort is ongoing to translate basic and clinical findings, increasingly obtained with the support of novel high-throughput technologies and powerful analytical tools, into clinical practice to benefit psoriasis patients. In line with a general shift from reaction to prevention medicine and from population to personalized medicine, stratified medicine approaches in psoriasis are no longer far-fetched. Here we review the psoriasis literature, describing the recent elucidation of critical pathogenic mechanisms, their translation into targeted therapies, and how they are being exploited in the quest for psoriasis biomarkers to guide patients’ stratification.