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Psoriasis — SCE Dermatology MCQ

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ModerateInflammatory DermatosesPsoriasisSCE Dermatology

A 28-year-old man with severe plaque psoriasis affecting 25% body surface area has an inadequate response to Methotrexate and Ciclosporin. He has no contraindications. According to BAD guidelines, which class of biologic has the highest short-term PASI 90 response rate?

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Correct answer: C — IL-17 inhibitors

IL-17 inhibitors (Secukinumab, Ixekizumab, Brodalumab, Bimekizumab) demonstrate the highest short-term PASI 90 response rates in network meta-analyses. The BAD 2020 biologic guideline (updated 2023) and supporting NMA data consistently show IL-17 class agents achieving superior short-term clearance compared to TNF-alpha inhibitors, IL-12/23 inhibitors, and IL-23 inhibitors, though IL-23 inhibitors show excellent durability. IL-4 receptor inhibitors (Dupilumab) are not licensed for psoriasis.

Reference: BAD 2020 Guidelines for biologic therapy for psoriasis (updated 2023)