Psoriasis and PsA Biologics — RACP Adult Medicine MCQ

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ModerateDermatologyPsoriasis and PsA BiologicsRACP Adult Medicine

A 45-year-old man with severe plaque psoriasis (PASI 22) fails methotrexate and ciclosporin. He has concurrent psoriatic arthritis. Which biologic class would address BOTH his skin and joint disease?

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Correct answer: C — Any of the above

All listed biologics have evidence for efficacy in both plaque psoriasis and psoriatic arthritis, though the magnitude of benefit varies. Anti-TNF (adalimumab), anti-IL-17 (secukinumab, ixekizumab), and anti-IL-12/23 (ustekinumab) all have PBS listings for both conditions. Anti-IL-23 agents (guselkumab, risankizumab) are highly effective for skin but have more modest joint data. The choice depends on comorbidities, patient preference, and specific disease characteristics. Anti-IL-17 should be used cautiously if IBD is comorbid.

Reference: eTG – 2025 – Dermatology; GRAPPA – 2024 – PsA Treatment Recommendations