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Focal resistant plaques are still common despite the use of biologics for psoriasis. significant impact on quality of life. We compared the relative efficacy of different biologics and tofacitinib in different body areas in 177 Asian patients with moderate-to-severe psoriasis in 10 biologics or tofacitinib trials conducted between 2004 and 2019. Pooled data were analyzed at weeks 12–16 and weeks 44–52, respectively, for total and four regional PASI 75, 90, and 100 responses. The result showed that secukinumab, ixekizumab, guselkumab, and risankizumab had more favorable efficacy, followed by adalimumab, ustekinumab, and tofacitinib, while etanercept showed the least efficacy. The regional PASI response peaked early in the head area with subsequent decline, while the lower extremities improved slowly. At week 52, the head and neck and lower extremities were less likely to achieve PASI responses compared to the trunk and upper extremities. The treatment responses of different body regions of biologics and tofacitinib were in line with the overall response. However, the head region responds fast, but total clearance at 52 weeks was similarly lower as the leg region. More subjects and prospective studies may be required to compare the efficacy of different biologics in different body regions.

expert review of clinical pharmacology

Comparison of the relative efficacy of different biologics in different body areas in patients with moderate to severe psoriasis receiving biologics and tofacitinib in phase 3 randomized controlled trials: a 15-year single-center experience