Efficacy and safety of biotechnological drugs for the treatment of moderate-to-severe psoriasis in the elderly population: a single-center, Italian experience

Background: Demographic changes impose a number of issues regarding the biological treatment of elderly patients with moderate-to-severe psoriasis. Patients and methods: A retrospective, single-center study was conducted on patients aged 65 years or older with moderate-severe psoriasis who had been undergoing treatment with biologic drugs for at least 60 weeks. Results: A total of 168 patients aged 65 years or older with moderate-to-severe psoriasis undergoing biologic therapy were retrieved: 45 were women and with a mean age of 73.23 ± 6.53 years. The decline in mean PASI, BSA, DLQI and NAPSI values over the 60 weeks of treatment was found to be statistically significant at each interval (p < 0.05). Multivariate statistical analysis showed that nearly all the considered independent variables did not influence the response to therapy in terms of PASI score reduction, except for psoriatic arthritis (p = 0.03). Discussion: We observed a better response by YOs, with 72.84% of subjects achieving PASI 75 and 71.6% achieving PASI 90 and 100 at the 60th week of treatment. The worst result was obtained by the MOs, with 60 percent of subjects reaching PASI 75 at the end of follow-up, while the OOs had a more mixed performance. The results obtained seem to indicate greater efficacy of anti-TNFα drugs, followed by the other classes of interleukin inhibitors. Conclusions: These results could provide a starting point for new and larger studies and guidelines for biologic treatment.