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Italian Journal of Dermatology and Venereology 2022 Jul 05

DOI: 10.23736/S2784-8671.22.07355-8


lingua: Inglese

Tuscany consensus for the treatment of moderate-severe psoriasis: update and focus on practical guidelines for place in therapy of anti-IL-17 and anti-IL-23 biologics

Francesca PRIGNANO 1 , Leonardo PESCITELLI 2, Emanuele TROVATO 3, Antonella DI CESARE 1, Aldo CUCCIA 4, Carlo MAZZATENTA 5, Michele PELLEGRINO 6, Franco MARSILI 7, Antonio CASTELLI 4, Luca BRANDINI 2, Maria C. NICCOLI 8, Franca TAVITI 8, Federica RICCERI 4, Salvatore PANDURI 9, Gionata BUGGIANI 2, Alberto GHILARDI 5, Pietro RUBEGNI 3, Marco ROMANELLI 9, Nicola PIMPINELLI 1

1 Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy; 2 Unit of Dermatology, San Giuseppe Hospital, Empoli, Florence, Italy; 3 Dermatology Section, Department of Medical, Surgical and Neurological Science, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy; 4 Unit of Dermatology, San Donato Hospital, Arezzo, Italy; 5 Unit of Dermatology, Hospital of Campo di Marte, Lucca, Italy; 6 Unit of Dermatology, Misericordia Hospital, Grosseto, Italy; 7 Unit of Dermatology, Versilia Hospital, Lido di Camaiore, Lucca, Italy; 8 Unit of Dermatology, Hospital of Prato, Prato, Italy; 9 Department of Dermatology, University of Pisa, Pisa, Italy


Psoriasis is a common chronic skin disease characterized by a worldwide distribution and a natural tendency towards progression. According to the many clinical forms, the extension of the disease and the many comorbidities, almost the 20% of the patients require a systemic treatment. Biologics have greatly changed the ongoing of psoriasis and the quality of life of psoriasis patients. After the anti-TNF-alpha, which were the first biologics in use for psoriasis, the improvement in knowledge of the pathogenetic mechanisms underlying the disease has led to the development of a series of more specific therapies for psoriasis. This “second generation” of biologics includes the interleukin (IL)-12/23 inhibitor ustekinumab, IL-17 inhibitors (secukinumab and ixekizumab), the IL-17 receptor A (IL-17RA) antagonist brodalumab, and the IL-23 inhibitors guselkumab, risankizumab and tildrakizumab. This paper represents an update of the Tuscany consensus focused on the use of new drugs, such as anti-IL-17 and anti-IL-23 in moderateto-severe psoriasis and their correct place in therapy according to specific clinical requests and in full respect of the current financial restrictions.

KEY WORDS: Psoriasis; Treatment; Biologics; anti-IL-17; anti-IL-23

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