Psoriasis: Targets and Therapy

Navigating Complexity: Real-World Evidence of Biologics in Elderly and Multimorbid Psoriasis Patients

Psoriasis: Targets and Therapy is pleased to announce a new Article Collection that investigates biological psoriasis therapies in complex patient profiles.

The therapeutic landscape of psoriasis has been revolutionized by the advent of biological agents, offering unprecedented levels of skin clearance and quality of life improvement. However, randomized controlled trials (RCTs) often employ strict inclusion criteria, leading to the underrepresentation of specific patient subgroups commonly encountered in daily practice, such as the elderly (including the "oldest old") and patients with significant multiple comorbidities. As the global population ages and the systemic nature of psoriasis becomes increasingly evident, bridging the gap between controlled trial environments and clinical reality is imperative. This Article Collection focuses on Real-World Evidence (RWE) regarding the use of biologics in these complex scenarios. We aim to gather data that elucidates how biological therapies perform outside the rigid constraints of RCTs, specifically targeting vulnerable populations where evidence-based guidance is often limited or extrapolated.

This Collection is crucial because clinicians frequently face the challenge of treating psoriatic patients who do not fit the "standard" profile of RCT participants. The management of psoriasis in the elderly is complicated by immunosenescence, polypharmacy, and frailty, while the presence of comorbidities—ranging from cardiovascular and metabolic diseases to malignancies—poses significant safety concerns and therapeutic dilemmas. Understanding the bidirectional relationship between psoriasis treatment and comorbidities is vital: not only how comorbidities influence effectiveness, safety and drug survival, but also how biologics might modify the natural history of associated conditions (e.g., potential cardio-protective effects or cancer risks). Collecting high-quality real-world data is essential to validate the long-term safety profile of these drugs, tailor treatments to individual phenotypic profiles, and ultimately optimize the risk-benefit ratio for the most fragile patients.

This Article Collection welcomes submissions that investigate the practical application of biological therapies in psoriasis, with a specific lens on complex patient profiles. We encourage the submission of Original Research, Reviews, and Real-World Case Series. Key subtopics of interest include, but are not limited to:

• Effectiveness and Safety in the Elderly: Impact of immunosenescence on biologic response and infection risk in geriatric populations;
• Comorbidities and Treatment Response: How metabolic syndrome, diabetes, chronic kidney disease (CKD) or cardiovascular disease influence effectiveness, safety and drug survival;
• Impact of Biologics on Comorbidities: Research into the potential protective effects of systemic inflammation reduction on organs and systems affected by chronic diseases, as well as the risk of disease progression;
• Malignancy: Real-world data on the safety of biologics in patients with a history of cancer or concurrent malignancies;
• Polypharmacy: Drug-drug interactions and management strategies in multimorbid patients.

Keywords: Real-world evidence; Biologics; Psoriasis comorbidities; Geriatric dermatology; Drug survival

Please review the journal scope and author submission instructions prior to submitting a manuscript.

The deadline for submitting manuscripts is 05 November 2026.

Please contact the Commissioning Editor Thalia Geiger with any queries and discount codes regarding this Article Collection.

Meet the Guest Advisors

Dr. Zeno Fratton

Dr. Zeno Fratton is a physician based at the Institute of Dermatology, University of Udine (Italy). His research focuses on chronic inflammatory skin diseases, particularly plaque psoriasis and biological therapies in the elderly and other special populations. He has authored numerous papers in high-impact journals and serves as a reviewer for top-tier publications. He graduated with honors from the University of Verona under the guidance of Prof. Paolo Gisondi and is an active member of the Italian Society of Pediatric Dermatology (SIDerP).

Dr. Stefano Bighetti

Dr. Stefano Bighetti is a dermatologist at the Dermatology Department, University of Brescia (Italy), with a clinical and academic focus on chronic inflammatory skin diseases, particularly atopic dermatitis and psoriasis, and on non-invasive therapeutic strategies including phototherapy and laser-based therapies. He has authored and co-authored several peer-reviewed publications in the international dermatology literature, with contributions spanning clinical research and real-world evidence. He serves on the Editorial Board of the Italian Journal of Dermatology and Venereology and acts as a peer reviewer for multiple dermatology journals. He is engaged in academic and educational activities within national scientific societies, supporting initiatives in continuing medical education and evidence-based dermatology.