Real-World Use of Biologic Therapy in Elderly Patients with Moderate-to-Severe Psoriasis: A Retrospective Single-Center Study

Background and Objectives: Psoriasis patients aged over 65 years, especially those with chronic comorbidities, constitute an increasingly important patient population. In this group, the selection of therapy, along with its efficacy and safety, is of relevance. Materials and Methods: A single-center retrospective analysis of clinical records of patients aged ≥ 65 years with moderate to severe plaque psoriasis, treated with biologic therapies. The study covered the period 2019–2025. Results: A total of 38 patients were included. Biologic switching occurred in 15 patients (39.5%). The primary reason for switching was loss of efficacy (86.7%), while adverse events accounted for 13.3% of cases. The mean duration from initiation of adalimumab (the mandatory first-line biologic therapy) to switching was 325 ± 191 days. Baseline PASI did not differ significantly between groups (p = 0.139). Psoriatic arthritis was significantly less frequent among patients who switched therapy (13.3% vs. 56.5%, p = 0.008). No significant associations were observed between switching and comorbidities or overall comorbidity burden (p > 0.05). Clinically relevant adverse events included infections, cardiovascular events, malignancies, and autoimmune laboratory abnormalities. Conclusions: Biologic therapy in elderly psoriasis patients appears to be generally well tolerated, based on descriptive real-world data. Treatment switching was primarily driven by loss of efficacy rather than comorbidities.