银屑病是一种全身性的免疫介导性疾病，与共患病的风险增加相关，例如银屑病关节炎、心血管疾病、代谢综合征、炎症性肠病、精神障碍和恶性肿瘤。近年来，随着生物制剂的出现，银屑病治疗的疗效和安全性显著提高。目前，肿瘤坏死因子-α抑制剂、白细胞介素-17抑制剂、白细胞介素-12/23抑制剂和白细胞介素-23抑制剂已获批用于中重度银屑病的治疗。小分子抑制剂，如阿普利莫和德姆卡瓦西汀，也已获批用于银屑病的治疗。尚不清楚的是，用于治疗银屑病的全身药物也通过改变全身炎症状态对其共患疾病产生了显著影响。来自生物制剂和小分子抑制剂的临床试验和研究数据为个性化的护理和银屑病患者的治疗提供了重要信息。值得注意的是，用白细胞介素-17抑制剂治疗与新发或加重炎症性肠病有关。此外，在银屑病患者中使用肿瘤坏死因子-α抑制剂时需要格外谨慎，尤其是伴有充血性心力衰竭、多发性硬化症和恶性肿瘤的患者。阿普利莫可能引起体重下降并呈现一些有益的代谢作用。更好地了解生物制剂和小分子抑制剂在银屑病共病的治疗特性，可以为不同共患疾病的患者提供更明确的指导。©2022. 作者（们）。

Psoriasis is a systemic immune-mediated disease associated with an increased risk of comorbidities, such as psoriatic arthritis, cardiovascular disease, metabolic syndrome, inflammatory bowel disease, psychiatric disorders, and malignancy. In recent years, with the advent of biological agents, the efficacy and safety of psoriasis treatments have dramatically improved. Presently, tumor necrosis factor-α inhibitors, interleukin-17 inhibitors, interleukin-12/23 inhibitors, and interleukin-23 inhibitors are approved to treat moderate-to-severe psoriasis. Small-molecule inhibitors, such as apremilast and deucravacitinib, are also approved for the treatment of psoriasis. Although it is still unclear, systemic agents used to treat psoriasis also have a significant impact on its comorbidities by altering the systemic inflammatory state. Data from clinical trials and studies on the safety and efficacy of biologics and small-molecule inhibitors provide important information for the personalized care and treatment for patients with psoriasis. Notably, treatment with interleukin-17 inhibitors is associated with new-onset or exacerbations of inflammatory bowel disease. In addition, great caution needs to be taken when using tumor necrosis factor-α inhibitors in patients with psoriasis with concomitant congestive heart failure, multiple sclerosis, and malignancy. Apremilast may induce weight loss as an adverse effect, presenting also with some beneficial metabolic actions. A better understanding of the characteristics of biologics and small-molecule inhibitors in the treatment of psoriasis comorbidities can provide more definitive guidance for patients with distinct comorbidities.© 2022. The Author(s).