Psoríase moderada a grave no Brasil: desafios no acesso às terapias biológicas pelo SUS

Psoriasis is a chronic, immune-mediated inflammatory disease that affects millions of people in Brazil and worldwide, with a significant impact on quality of life due to cutaneous lesions, physical symptoms, and associated comorbidities. Although conventional treatments such as methotrexate, cyclosporine, and phototherapy are effective for some patients, these approaches often present limitations related to sustained efficacy, safety profile, and long-term response. In this context, biological therapies—including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-12/23, IL-17, and IL-23 inhibitors—represent a major therapeutic advance in the management of psoriasis, providing improved clinical control, faster lesion clearance, and substantial improvement in patients’ quality of life. However, access to these medications in Brazil remains limited, particularly within the scope of the Unified Health System (Sistema Único de Saúde – SUS). Factors such as high costs, restricted incorporation of new biologics, regional inequalities in treatment availability, and the need for adequate infrastructure for drug administration contribute to unequal access, often relying on judicialization. This article reviews the main therapeutic advances in psoriasis treatment, outlines the current scenario of access to biological therapies in Brazil, and discusses the challenges that must still be addressed to ensure equitable and effective treatment for all patients.