Clinician reference tool — not medical advice. This is a clinical decision-aid intended for healthcare professionals: it gives deterministic suggestions to think with, not a diagnosis or a prescription. If you’re a patient, you’re welcome to look around — but please review anything here with your own doctor; it isn’t a substitute for personalized medical care.

Evidence: Diet & psoriasis: Mediterranean diet (MEDIPSO RCT 2025 — … 2025 · sources last checked 2026-08-20

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Ajax Harwood Clinic
Psoriasis treatment selector
Reference tool — not medical advice. Deterministic suggestions to think with, grounded in current guidelines and pivotal trials; clinician judgement, current product monographs, and live formulary coverage always required. Runs entirely in your browser — no data is collected.

Psoriasis treatment selector

Pick the patient's characteristics and get ranked, cited psoriasis treatment suggestions across the ladder — topicals, phototherapy, systemics and biologics.

Canadian view: Health Canada approvals + Canadian guidelines & coverage.

Patient characteristics

Disease severity

Special sites

Joints & bowel

Comorbidities & screening

Preferences & practical

Contraindications & cautions

These gate eligibility (e.g. active TB removes immunosuppressants; pregnancy removes teratogens).

Safety & guideline notes

  • • Canada: guidance reflects the Canadian Psoriasis Guidelines + CADTH. Public plans mandate biosimilars and usually require step therapy (a conventional systemic and/or TNF/ustekinumab) before IL-17/IL-23 agents; tildrakizumab is not on provincial formularies and certolizumab coverage is limited. Verify the live provincial/ODB e-formulary.

Select patient characteristics to begin.

e.g. Moderate-to-severe + Psoriatic arthritis, or add Inflammatory bowel disease to see the ranking shift away from IL-17 agents. Toggle Health Canada / US FDA above to compare jurisdictions.

References — Canadian view

  1. [1]Canadian Psoriasis Guidelines Committee. Canadian Guidelines for the Management of Plaque Psoriasis (2009) & 2016 Addendum (updated 2019). link
  2. [2]CADTH. Biologics for Plaque Psoriasis — streamlined class review & formulary analysis, 2023 (newer-generation IL-17/IL-23 agents show superior efficacy to TNF/ustekinumab). link
  3. [3]Health Canada — Drug Product Database & product monographs (biologics, systemics, topicals). link
  4. [4]Provincial biosimilar switching policies (e.g. Ontario ODB ustekinumab/TNF biosimilar transition, 2024; Biosimilars Canada). Publicly funded plans typically mandate the biosimilar. link
  5. [8]Gordon KB, et al. UltIMMa-1/UltIMMa-2: risankizumab (IL-23) — highest PASI-90/100 rates in class. Lancet 2018; and comparative network meta-analyses. link
  6. [9]Reich K, et al. BE VIVID/BE RADIANT: bimekizumab (dual IL-17A/F) — fastest, deepest skin clearance. Lancet/NEJM 2021. link
  7. [10]Blauvelt A, et al. VOYAGE-1/2: guselkumab (IL-23). J Am Acad Dermatol 2017. link
  8. [11]Reich K, et al. reSURFACE-1/2: tildrakizumab (IL-23). Lancet 2017. link
  9. [12]Armstrong AW, et al. POETYK PSO-1/PSO-2: deucravacitinib (oral TYK2). J Am Acad Dermatol 2023. link
  10. [13]Papp K, et al. ESTEEM-1/2: apremilast (oral PDE4). J Am Acad Dermatol 2015. link
  11. [14]IL-17 inhibitors: mucocutaneous candidiasis risk and caution/contraindication in inflammatory bowel disease (class reviews). link
  12. [15]Latent TB (and HBV) screening before and during biologic therapy for psoriasis (AAD–NPF / CDA). link
  13. [16]Certolizumab pegol in pregnancy (CRIB/CRADLE): minimal placental & breast-milk transfer — preferred biologic peri-conception. link
  14. [17]TNF inhibitors: contraindicated in demyelinating disease and cautioned in NYHA III–IV heart failure (recent data question the HF signal). link
  15. [18]Obesity/high body weight reduces fixed-dose biologic response; weight-based (infliximab, ustekinumab >100 kg) and BMI-resilient IL-23 agents preferred. link
  16. [19]Narrowband-UVB phototherapy: ~70% PASI-75; safe in pregnancy; 2–3×/week (AAD–NPF; CDA). link