Emerging Biologic Therapies in Autoimmune Diseases: Focus on Pemphigus Vulgaris, Generalized Myasthenia Gravis, and Psoriasis

Abstract

Biologic therapies have transformed the management of autoimmune diseases by targeting key immune pathways with precision, reducing dependence on broad immunosuppression. This review explores advances in monoclonal antibody–based therapies across three representative autoimmune conditions: pemphigus vulgaris (PV), generalized myasthenia gravis (gMG), and psoriasis. In PV, B-cell depletion with rituximab has become the preferred first-line therapy, achieving durable remission and steroid-sparing outcomes. In gMG, complement inhibitors (eculizumab, ravulizumab, zilucoplan) and neonatal Fc receptor (FcRn) antagonists (efgartigimod, rozanolixizumab) provide rapid, clinically meaningful improvements in refractory patients. In psoriasis, therapies targeting the IL-23/IL-17 axis (guselkumab, risankizumab, bimekizumab) have achieved unprecedented levels of skin clearance and durability. Safety, accessibility, and biomarker-driven personalization remain challenges, while future directions include antigen-specific cell therapies, bispecific antibodies, and oral biologic mimetics. Collectively, these advances highlight the transformative role of biologics in autoimmune disease and the trajectory toward precision immunotherapy.