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Background: Biologic drugs have revolutionized the treatment of psoriasis and other chronic inflammatory diseases. In recent years, numerous biosimilar molecules that target cytokines such as TNF-alpha or its receptors have been developed. The approval of biosimilars has made it possible to reduce the costs of biologic drugs, thereby increasing access to these therapies for more patients and enhancing psoriasis treatment globally. Imraldi and Idacio are both biosimilars of Adalimumab, approved for treating moderate to severe psoriasis., Methods: Our study aims to compare these two adalimumab biosimilars in psoriasis patients who have previously undergone treatment with other biologic drugs or systemic therapy in a real-life setting. Our cohort comprised 32 psoriatic patients. Of these patients, 15 were prescribed Imraldi, while the remaining were on Idacio. To assess the efficacy of these therapies, we utilized various measures including the Psoriasis Area and Severity Index, the Pruritus Visual Analog Scale, the Visual Analog Scale, the Dermatology Life Quality Index, and the Psoriasis Global Assessment, monitoring the patients over a 24-week period., Results: Our results indicated that the use of Idacio led to greater decreases in all scores compared to Imraldi. However, in terms of safety and efficacy, the two drugs were found to be comparable., Conclusions: The findings of this study support the efficacy and safety of Idacio and Imraldi in managing psoriasis, with Idacio demonstrating superior efficacy in reducing disease severity. Future studies could benefit from expanding the patient cohort and conducting further analyses to evaluate individual responses to treatment. more...