Psoriasis often manifests as red, scaly patches, causing discomfort and itchiness. Triggered by various factors like stress, cold weather, and genetics, it accelerates skin cell production, leading to the formation of dry, raised plaques. Psoriasis isn't merely a skin condition; it can extend its impact to joints, potentially causing psoriatic arthritis, along with various comorbidities such as heart disease, diabetes, and depression.
Managing psoriasis involves both non-pharmacological and medical approaches. Non-pharmacological methods encompass skin moisturization, cold showers, sunlight exposure, and dietary adjustments. Medical treatments range from topical therapies like corticosteroids to systemic medications, such as methotrexate, and biologics like adalimumab. Yet, the efficacy of these treatments varies among individuals, highlighting the importance of personalized approaches.
Psoriasis's impact extends beyond the physical, affecting mental health and quality of life. The visible symptoms can lead to social and emotional challenges, urging healthcare providers to address both the physical and emotional aspects of the disease. Recognizing psoriasis's systemic nature is crucial, considering its potential to induce inflammation in joints and various organs.
Psoriatic arthritis, a common consequence of psoriasis, necessitates early diagnosis and treatment to prevent permanent joint damage. The disease's inflammatory nature poses risks of arterial damage, potentially leading to heart disease. Modifiable risk factors like weight, physical activity, smoking, and stress play a role in managing psoriasis and reducing associated risks.
While there's no cure for psoriasis, ongoing research and evolving treatment options offer hope. Biologics like adalimumab neutralize TNF-alpha, mitigating inflammation, but their immunosuppressive nature requires careful consideration of potential complications. The continual expansion of treatment options emphasizes the importance of exploring diverse avenues to find the most effective and suitable approach for each patient.
Recent advancements in psoriasis treatment have brought forth a wave of innovation with the introduction of novel therapies. Among the notable additions, tapinarof, a topical aryl hydrocarbon receptor (AhR)–modulating agent, has shown promise in plaque psoriasis treatment. Derived from a bacterial symbiont, tapinarof activates AhR, leading to the suppression of helper T cells TH17 and TH22, subsequently improving skin barrier function. Phase 3 trials demonstrated significant efficacy, with 36.1% to 47.6% achieving a 75% reduction in psoriasis area and severity index (PASI 75) score at week 12.
Roflumilast, a selective phosphodiesterase 4 (PDE-4) inhibitor, represents another topical treatment for plaque psoriasis. In phase 3 trials (N=881), roflumilast exhibited efficacy in, with 37.5% to 42.4% of treated patients achieving investigator global assessment (IGA) success at week 8, and a notable absence of significant adverse effects, including gastrointestinal issues.
Deucravacitinib, an oral selective tyrosine kinase 2 (TYK2) allosteric inhibitor, showcased promising results in two phase 3 trials (N=1686). With a unique mechanism targeting the TYK2 pathway, deucravacitinib demonstrated efficacy, with 53.0% to 58.4% of patients achieving PASI 75 at week 16. Notably, long-term studies indicated persistent efficacy and consistent safety for up to 2 years.
The oral preparation EDP1815, derived from a single strain of Prevotella histicola, offers a unique approach. Targeting inflammatory diseases, including psoriasis, EDP1815 demonstrated superiority to placebo in a phase 2 study (NCT04603027), presenting a potential adjunctive treatment for mild to moderate psoriasis. These recent developments show a diverse array of treatment options for patients that could be a big help to them in the near future.
References:
Del Toro NP, Wu JJ, Han G. New Treatments for Psoriasis: An Update on a Therapeutic Frontier. Cutis. 2023 Feb;111(2):101-104. doi: 10.12788/cutis.0701. PMID: 37075192
Hilliard-Barth K, Cormack T, Ramani K, et al. Immune mechanisms of the systemic effects of EDP1815: an orally delivered, gut-restricted microbial drug candidate for the treatment of inflammatory diseases. Poster presented at: Society for Mucosal Immunology Virtual Congress; July 20-22, 2021, Cambridge, MA.
Strober B, Thaçi D, Sofen H, et al. Deucravacitinib versus placebo and apremilast in moderate to severe plaque psoriasis: efficacy and safety results from the 52-week, randomized, double-blinded, phase 3 Program for Evaluation of TYK2 inhibitor psoriasis second trial. J Am Acad Dermatol. 2023;88:40-51
Wrobleski ST, Moslin R, Lin S, et al. Highly selective inhibition of tyrosine kinase 2 (TYK2) for the treatment of autoimmune diseases: discovery of the allosteric inhibitor BMS-986165. J Med Chem. 2019;62:8973-8995
Psoriasis often manifests as red, scaly patches, causing discomfort and itchiness. Triggered by various factors like stress, cold weather, and genetics, it accelerates skin cell production, leading to the formation of dry, raised plaques. Psoriasis isn't merely a skin condition; it can extend its impact to joints, potentially causing psoriatic arthritis, along with various comorbidities such as heart disease, diabetes, and depression.
Managing psoriasis involves both non-pharmacological and medical approaches. Non-pharmacological methods encompass skin moisturization, cold showers, sunlight exposure, and dietary adjustments. Medical treatments range from topical therapies like corticosteroids to systemic medications, such as methotrexate, and biologics like adalimumab. Yet, the efficacy of these treatments varies among individuals, highlighting the importance of personalized approaches.
Psoriasis's impact extends beyond the physical, affecting mental health and quality of life. The visible symptoms can lead to social and emotional challenges, urging healthcare providers to address both the physical and emotional aspects of the disease. Recognizing psoriasis's systemic nature is crucial, considering its potential to induce inflammation in joints and various organs.
Psoriatic arthritis, a common consequence of psoriasis, necessitates early diagnosis and treatment to prevent permanent joint damage. The disease's inflammatory nature poses risks of arterial damage, potentially leading to heart disease. Modifiable risk factors like weight, physical activity, smoking, and stress play a role in managing psoriasis and reducing associated risks.
While there's no cure for psoriasis, ongoing research and evolving treatment options offer hope. Biologics like adalimumab neutralize TNF-alpha, mitigating inflammation, but their immunosuppressive nature requires careful consideration of potential complications. The continual expansion of treatment options emphasizes the importance of exploring diverse avenues to find the most effective and suitable approach for each patient.
Recent advancements in psoriasis treatment have brought forth a wave of innovation with the introduction of novel therapies. Among the notable additions, tapinarof, a topical aryl hydrocarbon receptor (AhR)–modulating agent, has shown promise in plaque psoriasis treatment. Derived from a bacterial symbiont, tapinarof activates AhR, leading to the suppression of helper T cells TH17 and TH22, subsequently improving skin barrier function. Phase 3 trials demonstrated significant efficacy, with 36.1% to 47.6% achieving a 75% reduction in psoriasis area and severity index (PASI 75) score at week 12.
Roflumilast, a selective phosphodiesterase 4 (PDE-4) inhibitor, represents another topical treatment for plaque psoriasis. In phase 3 trials (N=881), roflumilast exhibited efficacy in, with 37.5% to 42.4% of treated patients achieving investigator global assessment (IGA) success at week 8, and a notable absence of significant adverse effects, including gastrointestinal issues.
Deucravacitinib, an oral selective tyrosine kinase 2 (TYK2) allosteric inhibitor, showcased promising results in two phase 3 trials (N=1686). With a unique mechanism targeting the TYK2 pathway, deucravacitinib demonstrated efficacy, with 53.0% to 58.4% of patients achieving PASI 75 at week 16. Notably, long-term studies indicated persistent efficacy and consistent safety for up to 2 years.
The oral preparation EDP1815, derived from a single strain of Prevotella histicola, offers a unique approach. Targeting inflammatory diseases, including psoriasis, EDP1815 demonstrated superiority to placebo in a phase 2 study (NCT04603027), presenting a potential adjunctive treatment for mild to moderate psoriasis. These recent developments show a diverse array of treatment options for patients that could be a big help to them in the near future.
References:
Del Toro NP, Wu JJ, Han G. New Treatments for Psoriasis: An Update on a Therapeutic Frontier. Cutis. 2023 Feb;111(2):101-104. doi: 10.12788/cutis.0701. PMID: 37075192
Hilliard-Barth K, Cormack T, Ramani K, et al. Immune mechanisms of the systemic effects of EDP1815: an orally delivered, gut-restricted microbial drug candidate for the treatment of inflammatory diseases. Poster presented at: Society for Mucosal Immunology Virtual Congress; July 20-22, 2021, Cambridge, MA.
Strober B, Thaçi D, Sofen H, et al. Deucravacitinib versus placebo and apremilast in moderate to severe plaque psoriasis: efficacy and safety results from the 52-week, randomized, double-blinded, phase 3 Program for Evaluation of TYK2 inhibitor psoriasis second trial. J Am Acad Dermatol. 2023;88:40-51
Wrobleski ST, Moslin R, Lin S, et al. Highly selective inhibition of tyrosine kinase 2 (TYK2) for the treatment of autoimmune diseases: discovery of the allosteric inhibitor BMS-986165. J Med Chem. 2019;62:8973-8995