There are about eleven Injectable drugs in the phase 2 and 3 trial pipeline for psoriasis, according to the National Psoriasis Foundation. That doesn’t include biosimilars, which do not follow the traditional pathway through clinic trials.
“Where we stand now, there are three primary targets for injectable biologic medications for psoriasis. Those are: tumor necrosis factor-alpha (TNF-a), which is early in the signaling cascade of immune response, and that molecule has been targeted for many years in different immune-mediated diseases, including rheumatoid arthritis,” said Michael Siegel, Ph.D., director of research programs, National Psoriasis Foundation, Portland, Ore. “The other two targets that are being primarily targeted by these injectable biologics are interleukin 23 (IL-23) and interleukin 17 (IL17). Clinical trials for the specific IL-23 and IL-17 inhibitors have been extremely promising, with high clearance rates and long-term clearance.”
A closer look
Jashin (Jay) Wu, M.D., director of dermatology research for Kaiser Permanente Medical Center in Los Angeles, Calif., and a National Psoriasis Foundation medical board member, told Dermatology Times that there are several biologics in the pipeline that dermatologists should consider for the future treatment of their psoriasis patients.
“Probably the most exciting is an IL-23 inhibitor by Boehringer Ingelheim, called BI 655066,” Dr. Wu says. “That’s one of three IL-23 inhibitors in the pipeline right now and, of all the biologics, that’s actually the one that’s furthest away from approval. They’re going to start phase 3 trials soon.”
On October 8, 2015, Boehringer Ingelheim announced its investigational biologic cleared skin better, faster and for longer than ustekinumab in a phase 2 psoriasis study.
“After nine months, 69% of patients with moderate-to-severe plaque psoriasis maintained clear or almost clear skin (PASI 90) with BI 655066 in the higher-dose group compared to 30% of patients on ustekinumab. Patients also achieved this skin clearance significantly faster (approximately eight weeks versus approximately 16 weeks) and for more than two months longer (≥ 32 weeks versus 24 weeks) than those on ustekinumab. In addition, completely clear skin (PASI 100) was maintained after nine months in nearly triple the percentage of patients on BI 655066 compared with ustekinumab (43% versus 15%),” according to the press release.