Second Generation TYK2 Inhibitors Transform Psoriasis Management

In an interview with Dermatology Times at the 2025 Fall Clinical Dermatology Conference, Benjamin Lockshin, MD, a board-certified dermatologist practicing in Washington, DC, at US Dermatology Partners and director of their clinical trial center, discussed the evolving landscape of psoriasis management. He emphasized the impact of newer oral therapies, particularly 2nd generation TYK2 inhibitors, on patient outcomes and quality of life.

According to Lockshin:

“TYK2 inhibitors have really changed the landscape in terms of our management of patients with psoriasis. These medications provide meaningful response rates for patients with moderate to severe psoriasis vulgaris, including in difficult-to-treat regions such as the scalp, palms, and soles."

He highlighted that these oral therapies are particularly appealing for patients who prefer to avoid injections, citing younger patients or those living in shared environments like dormitories: “Many patients don't want the hassle of having an injection… just having that pill keeps your disease stay personal, so other people don't need to know what's going on.”

Lockshin indicated that the drugs occupy a unique niche in psoriasis management. They are considered especially appropriate for moderate disease, bridging the gap between topical therapies and biologics. While biologics generally outperform oral agents in efficacy, he noted that individual responses to medications can achieve high levels of skin clearance in the moderate category. He described these oral treatments as hitting “that sweet spot in terms of managing their disease, getting it significantly better, and it's a good complement to our treatment options that include biologics.”

Looking forward, Lockshin expressed optimism regarding emerging therapies. The new IL-23 peptide oral agent, icotrokinra (Johnson & Johnson), is expected to replicate some of the high clearance rates typically associated with biologics while maintaining a favorable safety profile. He also highlighted the potential for biologic agents with very long half-lives, allowing patients to achieve extended periods of disease control with only 1 or 2 injections per year.

Overall, the interview underscores a paradigm shift in psoriasis treatment. The variety of therapies offer clinicians a broader toolkit to individualize treatment, optimize outcomes, and improve adherence by aligning with patient preferences. Lockshin concluded with enthusiasm about 2026, stating that it will be “an exciting time to manage patients with psoriasis, given the multiple different MOAs and especially the introduction of a few new oral options.”