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Treating Plaque Psoriasis: What’s Next?


An overview of the most anticipated developments to come in plaque psoriasis treatment.

Andrew F. Alexis, MD, MPH: How do you anticipate the treatment landscape evolving? Why don’t I ask April Armstrong to start that discussion? In broad strokes, how is our approach going to evolve?

April W. Armstrong, MD, MPH: In broad strokes, I would say that in the psoriasis treatment landscape, we are going to look for agents that even have a higher efficacy, not only in the skin but also in the joint. Especially in the joint. In psoriatic arthritis, we still have a long way to go. We still use ACR20 as our bar. That aspect of psoriatic disease will just need to be addressed a little better with newer therapies.

We will also see that newer agents, with regard to topicals or oral therapies, are really looking at different classes of topical and oral therapies that work very differently from traditional therapies we have had. Therefore, addressing the need for patients who prefer oral therapies or patients who have limited psoriasis and would want to have safe and effective topical therapies.

Andrew F. Alexis, MD, MPH: Excellent. Briefly, Andy, what are some of the most anticipated developments in your mind that you think the audience should know about? The most anticipated developments in the field of treating plaque psoriasis.

Andrew Blauvelt, MD, MBA: Yeah. We do have more biologics on the way, but they’re of similar classes. We have a new IL-17 blocker that’s likely to be approved next year. We have a new IL-23 blocker that will be coming soon thereafter. But as far as something new, those will offer some incremental increases from where we’re at now. We have a new oral therapy likely to be approved in the next several years that blocks a molecule called TYK2. There, it will go to the head of the class, in terms of oral therapy for psoriasis.

It’s not going to be close to the best biologic therapy, but for those looking for oral therapies, it’s going to go to the head of the class, ahead of apremilast, ahead of methotrexate, ahead of cyclosporin, and acitretin. That’s something to look forward to. That will be really different. Then just 1 more comment. I’m involved in the scientific advisory committee for the National Psoriasis Foundation. They have a program that is Milestones to a Cure. We’re going to be using the C word more in the next 5 to 10 years, with strategies to look at cure, because we’ve gotten such great and effective therapies that we’ve spoken about, but they all require continued use. We’re going to start looking at strategies in the next 5 to 10 years that are more about knocking down disease permanently. That’s really the exciting thing if you’re going to be around for another 10 years.

Erin E. Boh, MD, PhD, FAAD: Let’s hope so.

Andrew F. Alexis, MD, MPH: Very exciting, indeed.

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