Why You Should You Be Prescribing Tapinarof for Plaque Psoriasis

At the Skin of Color Update meeting in New York City, Mona Shahriari, MD, FAAD, shares her thoughts on prescribing the recently-approved tapinarof (VTAMA) for plaque psoriasis.

"I am super stoked to be sharing one of the newest additions to our arsenal for psoriasis," Mona Shahriari, MD, FAAD, assistant clinical professor of dermatology at Yale University School of Medicine enthused. So began Shahriari's presentation on the recent approval of tapinarof (VTAMA) cream, 1%, an aryl hydrocarbon receptor agonist, indicated for the topical treatment of plaque psoriasis in adults, at the Skin of Color Update meeting in New York City on September 9.

Before going into details about tapinarof, Shahriari italicized one of the unique features of the cream, which is its remittive effect. "Patients can maintain a remission state for 4 to 6 months after stopping this drug, something truly unique for this disease state," she noted. Tapinarof is also the first new topical for psoriasis since 1997, important to consider, as 9 out of 10 patients are treated with topicals for plaque psoriasis. "Topicals are a cornerstone of this disease," noted Shahriari, "and innovation has been lacking in the topical arena." Tapinarof works by influencing gene expression and reduction in TH17 cytokines (proteins crucial to cell signaling), to reduce inflammation, as well as the TH2 cells, further reducing inflammation. This kind of targeted response is crucial in eliminating the appearance of plaque psoriasis on the body.

Shahriari shared details of the Psoaring 1 and 2 study design for tapinarof cream, which included subjects aged 18 to 75 years with mild, moderate, and severe plaque psoriasis. Pictures, however best tell the story: sharing images of subjects who had developed plaque psoriasis on their arms, hands, and legs, there was dramatic improvement for most subjects by week 4, with clear or almost clear skin by week 12 of the study. The most common adverse reactions were folliculitis, nasopharyngitis, contact dermatitis, headache, pruritus, and influenza.

Additionally, a patient satisfaction survey found that 90% of patients found the tapinarof cream easy to apply and nongreasy, with 83% noting they would use the cream again, or continue use of tapinarof.

"In the past, there was often a convuluted, complex regiment for patients to follow, having to use different medications on different parts of their body," said Shahriari. "This medication can simplify treatment: one topical, that you can use anywhere on your body. This could really make a difference in the lives of our patients."

Reference
Shahriari M. Vtama (tapinarof) cream, 1% as a novel topical therapy for plaque psoriasis. Skin of Color Update meeting. Sheraton New York Times Square Hotel. New York, New York. September 9, 2022.