Emerging Psoriasis and Psoriatic Arthritis Therapies Expand Treatment Landscape

Published in the Journal of Clinical Medicine, a new review highlights the evolving therapeutic landscape for psoriasis and psoriatic arthritis (PsA), emphasizing the role of novel agents in addressing unmet clinical needs. Recent advancements have broadened options beyond traditional corticosteroids, vitamin D analogs, and biologics, offering hope for patients with refractory disease.

Biologics targeting tumor necrosis factor-alpha (TNF-α), interleukin (IL)-12/23, IL-17, and IL-23 have transformed management by providing highly effective and safer alternatives. However, emerging oral small molecules—including Janus kinase (JAK) inhibitors and tyrosine kinase 2 (TYK2) inhibitors—are expanding the armamentarium.

"These different mechanisms of action not only expand treatment options but may offer potential solutions for patients who do not achieve adequate response with existing therapies," the authors noted.

The review details a variety of therapies currently under investigation, including selective JAK inhibitors, TYK2 inhibitors, RORγT inhibitors, oral IL-23 and IL-17A inhibitors, nanobody products, S1P1R antagonists, A3AR agonists, HSP90 inhibitors, and ROCK-2 inhibitors. While many of these agents show promise, safety considerations remain critical.

"Certain mechanisms may pose increased risks for infection, cardiovascular manifestations, malignancy, or other immune-related adverse events, necessitating careful monitoring and individualized treatment decisions," the study emphasized.

Oral IL-23 inhibitors demonstrate potential with favorable safety profiles, while oral IL-17 and TYK2 inhibitors offer efficacy but may present tolerability challenges. Clinicians are advised to balance efficacy, safety, and patient preferences, particularly regarding the convenience of oral delivery.

For dermatologists, the continued emergence of new targeted therapies requires careful patient selection and vigilance regarding long-term safety as the field moves toward more personalized and sustainable disease management strategies.

Reference
Yi RC, Akbik M, Smith LR, Klionsky Y, Feldman SR. Therapeutic advancements in psoriasis and psoriatic arthritis. J Clin Med. Published online February 16, 2025. doi:10.3390/jcm14041312