Skip to main content

Future Therapeutics in Psoriasis

  • Chapter
  • First Online:
Evidence-Based Psoriasis

Abstract

In recent years, investigations into psoriasis pathophysiology have expanded the development of immunomodulatory and biological molecules. These advancements have transformed treatment regimens for psoriasis by selectively targeting immune signaling molecules. The aim of this chapter is to review the clinical and research data surrounding these emerging treatments, ranging from those undergoing development to those already in clinical trials. Therapies are organized by method of administration (topicals, orals, and injectables) and then phase of clinical trial. Many of these promising medications are small-molecule inhibitors and biologics, while some draw from traditional mechanisms of actions like steroids and vitamin analogs. It is too soon to know how effective these future agents will be and where they will fit into treatment algorithms. It will remain critical for clinicians to be aware of the limitations, important monitoring, and drug safety when selecting these novel treatments. However, even as the psoriasis treatment armamentarium continues to expand, many psoriasis patients may continue to experience recalcitrant disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Nestle FO, Kaplan DH, Barker J Psoriasis. N Engl J Med [Internet]. 2009 [cited 2017 May 8];361:496–509. http://www.ncbi.nlm.nih.gov/pubmed/19641206

  2. Menter A, Gottlieb A, Feldman SR, Van Voorhees AS, Leonardi CL, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol [Internet]. 2008 [cited 2017 May 8];58:826–50. http://linkinghub.elsevier.com/retrieve/pii/S0190962208002739

  3. Jensen AM, Lladó MB, Skov L, Hansen ER, Larsen JK, Baadsgaard O. Calcipotriol inhibits the proliferation of hyperproliferative CD29 positive keratinocytes in psoriatic epidermis in the absence of an effect on the function and number of antigen-presenting cells. Br J Dermatol [Internet]. 1998 [cited 2017 Apr 27];139:984–91. http://www.ncbi.nlm.nih.gov/pubmed/9990360

  4. Kragballe K. Treatment of psoriasis with calcipotriol and other vitamin D analogues. J Am Acad Dermatol [Internet]. 1992 [cited 2017 Apr 27];27:1001–8. http://www.ncbi.nlm.nih.gov/pubmed/1479078

  5. Dimitris R, Palmieri R, Caserini M, Iorizzo M. Phase-2 controlled study to assess the efficacy of two new nail solutions in the treatment of nail psoriasis. J Am Acad Dermatol [Internet]. Elsevier; 2016 [cited 2017 Apr 28];74:AB137. http://linkinghub.elsevier.com/retrieve/pii/S0190962216006708

  6. Scott LJ, Dunn CJ, Goa KL. Calcipotriol ointment. A review of its use in the management of psoriasis. Am J Clin Dermatol [Internet]. 2001 [cited 2017 Apr 27];2:95–120. http://www.ncbi.nlm.nih.gov/pubmed/11705309

  7. Georgiou S, Tsambaos D. Hypercalcaemia and hypercalciuria after topical treatment of psoriasis with excessive amounts of calcipotriol. Acta Derm Venereol [Internet]. 1999 [cited 2017 Apr 25];79:86. http://www.ncbi.nlm.nih.gov/pubmed/10086871

  8. Valeant Pharmaceuticals Announces Results of Second Phase 3 Study for Psoriasis Treatment IDP-118 – Valeant [Internet]. [cited 2017 Apr 28]. http://ir.valeant.com/news-releases/2017/01-10-2017-110212002

  9. Study to Investigate the Efficacy and the Safety of M518101 in Plaque Psoriasis Patients—Full Text View—ClinicalTrials.gov-NCT01301157 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT01301157

  10. Study to Evaluate the Efficacy and Safety of M518101 in Subjects With Plaque Psoriasis—Full Text View—ClinicalTrials.gov-NCT01873677 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT01873677

  11. Efficacy Study Comparing Topical M518101 and Vitamin D3 in Adult Psoriasis Patients—Full Text View—ClinicalTrials.gov-NCT01989429 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT01989429

  12. Boguniewicz M, Paller AS, Tom WL, Lebwohl MG, Blumenthal RL, Call RS, et al. Efficacy and safety of crisaborole topical ointment, 2%, a novel, nonsteroidal, topical, anti-inflammatory, phosphodiesterase inhibitor in 2 Phase 3 studies in children and adults with mild-to-moderate atopic dermatitis. J Allergy Clin Immunol [Internet]. 2016 [cited 2017 Apr 28];137:AB397. http://linkinghub.elsevier.com/retrieve/pii/S0091674915030444

  13. AN2728 Topical Ointment to Treat Mild-to-Moderate Plaque-Type Psoriasis—Study Results—ClinicalTrials.gov-NCT01300052 [Internet]. [cited 2017 May 10]. https://clinicaltrials.gov/ct2/show/results/NCT01300052?sect=X40156#othr

  14. Paller AS, Tom WL, Lebwohl MG, Blumenthal RL, Boguniewicz M, Call RS, et al. Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults. J Am Acad Dermatol [Internet]. 2016 [cited 2017 Apr 28];75:494–503.e6. http://www.ncbi.nlm.nih.gov/pubmed/27417017

  15. Roblin D, Yosipovitch G, Boyce B, Robinson J, Sandy J, Mainero V, et al. Topical TrkA Kinase Inhibitor CT327 is an effective, novel therapy for the treatment of pruritus due to psoriasis: results from experimental studies, and efficacy and safety of CT327 in a Phase 2b clinical trial in patients with psoriasis. Acta Derm Venereol [Internet]. 2015 [cited 2017 Apr 27];95:542–8. http://www.ncbi.nlm.nih.gov/pubmed/25594427

  16. Uva L, Miguel D, Pinheiro C, Antunes J, Cruz D, Ferreira J, et al. Mechanisms of action of topical corticosteroids in psoriasis. Int J Endocrinol [Internet]. 2012 [cited 2017 Apr 28];2012:1–16. http://www.ncbi.nlm.nih.gov/pubmed/23213332

  17. Lowe MN, Plosker GL. Bexarotene. Am J Clin Dermatol [Internet]. Springer International Publishing; 2000 [cited 2017 Apr 26];1:245–50. http://link.springer.com/10.2165/00128071-200001040-00006

  18. A Intra-individual Comparison to Investigate the Efficacy and the Safety of LAS41004 Formulation in Mild to Moderate Psoriasis—Full Text View—ClinicalTrials.gov-NCT02180464 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT02180464

  19. An Efficacy and Safety Study of PH-10 Aqueous Hydrogel for the Treatment of Plaque Psoriasis—Full Text View—ClinicalTrials.gov-NCT00941278 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT00941278

  20. PH-10 For Psoriasis [Internet]. [cited 2017 Apr 28]. http://www.provectusbio.com/ph-10-for-psoriasis

  21. Randomized Study of PH-10 for Psoriasis—Full Text View—ClinicalTrials.gov-NCT01247818 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT01247818

  22. Bissonnette R, Bolduc C, Maari C, Nigen S, Webster JM, Tang L, et al. Efficacy and safety of topical WBI-1001 in patients with mild to moderate psoriasis: results from a randomized double-blind placebo-controlled, phase II trial. J Eur Acad Dermatol Venereol [Internet]. Blackwell Publishing Ltd; 2011 [cited 2017 Apr 26];26. http://doi.wiley.com/10.1111/j.1468-3083.2011.04332.x

  23. Zhao L, Chen X, Cai L, Zhang C, Wang Q, Jing S, et al. Randomized, double-blind, placebo-controlled, multiple-dose study of the safety, tolerability and pharmacokinetics of benvitimod, a candidate drug for the treatment of psoriasis. J Clin Pharm Ther [Internet]. 2014 [cited 2017 Apr 26];39:418–23. http://www.ncbi.nlm.nih.gov/pubmed/24673513

  24. Ports WC, Khan S, Lan S, Lamba M, Bolduc C, Bissonnette R, et al. A randomized phase 2a efficacy and safety trial of the topical Janus kinase inhibitor tofacitinib in the treatment of chronic plaque psoriasis. Br J Dermatol [Internet]. 2013 [cited 2017 Apr 27];169:137–45. http://doi.wiley.com/10.1111/bjd.12266

  25. Papp KA, Bissonnette R, Gooderham M, Feldman SR, Iversen L, Soung J, et al. Treatment of plaque psoriasis with an ointment formulation of the Janus kinase inhibitor, tofacitinib: a Phase 2b randomized clinical trial. BMC Dermatol [Internet]. 2016 [cited 2017 Apr 27];16:15. http://www.ncbi.nlm.nih.gov/pubmed/27716172

  26. NCI Thesaurus-Abacavir [Internet]. [cited 2017 Apr 29]. https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&version=17.03d&ns=NCI_Thesaurus&code=C61523&key=n785246928&b=1&n=null

  27. Bioequivalence and Pharmacokinetic Study of Prurisol™ and Abacavir Sulfate in Healthy Volunteers—Full Text View—ClinicalTrials.gov-NCT02101216 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT02101216

  28. XenoPort Announces Positive Phase 2 Study Results for XP23829 as a Potential Treatment for Patients with Psoriasis|Business Wire [Internet]. [cited 2017 May 8]. http://www.businesswire.com/news/home/20150915005703/en/XenoPort-Announces-Positive-Phase-2-Study-Results

  29. Zanin-Zhorov A, Weiss JM, Nyuydzefe MS, Chen W, Scher JU, Mo R, et al. Selective oral ROCK2 inhibitor down-regulates IL-21 and IL-17 secretion in human T cells via STAT3-dependent mechanism. Proc Natl Acad Sci [Internet]. 2014 [cited 2017 Apr 29];111:16814–9. http://www.ncbi.nlm.nih.gov/pubmed/25385601

  30. Zanin-Zhorov A, Weiss JM, Trzeciak A, Chen W, Zhang J, Nyuydzefe MS, et al. Cutting edge: selective oral ROCK2 inhibitor reduces clinical scores in patients with psoriasis vulgaris and normalizes skin pathology via concurrent regulation of IL-17 and IL-10. J Immunol [Internet]. 2017 [cited 2017 Apr 29]. http://www.jimmunol.org/content/early/2017/04/06/jimmunol.1602142

  31. NCI Thesaurus-Alitretinoin [Internet]. [cited 2017 Apr 29]. https://ncit.nci.nih.gov/ncitbrowser/pages/concept_details.jsf

  32. Irla N, Navarini AA, Yawalkar N. Alitretinoin abrogates innate inflammation in palmoplantar pustular psoriasis. Br J Dermatol [Internet]. Blackwell Publishing Ltd; 2012 [cited 2017 Apr 29];167:1170–4. http://doi.wiley.com/10.1111/j.1365-2133.2012.11063.x

  33. Reich K, Graff O, Mehta N. Oral alitretinoin treatment in patients with palmoplantar pustulosis inadequately responding to standard topical treatment: a randomized phase II study. Br J Dermatol [Internet]. 2016 [cited 2017 Apr 29];174:1277–81. http://www.ncbi.nlm.nih.gov/pubmed/26800106

  34. NCI Thesaurus-Baricitinib [Internet]. [cited 2017 Apr 29]. https://ncit.nci.nih.gov/ncitbrowser/pages/concept_details.jsf

  35. Papp KA, Menter MA, Raman M, Disch D, Schlichting DE, Gaich C, et al. A randomized phase 2b trial of baricitinib, an oral Janus kinase (JAK) 1/JAK2 inhibitor, in patients with moderate-to-severe psoriasis. Br J Dermatol [Internet]. 2016 [cited 2017 Apr 29];174:1266–76. http://www.ncbi.nlm.nih.gov/pubmed/26800231

  36. Nawas Z, Hatch M, Ramos E, Liu M, Tong Y, Peranteau A, et al. A review of guselkumab, an IL-23 inhibitor, for moderate-to-severe plaque psoriasis. Skin Ther Lett [Internet]. 2017 [cited 2017 Apr 28];22:8–10. http://www.ncbi.nlm.nih.gov/pubmed/28329405

  37. Sofen H, Smith S, Matheson RT, Leonardi CL, Calderon C, Brodmerkel C, et al. Guselkumab (an IL-23-specific mAb) demonstrates clinical and molecular response in patients with moderate-to-severe psoriasis. J Allergy Clin Immunol [Internet]. 2014 [cited 2017 Apr 28];133:1032–40. http://www.ncbi.nlm.nih.gov/pubmed/24679469.

  38. Gordon KB, Duffin KC, Bissonnette R, Prinz JC, Wasfi Y, Li S, et al. A Phase 2 trial of guselkumab versus adalimumab for plaque psoriasis. N Engl J Med [Internet]. Massachusetts Medical Society; 2015 [cited 2017 Apr 28];373:136–44. http://www.nejm.org/doi/abs/10.1056/NEJMoa1501646

  39. Blauvelt A, Papp KA, Griffiths CEM, Randazzo B, Wasfi Y, Shen Y-K, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol [Internet]. 2017 [cited 2017 Apr 28];76:405–17. http://www.ncbi.nlm.nih.gov/pubmed/28057360

  40. Reich K, Armstrong AW, Foley P, Song M, Wasfi Y, Randazzo B, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the treatment of patients with moderate to severe psoriasis with randomized withdrawal and retreatment: results from the phase III, double-blind, placebo- and active comparator-controlled VOYAGE 2 trial. J Am Acad Dermatol [Internet]. 2017 [cited 2017 Apr 28];76:418–31. http://linkinghub.elsevier.com/retrieve/pii/S0190962216311586

  41. Kopp T, Riedl E, Bangert C, Bowman EP, Greisenegger E, Horowitz A, et al. Clinical improvement in psoriasis with specific targeting of interleukin-23. Nature [Internet]. 2015 [cited 2017 Apr 28];521:222–6. http://www.ncbi.nlm.nih.gov/pubmed/25754330

  42. Papp K, Thaçi D, Reich K, Riedl E, Langley RG, Krueger JG, et al. Tildrakizumab (MK-3222), an anti-interleukin-23p19 monoclonal antibody, improves psoriasis in a phase IIb randomized placebo-controlled trial. Br J Dermatol [Internet]. 2015 [cited 2017 Apr 28];173:930–9. http://doi.wiley.com/10.1111/bjd.13932

  43. Krueger JG, Ferris LK, Menter A, Wagner F, White A, Visvanathan S, et al. Anti-IL-23A mAb BI 655066 for treatment of moderate-to-severe psoriasis: safety, efficacy, pharmacokinetics, and biomarker results of a single-rising-dose, randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol [Internet]. 2015 [cited 2017 Apr 29];136:116–124.e7. http://www.ncbi.nlm.nih.gov/pubmed/25769911

  44. Papp KA, Blauvelt A, Bukhalo M, Gooderham M, Krueger JG, Lacour J-P, et al. Risankizumab versus Ustekinumab for Moderate-to-Severe Plaque Psoriasis. N. Engl. J. Med. [Internet]. Massachusetts Medical Society; 2017 [cited 2017 Apr 29];376:1551–60. http://www.nejm.org/doi/10.1056/NEJMoa1607017

  45. Mease P, Genovese MC, Gladstein G, Kivitz AJ, Ritchlin C, Tak PP, et al. Abatacept in the treatment of patients with psoriatic arthritis: results of a six-month, multicenter, randomized, double-blind, placebo-controlled, phase II trial. Arthritis Rheum. [Internet]. Wiley Subscription Services, Inc., A Wiley Company; 2011 [cited 2017 Apr 29];63:939–48. http://doi.wiley.com/10.1002/art.30176

  46. Silverman D, Oliver A. Abatacept-induced psoriasis. Cutis [Internet]. 2011 [cited 2017 Apr 29];88:117–8. http://www.ncbi.nlm.nih.gov/pubmed/22017062

  47. Brigant F, Clavel G, Chatelain D, Lok C, Chaby G. Letter: a case of generalized guttate psoriasis induced by etanercept with relapse after abatacept. Dermatol Online J [Internet]. 2011 [cited 2017 Apr 29];17:11. http://www.ncbi.nlm.nih.gov/pubmed/21696691

  48. Florent A, Albert C, Giacchero D, Roux C, Euller-Ziegler L. Reactivation of cutaneous psoriasis during abatacept therapy for spondyloarthropathy. Joint Bone Spine [Internet]. 2010 [cited 2017 Apr 29];77:626–7. http://linkinghub.elsevier.com/retrieve/pii/S1297319X10002460

  49. Jost C, Hermann J, Caelen LE-S, Graninger W. New onset psoriasis in a patient receiving abatacept for rheumatoid arthritis. BMJ Case Rep [Internet]. 2009 [cited 2017 Apr 29];2009:bcr0920080845.http://casereports.bmj.com/cgi/doi/10.1136/bcr.09.2008.0845

  50. Sibilia J, Westhovens R. Safety of T-cell co-stimulation modulation with abatacept in patients with rheumatoid arthritis. Clin Exp Rheumatol [Internet]. [cited 2017 Apr 29];25:S46–56. http://www.ncbi.nlm.nih.gov/pubmed/17977488

  51. Lubrano E, Perrotta FM. Beyond TNF inhibitors: new pathways and emerging treatments for psoriatic arthritis. Drugs [Internet]. Springer International Publishing; 2016 [cited 2017 Apr 28];76:663–73. http://link.springer.com/10.1007/s40265-016-0557-4

  52. NCI Thesaurus-Neihulizumab [Internet]. [cited 2017 Apr 29]. https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C121711&ns=NCI_Thesaurus

  53. A Study of Multiple Doses of AbGn-168H by Intravenous Infusion in Patients With Moderate to Severe Chronic Plaque Psoriasis—Full Text View—ClinicalTrials.gov-NCT02223039 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/NCT02223039

  54. Mease PJ, Gottlieb AB, Berman A, Drescher E, Xing J, Wong R, et al. The efficacy and safety of clazakizumab, an anti-interleukin-6 monoclonal antibody, in a Phase IIb study of adults with active psoriatic arthritis. Arthritis Rheumatol [Internet]. 2016 [cited 2017 Apr 28];68:2163–73. http://doi.wiley.com/10.1002/art.39700

  55. Abufarag A, Aigner S, Czeloth N, Dalken B, Koch H, Niemann G, Uherek C, Osterroth F, Wartenberg-Demand A, Haefeli W, Schopf R, Enk A. Selective activation of naturally occurring regulatory T cells (Tregs) by the monoclonal antibody BT-061 as a novel therapeutic opportunity in psoriasis: early clinical results after single doses [Internet]. [cited 2017 Apr 29]. http://www.biotest.de/shared/data/pdf/biotherapeutics/esdr_2010.pdf

  56. Huizinga TWJ, Batalov A, Stoilov R, Lloyd E, Wagner T, Saurigny D, et al. Phase 1b randomized, double-blind study of namilumab, an anti-granulocyte macrophage colony-stimulating factor monoclonal antibody, in mild-to-moderate rheumatoid arthritis. Arthritis Res Ther [Internet]. 2017 [cited 2017 Apr 29];19:53. http://arthritis-research.biomedcentral.com/articles/10.1186/s13075-017-1267-3

  57. NCI Thesaurus-Namilumab [Internet]. [cited 2017 Apr 29]. https://ncit.nci.nih.gov/ncitbrowser/pages/concept_details.jsf

  58. Efficacy and Safety of Namilumab (MT203) for Plaque Psoriasis—Study Results—ClinicalTrials.gov-NCT02129777 [Internet]. [cited 2017 May 8]. https://clinicaltrials.gov/ct2/show/results/NCT02129777?sect=X01256#all

  59. Hari A, Flach TL, Shi Y, Mydlarski PR. Toll-like receptors: role in dermatological disease. Mediators Inflamm [Internet]. Hindawi Publishing Corporation; 2010 [cited 2017 Apr 29];2010:437246. http://www.ncbi.nlm.nih.gov/pubmed/20847936

  60. Balak DMW, Van Doorn A, Rissmann R, Sullivan T, Burggraaf J, Arbeit RD. Results from a randomized, double-blind, placebo-controlled, monotherapy trial of IMO-8400 demonstrate clinical proof- of-concept for Toll-like receptor 7, 8 and 9 antagonism in psoriasis. [cited 2017 Apr 29]; http://www.iderapharma.com/wp-content/uploads/2015/11/imo-8400_psoriasis_aad_poster-final.pdf

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Leah A. Cardwell .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Cline, A., Felix, K.H., Oussedik, E., Cardwell, L.A., Feldman, S.R. (2018). Future Therapeutics in Psoriasis. In: Bhutani, T., Liao, W., Nakamura, M. (eds) Evidence-Based Psoriasis. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-90107-7_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90107-7_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90106-0

  • Online ISBN: 978-3-319-90107-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics