Advancements in Targeted Therapies for Psoriasis Management

Ashamed Shah^*
*Correspondence: Ashamed Shah, Department of Surgery, University of KwaZulu-Natal, Durban 4001, South Africa, Email:

Keywords

Psoriasis • Targeted therapies • Biologics • Small molecules • Emerging treatments • Autoimmune skin condition

Introduction

Psoriasis is a chronic autoimmune skin disorder that affects approximately 125 million people worldwide, according to the World Psoriasis Day Consortium. This condition is characterized by red, scaly patches on the skin, joint pain and a range of psychosocial impacts. While there is no cure for psoriasis, recent advancements in targeted therapies have significantly improved the management of this debilitating condition. These breakthroughs are transforming the treatment landscape, offering new hope for patients seeking relief from the physical and emotional burdens of psoriasis. Before delving into the latest advancements in targeted therapies, it is essential to grasp the underlying mechanisms of psoriasis. This disorder arises from an overactive immune system, causing skin cells to grow at an accelerated rate. Normally, skin cells mature and shed every 28 to 30 days, but in psoriasis, this process takes only three to four days. This rapid cell turnover leads to the build-up of thick, scaly plaques on the skin's surface. Moreover, psoriasis is often accompanied by systemic inflammation, which can impact other organs and lead to conditions like psoriatic arthritis [1].

Literature Review

One of the most significant advancements in psoriasis management has been the development of biologic therapies. Biologics are genetically engineered proteins that target specific molecules in the immune system, effectively modulating the body's immune response. In the case of psoriasis, these therapies target key cytokines, such as Tumor Necrosis Factor-Alpha (TNF-alpha), Interleukin-17 (IL-17) and Interleukin-23 (IL-23), which plays pivotal roles in the development and progression of the disease. Etanercept, an anti-TNF-alpha biologic, was one of the earliest biologics approved for psoriasis treatment. It works by binding to TNF-alpha and neutralizing its inflammatory effects. This has proven effective in reducing skin lesions and providing relief from psoriatic symptoms. These biologics target IL-17, another important cytokine in psoriasis pathogenesis. By blocking IL-17, they reduce inflammation and help clear skin lesions. They have shown remarkable efficacy in clinical trials, offering hope to patients with moderate to severe psoriasis [2].

While biologics have been transformative in psoriasis management, they are administered via injection or infusion, which may not be suitable for all patients. Small molecule drugs, which are orally administered, have emerged as a more convenient alternative. These drugs target specific intracellular signalling pathways involved in psoriasis pathogenesis. It has shown promise in treating psoriasis by reducing skin inflammation and improving symptoms. Its oral formulation offers a more accessible option for patients. By inhibiting JAK enzymes, they reduce the activity of inflammatory cytokines. These drugs are currently being studied for their effectiveness in psoriasis management. The field of psoriasis research continues to evolve, with several emerging treatments on the horizon. These treatments aim to address unmet needs in current therapies, such as achieving higher response rates, reducing side effects and offering more convenient administration methods [3].

Gene therapy is an exciting frontier in psoriasis research. By modifying the genes responsible for psoriasis, scientists hope to develop curative treatments. While this field is in its early stages, it holds immense potential for transforming psoriasis care. To complement systemic JAK inhibitors, topical formulations are being explored. These formulations could offer targeted treatment for localized psoriasis plaques, minimizing systemic exposure and potential side effects. Advancements in targeted therapies are also paving the way for personalized medicine in psoriasis treatment. Genetic profiling and biomarker analysis can help identify the most suitable treatment for individual patients. This tailored approach enhances treatment efficacy while minimizing adverse effects, making it a promising avenue for the future of psoriasis management. Advancements in targeted therapies have revolutionized the management of psoriasis, offering hope and relief to millions of individuals affected by this chronic autoimmune skin condition.

Biologics, small molecules and emerging treatments have significantly improved treatment efficacy and the quality of life for many patients. Moreover, the prospect of personalized medicine in psoriasis care holds immense potential for tailoring treatments to individual needs. Despite these remarkable strides, challenges remain, including issues of cost, accessibility and long-term safety. Addressing these challenges and continuing to innovate in psoriasis research are essential for further improving patient outcomes and ultimately finding a cure for this complex and debilitating condition. In the coming years, as the field of psoriasis management continues to evolve, it is hopeful that even more effective, safe and accessible treatments will emerge, ultimately leading to a better quality of life for all individuals living with psoriasis. With on-going research, collaboration and dedication, the future of psoriasis management looks brighter than ever before. While the advancements in targeted therapies for psoriasis are undeniably promising, several challenges and considerations persist in the quest to improve patient outcomes [4].

Discussion

Many of the biologics and emerging therapies are costly, making them inaccessible to a significant portion of patients, particularly in countries without robust healthcare systems. Efforts to increase affordability and access to these treatments are crucial. The long-term safety profiles of some targeted therapies are still being studied. Continuous monitoring and research are necessary to ensure that these treatments do not have unforeseen side effects. Not all patients respond equally to targeted therapies. Some may experience limited efficacy or develop resistance over time. Identifying predictive markers of response is an on-going challenge. Psoriasis often has a profound psychosocial impact on patients, including depression, anxiety and reduced quality of life. Targeted therapies may alleviate physical symptoms, but addressing the psychological aspect of the disease remains essential. The future of psoriasis management holds great promise as researchers and clinicians continue to explore innovative strategies [5].

With the increasing availability of genetic and biomarker data, developing personalized treatment algorithms that consider an individual's genetic makeup and disease profile may become standard practice. Innovations in topical treatments, such as nanoparticles for drug delivery or novel formulations, may provide improved options for patients with milder forms of psoriasis. Telemedicine and digital health tools can facilitate remote monitoring of psoriasis patients, helping healthcare providers make timely treatment adjustments and offer support for psychosocial issues. Education and support programs that empower patients to manage their condition effectively, including lifestyle modifications and stress reduction, can complement medical treatments. Collaborative efforts among researchers, healthcare providers and pharmaceutical companies worldwide can accelerate the development and availability of new treatments while addressing global disparities in psoriasis care [6].

Conclusion

The management of psoriasis has come a long way thanks to advancements in targeted therapies. Biologics and small molecules have offered effective treatment options for patients, significantly improving their quality of life. Additionally, emerging treatments and the promise of personalized medicine continue to fuel optimism in the field. While there is no cure for psoriasis yet, these innovations are bringing us closer to more effective and individualized approaches to managing this chronic autoimmune skin condition. As research continues to evolve, the outlook for psoriasis patients is increasingly hopeful.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Egeberg, A., M. B. Ottosen, R. Gniadecki and S. Broesby‐Olsen, et al. "Safety, efficacy and drug survival of biologics and biosimilars for moderate‐to‐severe plaque psoriasis." Br J Dermatol 178 (2018): 509-519.

Google Scholar, Crossref Indexed at

2. Ghafoor, Rabia, Anant Patil, Paul Yamauchi and Jeffrey Weinberg, et al. "Treatment of scalp psoriasis." J Drugs Dermatol 21 (2022): 833-837.

Google Scholar, Crossref, Indexed at

3. Misiak-Galazka, Magdalena, Joanna Zozula and Lidia Rudnicka. "Palmoplantar pustulosis: Recent advances in etiopathogenesis and emerging treatments." Am J Clin Dermatol 21 (2020): 355-370.

Google Scholar, Crossref, Indexed at

4. Hoegler, K. M., A. M. John, M. Z. Handler and R. A. Schwartz. "Generalized pustular psoriasis: A review and update on treatment." J Eur Acad Dermatol Venereol 32 (2018): 1645-1651.

Google Scholar, Crossref, Indexed at

5. Tang, Lipeng, Xiaozhi Yang, Yongxin Liang and Hesong Xie, et al. "Transcription factor retinoid-related orphan receptor γt: A promising target for the treatment of psoriasis." Front Immunol 9 (2018): 1210.

Google Scholar, Crossref, Indexed at

6. Chen, Anqi, Yuting Luo, Jie Xu and Xueran Guan, et al. "Latest on biomaterial-based therapies for topical treatment of psoriasis." J Mater Chem B 10 (2022): 7397-7417.

Google Scholar, Crossref, Indexed at