Department of Dermatology, Baylor University Medical Center, 3900 Junius Street, Suite 125, Dallas, TX 75204, USA.
Expert Opin Investig Drugs. 2012 Apr;21(4):473-87. doi: 10.1517/13543784.2012.669372. Epub 2012 Mar 8.
The advent of biologic therapies has revolutionized the treatment of psoriasis. Increased understanding of immunogenetic pathways has allowed for the development of more selective targeted biologic therapies. Multiple new treatments are currently in development for the treatment of psoriasis. Preliminary data for many of these agents, particularly with regard to agents targeting the IL-23/Th17 pathway, are promising. Proven long-term safety, however, is an absolute necessity with newly developed drugs, and should, therefore, still be considered second-line agents to current established treatments with long-term safety data.
This review details the mechanisms of action of drugs currently in development or in clinical trials for the treatment of psoriasis, using clinical trial registries and associated publications. Readers will gain a comprehensive overview about the mechanism of action of emerging treatments targeting various immune pathways deeply involved in psoriasis. Pathogenesis, clinical efficacy and safety data for these treatments are discussed where available.
Psoriasis remains a heavily undertreated systemic immune-mediated disease despite increased understanding of immunopathogenesis of the disease and advent of a multitude of novel therapeutic agents with potentially improved bioavailability and safety profiles. Limitations, however, remain in the realm of topical agents for treatment of mild to moderate psoriasis, which has seen little progress over the years. A concerted effort will need to be made among researchers, clinicians and patient advocacy groups to ensure new therapeutic agents are developed and gain proper exposure.
生物疗法的出现彻底改变了银屑病的治疗方式。对免疫遗传途径的深入了解，使得更具选择性的靶向生物疗法得以发展。目前，有多种新的治疗方法正在开发用于治疗银屑病。这些药物中的许多药物的初步数据，特别是针对 IL-23/Th17 途径的药物，都很有前景。然而，对于新开发的药物，长期安全性是绝对必要的，因此，它们仍应被视为具有长期安全性数据的现有治疗方法的二线药物。
本综述详细介绍了目前正在开发或临床试验中用于治疗银屑病的药物的作用机制，使用了临床试验注册处和相关出版物。读者将全面了解针对银屑病中涉及的各种免疫途径的新兴治疗方法的作用机制。只要有可用的数据，就会讨论这些治疗方法的发病机制、临床疗效和安全性。
尽管对疾病的免疫发病机制有了更深入的了解，并且出现了许多新型治疗药物，这些药物具有潜在的改善生物利用度和安全性，但是银屑病仍然是一种严重治疗不足的全身性免疫介导疾病。然而，在治疗轻度至中度银屑病的局部治疗药物方面，多年来几乎没有进展。研究人员、临床医生和患者权益组织之间需要共同努力，以确保新的治疗药物得到开发并得到适当的推广。
