Drakos Anastasia, Vender Ronald
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Dermatrials Research Inc., Venderm Innovations in Psoriasis, Hamilton, ON, Canada.
Dermatol Ther (Heidelb). 2022 Dec;12(12):2715-2730. doi: 10.1007/s13555-022-00840-9. Epub 2022 Nov 1.
As our understanding of the pathogenesis of psoriasis has evolved over the past two decades, so has the number of treatment options. The introduction of biologic agents targeting specific cytokines in the interleukin (IL)-23/IL-17 pathway has proven successful in promoting skin clearance among patients. However, their use is often limited owing to cost, parenteral administration, and possible reduced efficacy over time. Topical therapies have also seen limited advancement, with agents such as corticosteroids and vitamin D derivatives remaining the mainstay of treatment, despite side effects limiting their long-term use. New therapeutic agents are needed to improve disease management for patients. In this review, we summarize pipeline and recently approved therapies undergoing clinical trials for psoriasis during a 12-month search period (30 June 2021 to 30 June 2022) using ClinicalTrials.gov. New-generation biologics and oral small molecules in phase II or III development were included, and pivotal data identified through various search modalities (PubMed, conference presentations, etc.) evaluating each drug candidate will be discussed. Topical therapies will also be discussed in line with recent US Food and Drug Administration approvals. As new therapies continue to enter the treatment landscape, long-term data and comparative trials will be needed to better understand their place among existing therapeutic agents.
在过去二十年中,随着我们对银屑病发病机制的理解不断发展,治疗选择的数量也在增加。事实证明,引入针对白细胞介素(IL)-23/IL-17途径中特定细胞因子的生物制剂,对于促进患者皮肤病变的清除是成功的。然而,由于成本、肠胃外给药以及随着时间推移可能出现的疗效降低,其应用往往受到限制。局部治疗的进展也很有限,尽管皮质类固醇和维生素D衍生物等药物存在限制其长期使用的副作用,但它们仍然是治疗的主要手段。需要新的治疗药物来改善对患者疾病的管理。在本综述中,我们使用ClinicalTrials.gov总结了在12个月搜索期(2021年6月30日至2022年6月30日)内正在进行银屑病临床试验的在研和最近获批的疗法。纳入了处于II期或III期开发阶段的新一代生物制剂和口服小分子药物,并将讨论通过评估每个候选药物的各种搜索方式(PubMed、会议报告等)确定的关键数据。还将根据美国食品药品监督管理局最近的批准情况讨论局部治疗方法。随着新疗法不断进入治疗领域,需要长期数据和对比试验,以更好地了解它们在现有治疗药物中的地位。