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银屑病:聚焦即将问世的口服制剂。

Psoriasis: a focus on upcoming oral formulations.

作者信息

Rusiñol Lluís, Carmona-Rocha Elena, Puig Lluís

机构信息

Dermatology Department IIB Sant Pau, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.

出版信息

Expert Opin Investig Drugs. 2023 Jul-Dec;32(7):583-600. doi: 10.1080/13543784.2023.2242767. Epub 2023 Aug 1.

Abstract

INTRODUCTION

Targeted therapies have greatly improved the quality of life of patients with psoriasis. Despite the extensive list of treatments available, multiple new drugs are being developed, especially oral therapies with potential advantages as regards comfort of administration. However, the efficacy and safety of these new oral therapies need to be improved to match those of novel biologics.

AREAS COVERED

We provide a narrative review of the oral therapies for psoriasis that are currently under development, from Jak inhibitors to oral IL-17 and IL-23 inhibitors, among others. A literature search was performed for articles published from 1 January 2020, to 6 June 2023.

EXPERT OPINION

The approval of deucravacitinib, the first Jak inhibitor for the treatment of moderate-to-severe plaque psoriasis, heralds a bright therapeutic future with multiple new oral formulations. A great number of oral treatments with singular mechanism of action, like A3AR agonists, HSP90 inhibitors, ROCK-2 inhibitors, oral TNF inhibitors, oral IL-23 inhibitors, oral IL-17 inhibitors, PD4 inhibitors (orismilast) and several Tyk2 inhibitors, are currently being evaluated in clinical trials and could be suitable for approval in the future. Growing variation in treatment modes of administration will allow dermatologists to better integrate patient preferences in the therapeutic decision process.

摘要

引言

靶向治疗极大地改善了银屑病患者的生活质量。尽管现有治疗方法众多,但仍有多种新药正在研发中,尤其是口服疗法,在给药便利性方面具有潜在优势。然而,这些新型口服疗法的疗效和安全性仍需提高,以与新型生物制剂相匹配。

涵盖领域

我们对目前正在研发的银屑病口服疗法进行了叙述性综述,包括从Jak抑制剂到口服IL-17和IL-23抑制剂等。对2020年1月1日至2023年6月6日发表的文章进行了文献检索。

专家观点

首个用于治疗中度至重度斑块状银屑病的Jak抑制剂德卡伐替尼的获批,预示着多种新型口服制剂将带来光明的治疗前景。大量具有独特作用机制的口服治疗药物,如A3AR激动剂、HSP90抑制剂、ROCK-2抑制剂、口服TNF抑制剂、口服IL-23抑制剂、口服IL-17抑制剂、PD4抑制剂(奥瑞司他)和几种Tyk2抑制剂,目前正在临床试验中进行评估,未来可能适合获批。给药方式的不断变化将使皮肤科医生能够在治疗决策过程中更好地整合患者的偏好。

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