Yilmaz Orhan, Pinto João Pedro, Torres Tiago
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.
Drugs Context. 2024 Aug 1;13. doi: 10.7573/dic.2024-5-6. eCollection 2024.
Psoriasis is a chronic inflammatory skin disease affecting 2-3% of the global population. Traditional systemic treatments, such as methotrexate, cyclosporine, acitretin and fumaric acid esters, have limited efficacy and are associated with significant adverse effects, necessitating regular monitoring and posing risks of long-term toxicity. Recent advancements have introduced biologic drugs that offer improved efficacy and safety profiles. However, their high cost and the inconvenience of parenteral administration limit their accessibility. Consequently, there is a growing interest in developing new, targeted oral therapies. Small molecules, such as phosphodiesterase 4 inhibitors (e.g. apremilast) and TYK2 inhibitor (e.g. deucravacitinib), have shown promising results with favourable safety profiles. Additionally, other novel oral agents targeting specific pathways, including IL-17, IL-23, TNF, S1PR1 and A3AR, are under investigation. These treatments aim to combine the efficacy of biologics with the convenience and accessibility of oral administration, addressing the limitations of current therapies. This narrative review synthesizes the emerging oral therapeutic agents for psoriasis, focusing on their mechanisms of action, stages of development and clinical trial results.
银屑病是一种慢性炎症性皮肤病，影响全球2%-3%的人口。传统的全身治疗方法，如甲氨蝶呤、环孢素、阿维A和富马酸酯，疗效有限且伴有显著的不良反应，需要定期监测，并存在长期毒性风险。最近的进展引入了生物药物，其疗效和安全性有所改善。然而，它们的高成本和肠胃外给药的不便限制了其可及性。因此，开发新的靶向口服疗法的兴趣日益浓厚。小分子药物，如磷酸二酯酶4抑制剂（如阿普米司特）和酪氨酸激酶2抑制剂（如氘可来昔替尼），已显示出有前景的结果和良好的安全性。此外，其他针对特定途径（包括白细胞介素-17、白细胞介素-23、肿瘤坏死因子、鞘氨醇-1-磷酸受体1和A3型腺苷受体）的新型口服药物正在研究中。这些治疗旨在将生物制剂的疗效与口服给药的便利性和可及性相结合，解决当前疗法的局限性。这篇叙述性综述综合了银屑病新兴的口服治疗药物，重点关注其作用机制、开发阶段和临床试验结果。
