Childs Beth, Romanelli Sarah, Merola Joseph F, Gottlieb Alice B
Ms. Childs and Dr. Merola are with the Department of Dermatology and Department of Medicine, Division of Rheumatology at UT Southwestern Medical Center in Dallas, Texas.
Ms. Romanelli and Dr. Gottlieb are with the Department of Dermatology and Department of Medicine, Division of Rheumatology at Icahn School of Medicine at Mount Sinai in New York, New York.
J Clin Aesthet Dermatol. 2025 Feb;18(2):16-22.
Psoriasis (PsO) is an immune-mediated, chronic inflammatory skin disease that significantly impairs quality of life. Its treatment landscape is rapidly evolving, providing better disease control. Here, we highlight updates in biologics, obtaining coverage for biologics under Medicare, the PsO-to-psoriatic arthritis (PsA) transition, and orally administered drugs, as presented at the 2024 Masterclass in Dermatology in Puerto Rico. We provide a concise overview of the evolving therapeutic landscape and its impact on personalized care for patients with PsO. The toolkit of biologics is expanding, with agents that target interleukin (IL)-17 and IL-23 pathways addressing symptoms across multiple disease domains. Interchangeable biosimilars reduce financial barriers to access, particularly for tumor necrosis factor (TNF) inhibitors. An IL-36 receptor antibody, spesolimab, demonstrates efficacy in generalized pustular psoriasis. Further, Medicare has expanded coverage of certain biologics, addressing challenges to treating patients of this population. PsA is an important comorbidity that can significantly reduce quality of life. Recent studies suggest that biologic therapies-including TNF inhibitors, as well as anti-IL-17, anti-IL-23, and anti-IL-12/23 agents-protect against arthritis onset in PsO patients. In addition to traditional modes of delivery, novel formulations address widespread preference for orally administered therapies. Deucravacitinib, a tyrosine kinase (TYK) 2 inhibitor, is highly selective, effective, and safe. Additionally, JNJ-77242113, an investigational IL-23 receptor antagonist, constitutes an orally administered, targeted biologic therapy. Together, these developments are shaping the future for patients with PsO. It is our goal to simplify the complexities of emerging treatment options, offering clinicians a concise and useful guide for patient management.
银屑病(PsO)是一种免疫介导的慢性炎症性皮肤病,严重影响生活质量。其治疗格局正在迅速演变,能更好地控制病情。在此,我们重点介绍生物制剂的最新进展、医疗保险对生物制剂的覆盖范围、PsO向银屑病关节炎(PsA)的转变以及口服药物,这些内容均在2024年波多黎各皮肤病学大师班上有所展示。我们简要概述了不断演变的治疗格局及其对PsO患者个性化护理的影响。生物制剂的种类正在不断扩大,针对白细胞介素(IL)-17和IL-23通路的药物可解决多个疾病领域的症状。可互换生物类似药降低了获取药物的经济障碍,尤其是对于肿瘤坏死因子(TNF)抑制剂而言。一种IL-36受体抗体——司库奇尤单抗,在泛发性脓疱型银屑病中显示出疗效。此外,医疗保险扩大了某些生物制剂的覆盖范围,解决了该人群患者治疗面临的挑战。PsA是一种重要的合并症,会显著降低生活质量。最近的研究表明,生物疗法——包括TNF抑制剂以及抗IL-17、抗IL-23和抗IL-12/23药物——可预防PsO患者发生关节炎。除了传统给药方式外,新型制剂满足了人们对口服疗法的广泛偏好。酪氨酸激酶(TYK)2抑制剂氘可来昔替尼具有高度选择性、有效性和安全性。此外,研究性IL-23受体拮抗剂JNJ-77242113构成了一种口服靶向生物疗法。这些进展共同为PsO患者塑造着未来。我们的目标是简化新兴治疗选择的复杂性,为临床医生提供一份简洁实用的患者管理指南。