Plaque psoriasis is the most common form of psoriasis, accounting for about 80% of all cases. Also known as psoriasis vulgaris, this is a chronic skin condition with visible symptoms such as raised, red patches covered with white or silvery scales on the skin. These patches, known as plaques, are known to occur anywhere on the body, but are commonly found on the elbows, knees, scalp, and lower back. Various drugs and lines of treatment are presently used for treating the condition, with new drug discoveries helping to manage the condition effectively. A question commonly asked by patients is – what are the new drugs for the treatment of plaque psoriasis? Following subsection offer answers to the question along with desired background information on the condition and its treatment.
Overview of plaque psoriasis
The exact cause of plaque psoriasis is not fully established, and is believed to be attributed to a combination of genetic, immune, and environmental factors. Plaque psoriasis is often linked to an autoimmune disorder, wherein the immune system mistakenly attacks healthy skin cells, leading to the rapid growth of skin cells and the formation of plaques. The condition affects the quality of life, due to the physically uncomfortable and emotionally distressing situation. Treatment options for plaque psoriasis include topical corticosteroids, topical calcineurin inhibitors, vitamin D analogues, retinoids, phototherapy, systemic medications, and supportive measures.
Symptoms of plaque psoriasis?
The common symptoms of plaque psoriasis include the following:
- Raised, red patches of skin – characterized by the development of well-defined, raised patches of red skin often covered with thick, silvery-white scales.
- Scaling and flaking – affected skin becomes dry, scaly, and prone to flaking, typically silvery-white in color and may be thick and adherent to the skin surface.
- Itching or burning sensation – the condition is accompanied by itching or burning sensations in the affected areas, causing discomfort and distress.
- Dry, cracked skin – the skin turns dry, rough, and may crack or bleed, especially in severe cases.
- Nail changes – the condition can affect the nails, causing changes such as pitting, thickening, discoloration, or separation of the nail from the nail bed.
- Joint pain or stiffness – a small section of individuals may also experience joint pain or stiffness (psoriatic arthritis). This affect joints in the fingers, toes, wrists, knees, or other areas, and may cause swelling, tenderness, and reduced range of motion.
- Emotional distress – the condition may significantly impact a person’s emotional well-being, as the visible symptoms of the condition may cause embarrassment, self-consciousness, and social isolation.
Treatment options for plaque psoriasis?
There are several treatment options available for plaque psoriasis, which can be tailored to the severity of the condition and the individual patient’s needs. Common treatment options are as listed below:
- Topical corticosteroids: Available in various strengths and formulations, and often used as a first-line treatment for mild to moderate plaque psoriasis. Applied directly to the affected skin, helps reduce inflammation, itching, and scaling.
- Topical calcineurin inhibitors: non-steroidal medications applied to the skin, help reduce inflammation and itching. Typically used in sensitive areas where corticosteroids may be less suitable, such as the face or genitals.
- Vitamin D analogues: Topical medications that help regulate the growth of skin cells and reduce scaling, commonly used as a standalone treatment or in combination with other topical treatments.
- Coal tar preparations: Topical medications from coal tar that help reduce inflammation, itching, and scaling, often used in combination with other treatments, such as corticosteroids or salicylic acid.
- Salicylic acid: Topical medication that helps remove scales and reduce scaling, often used in combination with other topical treatments to enhance effectiveness.
- Phototherapy: Involves the use of ultraviolet light to treat plaque psoriasis. Different types of phototherapy, include narrowband UVB, broad-band UVB, and PUVA, used alone or in combination with other treatments.
- Systemic medications: Medications taken orally or by injection and work throughout the body to reduce inflammation and symptoms of plaque psoriasis (for instance methotrexate, cyclosporine, and acitretin). Typically used for more severe cases of plaque psoriasis or cases that do not respond to other treatments.
- Biologic therapies: New class of medications injected or infused and target specific components of the immune system to reduce inflammation and symptoms of plaque psoriasis (for instance, adalimumab, etanercept, and ustekinumab). Biologics are usually used for moderate to severe plaque psoriasis or cases that do not respond to other treatments.
- Lifestyle measures: Certain lifestyle changes, including avoiding triggers that worsen plaque psoriasis, maintaining good skin hygiene, moisturizing regularly, and avoiding hot showers or baths.
What are the new drugs for the treatment of plaque psoriasis?
New drugs have emerged in recent years for treating plaque psoriasis, and these drugs belong to the class of biologic therapies. These targeted medications work by blocking specific components of the immune system involved in the development of psoriasis. A few of the newer drugs include the following:
- IL-17 inhibitors block interleukin-17, a cytokine that plays a key role in the inflammation and immune response associated with plaque psoriasis. Examples of IL-17 inhibitors include secukinumab, ixekizumab, and brodalumab.
- IL-23 inhibitors block interleukin-23, another cytokine involved in the immune response and inflammation seen in plaque psoriasis. Examples of IL-23 inhibitors include guselkumab, tildrakizumab, and risankizumab.
- PDE4 inhibitors inhibit phosphodiesterase 4, an enzyme that regulates the production of certain inflammatory mediators. An example of a PDE4 inhibitor is Apremilast, approved for the treatment of plaque psoriasis.
- Janus kinase (JAK) inhibitors block specific enzymes known as Janus kinases involved in the signaling pathways associated with inflammation and immune response. An example of a JAK inhibitor is Tofacitinib, studied for the treatment of plaque psoriasis.
These newer drugs have shown promising results in clinical trials and have been approved for the treatment of plaque psoriasis in certain countries. They offer additional options for patients who may not have responded to traditional treatments or who require alternative treatment approaches due to contraindications or intolerances to other medications.
What is tyrosine kinase 2 (TYK2) inhibitor deucravacitinib (Sotyktu)
Deucravacitinib (Sotyktu), also known by its brand name Sotyktu, is a novel prescription only medication that belongs to the class of tyrosine kinase inhibitors. The drug specifically targets the enzyme tyrosine kinase 2, that is involved in signaling pathways associated with the immune response and inflammation. This enzyme plays a key role in various autoimmune and inflammatory diseases, including psoriasis. Deucravacitinib works by selectively inhibiting TYK2, modulating the immune response and reducing inflammation. By inhibiting TYK2, deucravacitinib disrupts the signaling pathways responsible for the production of various pro-inflammatory cytokines, IL-12, IL-23, and IFN-gamma.
Deucravacitinib is administered orally as tablets and is typically prescribed as a once-daily medication. Clinical trials have demonstrated that deucravacitinib can significantly improve the signs and symptoms of plaque psoriasis, including skin clearance and quality of life, in patients with moderate to severe disease.
Education: Master’s in Public Health (MPH) from the University of Michigan. Experience: Over 8 years of experience writing for health and wellness websites, including WebMD and Healthline, specializing in women’s health and nutrition.
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