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Source: Dermatology Times
In 2023 and beyond, patients with psoriasis fortunately have more to look forward to in terms of newly available systemic and topical treatment options, as well as those upcoming in the pipeline.
The tyrosine kinase 2 (TYK2) inhibitor deucravacitinib (Sotyktu; Bristol Myers Squibb) was approved by the US Food and Drug Administration (FDA) in September 2022 for the treatment of patients with moderate to severe plaque psoriasis. Deucravacitinib offers a treatment option for patients who are candidates for systemic therapy of phototherapy with superior efficacy shown in phase 3 studies. TYK2 inhibitors inhibit TYK2, an intracellular signaling kinase that mediates signaling of interleukin (IL)-12, IL-23, and type I interferon.
Also recently approved by the FDA are 2 novel, nonsteroid, topical treatment options, an exciting development for plaque psoriasis patients who may require long-term topical therapy to manage their condition. The first is tapinarof (Vtama; Dermavant) 1% cream, an aryl hydrocarbon receptor agonist that is responsible for decreasing IL-17, one of the hallmark cytokines that drive psoriasis.
Corticosteroids largely remain the workhorse for providers treating patients with plaque psoriasis. In addition, topical calcineurin inhibitors used off-label, including tacrolimus and pimecrolimus, as well as vitamin D analogue creams such as calcipotriene are all effective psoriatic treatments and are particularly useful when administered intermittently during a corticosteroid drug holiday. Oral deucravacitinib and the topical roflumilast and tapinarof creams are welcome additions.
It is crucial to review the patient’s comorbidities, according to Cohen, as well as understand which medications are better for psoriatic arthritis, inflammatory bowel disease, or other concomitant existing medical conditions such as congestive heart failure. Although there have been significant breakthroughs recently in psoriasis therapy, personalized treatment choices remain the holy grail in ideal patient care.