This is how current treatments for plaque psoriasis work

30 years ago, patients had to enter a light box 3 times a week for 12 weeks.

More than 125 million people suffer from psoriasis worldwide. Photo: Shutterstock

Psoriasis is a common chronic skin disease that affects more than 125 million people worldwide. It causes scaly patches on the skin and can also affect the nails. It can have a severe impact on the patient’s quality of life.

The drugs we have now are markedly more effective and relatively safe than in the past. Thirty years ago, patients were required to enter a light box 3 times a week for 12 weeks, using tar at night and moisturizers in the morning.

However, although we have made progress, that does not mean that there are no challenges in managing psoriasis today. Many patients are still reluctant to take biologics because of concerns regarding their safety profile, and some people stop taking their medications when they are doing well. They take it when they are bad and they don’t take it when things are better. Therefore, education is key to advancing in the management of these patients.

One of the new agents available for the treatment of plaque psoriasis is Deucravacitinib. A new molecule designed to bind to the TYK2 portion of the JAK protein involved in the pathophysiology of psoriasis, modifying its structure and therefore its function, resulting in the inhibition of inflammatory pathways mediated by interleukins 12 and 23 and type 1 interferon.

This point is important, since in this way the agent is not inhibiting all JAK proteins; it’s just inhibiting some particular pathways. Therefore, it is not resulting in all of the adverse events such as thrombosis, malignancy, or high triglycerides, which would be seen if all JAK1, JAK2, JAK3, etc. molecules were inhibited.

As for how it works, it’s 6mg by mouth every day. As a result, he had a PASI score of 75, that is, a 75% reduction in the psoriasis severity and area index has been experienced. It also had good efficacy in PsA (psoriatic arthritis).

Looking ahead, the next steps in the field of skin and musculoskeletal psoriasis might be the search for personalized endpoints and treatments. This might include more uses of PASI scores tailored to specific parts of the body, as well as personalized treatments according to certain genetic factors and environmental triggers. Meanwhile, a drug list sheds light on the future of drug development in plaque psoriasis and PSA.