Opinion
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The Future of Plaque Psoriasis Therapy
Expert dermatologists highlight the future of plaque psoriasis treatment, commenting on advances in therapy as well as increasing access to treatment.
Bruce Strober, MD, PhD, FAAD: Ben, what are some of the pipeline therapeutics, future developments that you’re excited about with regard to psoriasis?
Benjamin Lockshin, MD, FAAD: If you look at this space in terms of the treatment options, you’d think that we’re close to the goal line using a football analogy or that we’re in the red zone. I think we’re somewhere between the 50-yard line and approaching the red zone in terms of therapeutics. We have high levels of clearance; we’ve got drugs that are well tolerated. Is there room for more agents in different MOAs [mechanisms of action]? I think absolutely yes. I’d love to see something that provides 1 shot and you’re clear for life—a cure for disease. I think that the small molecules that are targeting these interleukins, these small-molecule peptides that target IL-23, are going to be an exciting new endeavor. I’m very excited to see what future studies show with these, in addition, getting some data in terms of different patient populations that have response rates, being able to target these patients, identify what cytokines are overexpressed in each individual, and having more customized health care for them.
Bruce Strober, MD, PhD, FAAD: Jennifer, how about you, in terms of developments on the horizon that really you think could bear fruit?
Jennifer Soung, MD: I’m going to answer this question slightly differently. I’m going to say future developments focused on increasing access. I think we have really awesome treatments and some places where there are disparities in care and where some patients perhaps have a greater impact on their life. We’ve talked today about the impact on physical, psychosocial, and—I will even argue in some patients who don’t have access to care—even financial losses from psoriasis. I even had a patient who came to me, erythrodermic, and has never had been offered a systemic option. And in fact, year after year, he’s had so many flares and just been told to use topicals that he hasn’t been able to work, lost his job. And then his family divorced him because he was not able to provide for the family. How sad is that? And so, a kind of personal passion project of mine is really increasing access to care in these underserved communities where you see that skin conditions, chronic skin conditions like psoriasis have an even bigger impact on these patients’ lives. And so these new treatments that we have for psoriasis are just so amazing to me that that they both combine safety and efficacy. And so whatever way we can get more patients treated, that’s research that I would want to continue to be involved in.
Bruce Strober, MD, PhD, FAAD: One avenue to doing that is biosimilars, which hopefully will reduce costs for some of the medications that are more mature because ultimately branded medications will become biosimilars. We’re seeing that right now. And that allows access at a lower cost for people like you’re describing. I just think that’s the cycle of innovation. We get new drugs, they’re branded, they’re necessarily expensive. But in the long run, they become Tylenol, where everyone can get Tylenol in their local drugstore. And they still call it Tylenol, but it’s just acetaminophen. And it’s like less than 0.5 cents per pill. So, you know, we know there’s a natural progression of innovation and maturation of drugs. And so I see the new biologics that we are talking about today as ultimately part of the pathway to access and affordability.
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Transcript is AI-generated and edited for clarity and readability.
