Emerging Oral Therapies for the Treatment of Psoriasis: A Review of Pipeline Agents

Author:

Drakos Anastasia1,Torres Tiago23ORCID,Vender Ronald45ORCID

Affiliation:

1. Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada

2. Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal

3. Department of Dermatology, Centro Hospitalar de Santo António, 4099-001 Porto, Portugal

4. Dermatrials Research Inc. & Venderm Consulting, Hamilton, ON L8N 1Y2, Canada

5. Department of Medicine, McMaster University, Hamilton, ON L8N 3Z5, Canada

Abstract

The introduction of biologic agents for the treatment of psoriasis has revolutionized the current treatment landscape, targeting cytokines in the interleukin (IL)-23/IL-17 pathway and demonstrating strong efficacy and safety profiles in clinical trials. These agents however are costly, are associated with a risk of immunogenicity, and require administration by intravenous or subcutaneous injection, limiting their use among patients. Oral therapies, specifically small molecule and microbiome therapeutics, have the potential to be more convenient and cost-effective agents for patients and have been a focus of development in recent years, with few targeted oral medications available for the disease. In this manuscript, we review pipeline oral therapies for psoriasis identified through a search of ClinicalTrials.gov (30 June 2022–1 October 2023). Available preclinical and clinical trial data on each therapeutic agent are discussed. Small molecules under development include tumor necrosis factor inhibitors, IL-23 inhibitors, IL-17 inhibitors, phosphodiesterase-4 inhibitors, Janus kinase inhibitors, A3 adenosine receptor agonists, and sphingosine-1-phosphate receptor 1 agonists, several of which are entering phase III trials. Oral microbials have also demonstrated success in early phase studies. As new oral therapies emerge for the treatment of psoriasis, real-world data and comparative trials are needed to better inform their use among patients.

Publisher

MDPI AG

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