The 2024 Psoriasis Treatment Landscape: Charting Your Course to Clearer Skin

April 22, 2024

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Psoriasis is a common autoimmune condition that causes skin cells to build up rapidly on the surface of the skin, forming itchy, painful plaques. Over 125 million people worldwide live with psoriasis. While there is no cure, recent advances in biologic drugs offer new hope for effectively managing this chronic disease.

What Are Biologics for Psoriasis?

Biologics are a class of medications that target specific parts of the immune system involved in psoriasis. They work by blocking or modifying the actions of certain immune cells, cytokines, or proteins that drive inflammation and rapid skin cell growth.

Some examples of biologics used for psoriasis treatment include:

  • Tumor necrosis factor (TNF) inhibitors – Adalimumab, etanercept, infliximab
  • Interleukin (IL) inhibitors – Secukinumab, ixekizumab, brodalumab
  • T cell inhibitors – Abatacept

Over the past decade, biologics have transformed psoriasis care by providing rapid and lasting clearance of symptoms for many patients.

Evaluating New Psoriasis Biologics in 2024

The psoriasis treatment landscape continues to evolve quickly. Several new biologics have recently been approved or are in late-stage clinical trials showing promising results.

Recently Approved Biologics

The latest biologic medication approved for moderate-to-severe psoriasis is risankizumab (Skyrizi) in 2019. This IL-23 inhibitor demonstrated high efficacy for clearing skin and improving quality of life in clinical trials.

In 2022, the dual IL-17 inhibitor bimekizumab (Bimzelx) was approved. By blocking two inflammation pathways, bimekizumab showed superior results to existing biologics for both skin clearance and symptom remission.

Biologics in Development

Several emerging psoriasis therapies are progressing through phase 3 trials:

  • IL-23 inhibitor – Guselkumab
  • Oral PDE4 inhibitor – Apremilast
  • JAK inhibitors – Upadacitinib, tofacitinib
  • IL-17RA inhibitor – KY1005

These new drugs for psoriasis treatment in 2024 demonstrate strong efficacy so far, with good safety and tolerability.

As research expands knowledge of psoriasis pathophysiology, even more selective biologic targets are emerging. Dual pathway inhibitors like bimekizumab show particular promise to push therapeutic boundaries further.

So which of these innovative new biologic options is the best choice?

Choosing the Best Biologic Treatment

With many excellent biologics for psoriasis now available, selecting the optimal medication involves assessing:

  • Treatment goals
  • Disease severity
  • Individual patient factors

Doctors consider these key questions when evaluating biologic therapy:

What Level of Efficacy Is Needed?

For mild psoriasis, topical creams or phototherapy may suffice to control symptoms. Moderate or severe cases often require a biologic drug to adequately treat the underlying immune dysfunction.

The latest generation of IL inhibitors like Skyrizi and Bimzelx demonstrate among the highest efficacy results seen to date from clinical trials. For patients with extensive, stubborn plaques unresponsive to other systemic therapies, these powerful new options offer superior skin clearance.

What Areas of Skin Are Impacted?

Certain biologics show enhanced efficacy depending on body regions affected:

  • Secukinumab and ixekizumab clear scalp psoriasis exceptionally well
  • Etanercept and infliximab work better for palmoplantar psoriasis (hands and feet)
  • Ustekinumab helps genital lesions and nail psoriasis

Mapping medications to involved areas improves treatment precision.

What Other Health Conditions Are Present?

Some biologics offer extra benefits for comorbidities frequently accompanying psoriasis:

  • Adalimumab, etanercept, infliximab help psoriatic arthritis
  • Brodalumab improves high blood pressure and cardiometabolic risk
  • Tofacitinib treats other related autoimmune diseases

Integrative management driving better patient outcomes.

How Fast Is Response Time?

Patients with severe, unstable psoriasis need urgent relief. The latest biologic drugs achieve remarkably rapid response:

  • 90% saw 75% skin improvement in 12 weeks on Skyrizi
  • Nearly 60% achieved 90% clearance in 16 weeks on Bimzelx

For mild or moderate cases with less urgent need for quick control, older generation TNF inhibitors remain viable options.

Evaluating the unique efficacy, safety, and convenience profiles of all available biologics allows precision matching to each patient’s therapeutic priorities.

Biologic Side Effects and Safety

While biologics revolutionized psoriasis care, their targeted effects on the immune system can increase susceptibility to certain side effects.

Monitoring for and promptly managing any reactions enhances long-term safety on these medications.

Infection Risk

Suppressing parts of the immune response makes patients more prone to bacterial, viral, or fungal infections. Upper respiratory infections like sinusitis or bronchitis occur most frequently.

Rare but serious infections reported include:

  • Tuberculosis
  • Hepatitis B virus reactivation
  • Invasive fungal infections

Doctors screen for latent infections and closely track development of any new symptoms suggestive of infection.

Other Adverse Reactions

Allergic reactions can sometimes occur with monoclonal antibody biologics derived from non-human proteins. These infusion or injection reactions are usually mild, but anaphylaxis is possible in rare cases.

Additional side effects like headache, nausea or diarrhea also occasionally result from biologics. Ongoing pharmacovigilance assesses longer-term effects. Recent research shows no increased overall cancer risk, though slight elevation in skin cancer rates may emerge with some treatments.

Ultimately by better understanding each medication’s safety issues through extensive clinical experience, providers can mitigate risks via careful patient selection and monitoring.

The vital endpoint remains optimizing the benefit-risk ratio to ensure biologics safely help patients reach treatment goals.

Future Outlook: Biologics Leading Psoriasis Innovation

While biologics transformed psoriasis care in recent decades, these scientific solutions keep rapidly advancing. The future is bright for people living with this complex immunological disorder.

Expanding Options

The psoriasis drug pipeline continues to grow as research uncovers new inflammatory pathways driving this heterogeneous disease.

Oral JAK inhibitors like tofacitinib, promising reduced injection burden, may reach approval in coming years. Other emerging approaches include topical biologics, apremilast add-on therapy, and biome-derived medications.

Such diversifying choices allow ever more personalized precision.

Earlier Intervention

Traditionally reserved for moderate-severe psoriasis unresponsive to other treatments due to cost and safety concerns, experience and evidence now support employing biologics earlier in the disease course for better outcomes.

New 2021 American Academy of Dermatology guidelines recommend biologics as a first-line systemic treatment, given their high efficacy and favorable safety record.

This shift may help prevent cumulative skin damage and manifestation of related health conditions over time.

Combination Strategies

While biologics greatly boost efficacy over previous conventional options alone, monotherapy only helps some patients reach treatment targets.

Combining modes such as topical medication, phototherapy, oral systemic or targeted therapy provides synergistic benefit. For example, adding topical vitamin D analogue calcipotriol to etanercept biologic therapy enhances efficacy.

Such integrative protocols usher in a new era of holistic psoriasis healing.

Biologic drugs spearhead medical innovation to turn the tide for millions suffering from psoriasis worldwide.

Ongoing advances ensure light at the end of the tunnel by transforming this previously untreatable, life-disrupting disease into a highly manageable condition.

5 Key Takeaways: Choosing Your Best Psoriasis Biologic

  • Newest generation IL-17 inhibitors (Skyrizi, Bimzelx) achieve among highest skin clearance results.
  • Match treatment to disease severity and areas of skin impacted.
  • Consider benefits for comorbid conditions like psoriatic arthritis.
  • Prioritize rapid relief if symptoms are urgent and unstable.
  • Combination therapy boosts treatment success.

FAQs

What are the most common side effects of psoriasis biologic drugs?

The most frequent side effects of biologics for psoriasis involve an increased susceptibility to infections, especially upper respiratory infections like bronchitis or sinusitis. Allergic reactions can also sometimes occur. Other possible side effects include headaches, nausea, and diarrhea. Serious but rare infections reported with some biologics include hepatitis B virus reactivation, tuberculosis, and invasive fungal infections.

How much do biologics for psoriasis treatment cost?

The exact pricing for psoriasis biologics varies by specific medication, dosing/frequency, and individual insurance coverage. But these advanced psoriasis drugs are generally quite expensive, with average U.S. wholesale monthly costs ranging from $2,500 to $6,000. However, copay assistance programs from manufacturers and favorable medical insurance coverage can reduce out-of-pocket expenses for patients.

How long do psoriasis biologic drugs take to work?

Patients can see significant improvements in psoriasis symptoms from biologics within the first couple months of treatment. The latest IL-17 inhibitor biologics like Skyrizi and Bimzelx work exceptionally fast, with around 90% and 60% of clinical trial participants respectively seeing 75-90% skin clearance after just 12-16 weeks of treatment.

What tests or vaccinations are needed before starting biologics?

To minimize infection risk on psoriasis biologics, pretreatment screening should check for latent TB, HIV, and hepatitis B/C. Blood tests also help assess general health status. Updating all immunizations, especially annual influenza vaccine, further reduces susceptibility to contagious illnesses while on biologics.

Can psoriasis biologic drugs cause cancer?

Extensive research and clinical experience reassure us these psoriasis treatments do not cause overall elevated cancer risk. One exception involves slightly increased skin cancer rates specifically, so dermatology monitoring helps catch any suspicious lesions early. But providers generally agree carefully managed biologic therapy proves safe for most patients long-term regarding cancer development.

References:

  1. Bachelez, H. (2021). International guidelines for the management of psoriasis: a critical appraisal. Drugs81(2), 125-144.
  2. Takeshita, J., & Koo, J. (2021). A review of the mechanism of action, efficacy, and safety of emerging psoriasis therapies. Journal of Dermatological Treatment32(4), 343-365.
  3. Schafer, P. H., Parton, A., Capone, L., Cedeno-Laurent, F., Muller, G. W., Mendelsohn, A. M., … & Kricorian, G. (2019). Apremilast is associated with long-term (≥ 52 weeks) improvement in the signs and symptoms of psoriatic arthritis: Post hoc analyses from a phase III, randomized controlled trial. Advances in Therapy36(12), 3354-3365.
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