J Korean Med Assoc.  2019 Mar;62(3):176-180. 10.5124/jkma.2019.62.3.176.

Recent medical therapy for psoriasis

• Youn SW

• KMID: 2441069
• DOI: http://doi.org/10.5124/jkma.2019.62.3.176

Abstract

Psoriasis is a chronic inflammatory disease. Medical therapy is the mainstay of the management of psoriasis, and the main target of psoriasis treatment is immunological dysregulation. Cyclosporine and methotrexate, the main conventional psoriasis treatments, usually lead to a Psoriasis Area and Severity Index (PASI) 75 response in 50% to 60% of patients, but show some organ toxicity. Biologics for psoriasis have recently become the main therapeutic agents for moderate to severe psoriasis unresponsive to conventional treatment. Tumor necrosis factor-α inhibitors were the first anti-psoriatic biologics to be developed, and also show good efficacy for psoriatic arthritis. Ustekinumab, the sole biologic designed for the inhibition of interleukin (IL)-12/23, has been most widely used for psoriasis in Korea. The main strength of ustekinumab is its relatively long treatment interval. IL-17 inhibitors have recently been introduced in Korea for psoriasis treatment. Secukinumab and ixekizumab are currently available IL-17 inhibitors that block the development of psoriasis lesions in the downstream events of psoriasis pathogenesis. They have excellent therapeutic efficacy, with a PASI 90 response in up to 60%-70% of patients. Selective IL-23 inhibitors have been more recently introduced in our country. They have an excellent PASI 90 response, and a longer injection interval than IL-17 inhibitors. New immunological modulators such as phosphodiesterase inhibitors, tyrosine kinase 2 inhibitors, and janus kinase inhibitors are planned to be introduced for psoriasis treatment. These are small molecules that can be administered orally, and some patients who are reluctant to receive injection therapy are expected to favor these therapeutic agents.

Keyword

Psoriasis; Severity of illness index; Tumor necrosis factor-alpha; Interleukin-17; Interleukin-23

MeSH Terms

Arthritis, Psoriatic
Biological Products
Cyclosporine
Humans
Interleukin-17
Interleukin-23
Interleukins
Korea
Methotrexate
Necrosis
Phosphodiesterase Inhibitors
Phosphotransferases
Psoriasis*
Severity of Illness Index
Tumor Necrosis Factor-alpha
TYK2 Kinase
Ustekinumab
Biological Products
Cyclosporine
Interleukin-17
Interleukin-23
Interleukins
Methotrexate
Phosphodiesterase Inhibitors
Phosphotransferases
TYK2 Kinase
Tumor Necrosis Factor-alpha
Ustekinumab

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