(Maybe) coming soon to a pharmacy near you

| Melissa Leavitt

A few times a year, experts in psoriasis and psoriatic arthritis gather in cities around the world to talk shop. They share the latest discoveries from their research, report new findings on treatments for psoriatic disease and hear the latest data on drugs that are still being developed.

Last October, we gave you a sneak peek of some psoriasis drugs in development that were discussed at the European Academy of Dermatology and Venereology meeting (EADV). We followed that in December with a report on psoriatic arthritis drugs from the American College of Rheumatology meeting.

Now we’re bringing you news on topical, oral and biologic drugs being tested in psoriatic disease from the American Academy of Dermatology (AAD) meeting, held in Orlando, Florida in March 2017.

Oral drugs are taken by mouth, usually in pill form. Biologic drugs, also known as biologics, are taken by injection or by intravenous (IV) infusion. Biologics target specific cytokines, or proteins, that drive an inflammatory response in people with psoriatic disease. Topicals are applied directly to the skin, most often as a cream or ointment.

Keep reading to see a sampling of clinical trial data presented at AAD. The first three drugs have not received FDA approval. The last three have already approved for some diseases, but are still being tested in psoriasis or psoriatic arthritis.

Still in development                       

Tildrakizumab

Tildrakizumab blocks a specific cytokine called interleukin (IL)-23. There are no psoriatic disease treatments currently FDA-approved that block only IL-23, but a few are in the works.

In our report from EADV, we shared information about the safety and effectiveness of tildrakizumab, an IL-23 blocker being tested in psoriasis. Researchers at AAD discussed more data on the drug, offering information on how well it may work in specific circumstances.

Although most psoriatic disease treatments are intended to be taken regularly, sometimes life gets in the way and you may need to take a break from your treatment. Researchers examined what happened if you were taking tildrakizumab and had to stop and restart the medication.

For part of a phase three trial of tildrakizumab, some patients were randomly selected to stop taking the drug and put on a placebo instead. According to an abstract of the results presented at AAD, among these people, no more than one-fifth relapsed when they stopped their treatment, and nobody’s psoriasis became worse than it was before they started on tildrakizumab.

About half maintained a 75 percent improvement in their psoriasis, even nine months after stopping tildrakizumab.

Among those who did relapse, more than 80 percent were able to see at least 75 percent improvement in their psoriasis when they went back on tildrakizumab.

Another fact of life for people searching for the right psoriasis treatment is that you often have to try more than one before you find the best fit for you. An abstract presented at AAD explored the effects of taking tildrakizumab after failing to see improvement on another biologic—in this case, Enbrel (etanercept), a drug that’s already on the market.

According to the phase three trial data, more than 80 percent of people in the study who didn’t achieve at least 75 percent improvement in their psoriasis on Enbrel did see that improvement after about five months on tildrakizumab. About 15 percent of people who tried tildrakizumab after Enbrel had completely clear skin in the same about of time.

Researchers noted that tildrakizumab was well-tolerated in the study.

Guselkumab

Data on another IL-23 blocker in development, guselkumab, was also discussed at AAD. You can read about guselkumab data presented at EADV here. This time, we’re sharing data about how guselkumab performed when treating psoriatic arthritis or specific forms and locations of psoriasis.

According to an abstract of phase three trial data comparing guselkumab to Humira (adalimumab), a biologic already on the market, guselkumab delivered more improvement to psoriasis on the scalp, hands and feet, while Humira performed better in nail psoriasis.

About 80 percent of people on guselkumab had either no scalp psoriasis or very mild scalp psoriasis after four months on the drug, compared with 67 percent of people on Humira. Looking at improvement in psoriasis of the hands or feet in the same amount of time, about 77 percent of people on guselkumab had clear or almost clear hands or feet, while about 71 percent of people on Humira did.

In terms of fingernail psoriasis, almost 60 percent of people on Humira had clear or almost clear nails after four months, compared with 52 percent of people on guselkumab.

Generalized pustular psoriasis (GPP) and erythrodermic psoriasis are particularly severe forms of psoriasis, both of which can be life-threatening. In a phase three trial of Japanese people with these forms of psoriasis, about 78 percent of people with GPP and about 90 percent of people with erythrodermic psoriasis saw what researchers called “treatment success,” based on criteria called Clinical Global Impression, after four months, according to an abstract presented at AAD.

Data on a phase two trial testing guselkumab in psoriatic arthritis was also presented at AAD. According to the data, after six months on the drug, 58 percent of people saw a 20 percent improvement in psoriatic arthritis, while 34 percent saw a 50 percent improvement in psoriatic arthritis.

Researchers noted that guselkumab was “well-tolerated” and there were no unexpected issues that arose regarding safety.

Tapinarof (GSK2894512)

While most of the attention surrounding new psoriatic disease treatments tends to focus on oral drugs and biologics, topicals are still the go-to for many people with mild or moderate psoriasis.  Topicals are also commonly used in combination with other therapies. Researchers at AAD presented data from a phase two clinical trial of a cream that’s currently being developed for psoriasis.

Tapinarof (GSK2894512) is a cream that targets the aryl hydrocarbon receptor, which is a protein that helps regulate inflammation. According to an abstract presented at AAD, almost two-thirds of people who used a one percent formula of the cream experienced a 75 percent improvement in their psoriasis after three months.

Researchers also noted that ten percent of people in the study stopped using the cream due to side effects, the most common being contact dermatitis.

FDA-approved, but still being tested for psoriasis or psoriatic arthritis

Taltz (ixekizumab)

A biologic you might already be familiar with is Taltz, which targets the cytokine IL-17. Taltz was approved for the treatment of moderate-to-severe psoriasis in 2016. It is currently being studied as a treatment for psoriatic arthritis.

Data from a phase two trial testing Taltz in people with both psoriasis and psoriatic arthritis was presented at AAD. According to an abstract of the data, researchers found that after up to four years on Taltz, people experienced what researchers called a “sustained improvement” in pain associated with psoriatic arthritis.

Researchers reported that findings regarding safety and side effects were similar for people with psoriasis alone and for people who had psoriasis as well as psoriatic arthritis. You can read more about Taltz here.

Cimzia (certolizumab pegol)

This one might ring a bell, too. Cimzia is a biologic that’s already FDA-approved for the treatment of psoriatic arthritis, but it’s also being tested for psoriasis. It targets a cytokine called tumor necrosis factor-alpha (TNF-alpha).

Data from a phase three study of Cimzia presented at AAD found that after about two years on the drug, up to 74 percent of people with both skin psoriasis and psoriatic arthritis experienced at least a 75 percent improvement in their psoriasis.

Data from other phase three trials testing Cimzia in psoriasis were also announced at AAD. According to a statement from UCB and Dermira, the companies who make Cimzia, up to about 82 percent of people taking Cimzia saw a 75 percent improvement in their psoriasis after four months on the drug.

Read more about Cimzia, including information on safety, here.

Xeljanz (tofacitinib)

Xeljanz (tofacitinib) is a pill that’s already FDA-approved for the treatment of rheumatoid arthritis. At AAD, researchers presented information about how it might work for psoriatic arthritis. Just as with the study of tildrakizumab, these studies also looked at how someone might respond to a new drug if they didn’t see improvement on another one.

According to abstracts on phase three trial data, up to 60 percent of people who tried Xeljanz after they didn’t improve on biologics that target TNF-alpha experienced at least a 20 percent improvement in their psoriatic arthritis after six months. Up to 70 percent of people who tried Xeljanz after they didn’t improve on a type of treatment called a disease-modifying anti-rheumatic drug (DMARD) saw at least a 20 percent improvement after about a year.

Researchers noted that there was a low frequency of side effects in the trial, and that safety information was similar to what is already known about the safety of Xeljanz.


Driving Discovery, Creating Community

This year, we’re celebrating 50 years of driving efforts to cure psoriatic disease and improve the lives of those affected. See how far we’ve come with this timeline of NPF’s history. But there’s still plenty to do, and we can’t do it without you! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funding to promote research into better treatments and a cure by joining Team NPF, where you can walk, run, cycle, play bingo or even create your own DIY event. Contact our Patient Navigation Center for free, personalized support for living a healthier life with psoriatic disease. And keep the National Psoriasis Foundation going strong by making a donation today! Together, we will find a cure.

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