Two Centuries of Progress in One Short Timeline

Research breakthroughs are borne on the back of countless steps, failures, late hours in the lab, struggles to secure funding, clinical trials, willing patients, and support from a large community. Here at NPF, we’ve helped foster advances in discovery and treatment on the journey to reach our ultimate goal: the cure for psoriasis and psoriatic arthritis (PsA). Getting to this point has meant many stops on the way, with many more to come.

Thanks to a sustained effort by researchers and clinicians over the past 200-plus years, people living with psoriasis and PsA have the best treatment options and care that has ever been available. Though a cure hasn’t yet been found, the future is bright – and the coming years will continue to bring about new and improved treatments and knowledge.

Speaking specifically about psoriasis, dermatologist Abby S. Van Voorhees, M.D., chair of the NPF medical board, says that clearing skin and keeping it clear for a longer time span is very much obtainable.

“Our current therapies are getting close to a point where a significant percentage of patients are truly getting clear,” says Van Voorhees. “Then the next milestone will be to have therapies become more episodic, rather than continuous.”

As for PsA, the future holds promise, especially when it comes to starting treatment early when it can do the most good. The NPF PsA Diagnosis Project looks to do just that by funding the development of a diagnostic test for early detection of the disease.

These are exciting times for psoriatic disease research. As we look ahead to the possibilities of future treatments, let’s look back at some milestones that led us here.

1808

Robert Willan, M.D. (1757-1812), the founder of dermatology as a medical specialty, offers the first accurate clinical description of psoriasis.

1900

Coal tar is a common treatment for psoriasis.

1920s

William Goeckerman, M.D. (1884-1954), develops the Goeckerman therapy for treating psoriasis, combining coal tar with broadband ultraviolet light B (UVB) phototherapy.

1950s

Two new treatments for psoriasis are introduced: the light-sensitizing medication psoralen with ultraviolet light A (PUVA) and corticosteroids.

1960s

PsA is identified as a clinical disease.

1972

NPF successfully lobbies the U.S. Food and Drug Administration (FDA) for approval of methotrexate for the treatment of severe psoriasis. Methotrexate was introduced in the late 1940s as a cancer treatment.

1983

The immunosuppressant medication cyclosporine (also spelled cyclosporin), originally introduced to combat organ rejection and later used to treat psoriasis, is approved by the FDA for clinical use.

1987

NPF-funded researcher Hans-Jurgen Ristow, M.D., identifies interleukin-1 (IL-1) as a cause of skin proliferation, or rapid growth of skin cells, in inflammatory skin diseases. IL-1 is a kind of protein, called a cytokine, involved in inflammatory immune responses.

1986-1988

NPF-funded researcher Michael Holick, M.D., introduces vitamin D3 as a treatment for psoriasis. Vitamin D3 is used in Dovonex (calcipotriene), a topical psoriasis treatment.

1988

Narrowband UVB phototherapy is introduced as a psoriasis treatment.

1989

NPF-funded researcher Alice Gottlieb, M.D., Ph.D., and colleagues discover the role that interleukin-6 (IL-6) plays in the inflammatory response seen in psoriasis.

1990

Kirk Wuepper, M.D., publishes results from his genetic studies of psoriasis, conducted in partnership with NPF.

1998

NPF-funded researcher Christopher Ritchlin, M.D., analyzes cytokines found in joint tissue of people with PsA, identifying key differences between PsA and rheumatoid arthritis.

2000

NPF-funded researcher Alice Gottlieb, M.D., Ph.D., and colleagues are the first team to successfully treat a person for psoriasis using an antibody to the cytokine tumor necrosis factor-alpha (TNF-alpha). Anti-TNF-alpha therapies become the basis for many biologic medications for psoriatic disease.

2001

NPF-funded researcher Gerald G. Krueger, M.D., and colleagues publish clinical trial results on alefacept, which would become the first biological agent approved by the FDA for the treatment of moderate-to-severe plaque psoriasis.

2003

NPF-funded researchers Anne Bowcock, M.D., Alan Menter, M.D., and colleagues publish multiple studies identifying the genetic causes of psoriasis.

NPF-funded researchers Gerald G. Krueger, M.D., and Kristina Callis Duffin, M.D., launch the Utah Psoriasis Initiative (a large database of people with psoriasis) supported by NPF funding.

Amevive (alefacept) and Raptiva (efalizumab) become the first biologic treatments approved for psoriasis.

2004

The biologic Enbrel (etanercept), a TNF-alpha inhibitor, is approved for the treatment of psoriasis. Enbrel acts as a TNF inhibitor. NPF-funded researchers Alice Gottlieb, M.D., Ph.D., Gerald G. Krueger, M.D., and colleagues publish clinical trial results on etanercept as a treatment for psoriasis.

2005

The biologic Remicade (infliximab) is approved for the treatment of psoriasis. NPF-funded researchers Alice Gottlieb, M.D., Ph.D., Alan Menter, M.D., and colleagues publish clinical trial results on infliximab as a treatment for psoriasis.

The biologic Humira (adalimumab) is approved for the treatment of PsA. NPF-funded researchers Dafna Gladman, M.D., Christopher Ritchlin, M.D., and colleagues publish clinical trial results for adalimumab.

2006

NPF-funded researcher Joel Gelfand, M.D., and colleagues identify an increased risk of cardiovascular disease and heart attacks in people with psoriatic disease.

The biologic Remicade (infliximab) is approved for the treatment of PsA. NPF-funded researchers Dafna Gladman, M.D., and Gerald G. Krueger, M.D., publish clinical trial results on the use of infliximab as a treatment for PsA.

2007

NPF-funded researcher Hyon Choi, M.D., publishes the first of a series of studies uncovering comorbidities (related concurrent diseases) and risk factors for psoriatic disease.

NPF-funded researchers and medical board chairmen emeritus Gerald G. Krueger, M.D., Mark Lebwohl, M.D., and colleagues publish study results for a new psoriasis therapy targeting the cytokines IL-12 and IL-23. The biologic Stelara (ustekinumab), an anti-IL-12/23 drug, would be approved for the treatment of PsA in 2013.

2008

NPF-funded researchers Anne Bowcock, M.D., Alan Menter, M.D., Wilson Liao, M.D., and colleagues identify new genetic links to psoriasis and PsA.

NPF-funded researchers Allen Bruce, M.D., Johann Gudjonsson, M.D., James T. Elder, M.D., Ph.D., and colleagues identify the role of cytokine interleukin-17 in psoriasis.

NPF-funded researchers Gerald G. Krueger, M.D., Mark Lebwohl, M.D., and colleagues publish results from a clinical trial on ustekinumab. Ustekinumab would become Stelara, a biologic medication for psoriasis and PsA.

The biologic Humira (adalimumab) is approved for the treatment of psoriasis.

2009

The biologic Simponi (golimumab) is approved for the treatment of PsA. NPF-funded researchers Dafna Gladman, M.D., Gerald G. Krueger, M.D., and colleagues publish the first clinical trial results on golimumab as a treatment for PsA.

2011

NPF-funded researcher Francesca Capon, M.D., identifies gene mutations associated with pustular psoriasis.

2012

NPF-funded researchers Anne Bowcock, M.D., Gerald G. Krueger, M.D., Alan Menter, M.D., James T. Elder, M.D., Ph.D., Dafna Gladman, M.D., Wilson Liao, M.D., Kristina Callis Duffin, M.D., M.S., and colleagues publish the first study using material from the National Psoriasis Victor Henschel BioBank, identifying the first gene directly linked to psoriasis. They discover that mutations in this gene, known as CARD14, can be activated by an environmental trigger.

NPF-funded researcher Nicole Ward, Ph.D., and colleagues discover how psoriasis leads to cardiovascular disease.

NPF-funded researcher Alexis Ogdie, M.D., and colleagues use microscopy techniques to analyze joint tissue in people with PsA, discovering important characteristics of the disease such as vascular changes.

2013

The biologic Stelara (ustekinumab) is approved for treatment for PsA. NPF-funded researchers Alice Gottlieb, M.D., Ph.D., Christopher Ritchlin, M.D., and colleagues publish the first clinical trial results on ustekinumab as a treatment for PsA.

The biologic Cimzia (certolizumab pegol) is approved for the treatment of PsA in adults. Cimzia works by inhibiting tumor necrosis factor-alpha.

2014

NPF-funded researcher Lorena Riol-Blanco, Ph.D., and colleagues discover the role of the nervous system in triggering psoriasis inflammation.

Otezla (apremilast), an oral treatment, is approved for the treatment of psoriatic disease. NPF-funded researcher Dafna Gladman, M.D., and colleagues publish a study of apremilast as a treatment for PsA.

2015

NPF and Corrona (now CorEvitas), a health research company, register the first patient in the Corrona Psoriasis Registry. Patient data from the registry will improve researchers’ understanding of psoriasis and improve treatments.

NPF launches Citizen Pscientist, a global, patient-powered, psoriatic disease research platform.

The biologic Cosentyx (secukinumab) is approved for the treatment of chronic plaque psoriasis.

Taclonex, a topical medication, is approved for the treatment of scalp psoriasis in adolescents ages 12 to 17. Taclonex, which combines a topical steroid with calcipotriene, a vitamin D analog, had already been approved to treat scalp and body psoriasis in adults. With this new indication, it becomes the first FDA-approved treatment for scalp psoriasis in teenagers.

2016

The NPF medical board sets specific treatment goals that will make achieving clear or almost clear skin the new standard of care for psoriasis. This strategy, known as Treat to Target, was published online in the Journal of the American Academy of Dermatology.

Inflectra, a biosimilar for Remicade (infliximab), becomes the first biosimilar approved in the U.S. for psoriasis and PsA. A biosimilar is an FDA-approved biological product that is highly similar to an already FDA-approved biological product. A biosimilar, in the FDA’s parlance, “has been shown to have no clinically meaningful differences from the reference product.” (The reference product is the already-approved biologic.)

The biologic Cosentyx (secukinumab) is approved for the treatment of PsA.

The biologic Taltz (ixekizumab) is approved for the treatment of moderate-to-severe plaque psoriasis.

The biologic Enbrel (etanercept) is approved for the treatment of moderate-to-severe plaque psoriasis in children ages 4 to 17. Enbrel is the first biologic approved for treating pediatric plaque psoriasis.

Enstilar, a new topical therapy, is approved for the treatment of plaque psoriasis in adults. Enstilar is an aerosol foam that combines two medications: calcipotriene, a vitamin D-based treatment, and betamethasone dipropionate, a corticosteroid.

2017

Xeljanz (tofacitinib) is approved for the treatment of PsA. Xeljanz is the first of a new class of treatments called Janus kinase (JAK) inhibitors approved for the treatment of PsA. The active ingredient in Xeljanz binds to the protein JAK, preventing the body’s inflammatory response that plays a role in the development of PsA. NPF-funded researcher Dafna Gladman, M.D., led one of the clinical studies.

The biologic Tremfya (guselkumab) is approved for the treatment of moderate-to-severe plaque psoriasis in adults. Tremfya is the first approved biologic therapy that targets IL-23.

The biologic Stelara (ustekinumab) is approved for the treatment of moderate-to-severe plaque psoriasis in youth ages 12 and older.

The biologic Orencia (abatacept) is approved for the treatment of adults with PsA. The drug is designed to keep overactive cytokines from creating an undesired immune response resulting in inflammation.

The biologic Siliq (brodalumab) is approved for the treatment of moderate to severe plaque psoriasis in adults. Siliq is designed to block cytokine IL-17.

The biologic Simponi Aria (golimumab), a TNF-alpha inhibitor, is approved for the treatment of adults with PsA.

2018

The American College of Rheumatology and NPF publish a PsA treatment guideline in Arthritis & Rheumatology and in NPF’s Journal of Psoriasis and Psoriatic Arthritis®. For the first time, health care providers who care for people with PsA have a standard guide to all current treatments and an evidence-backed recommendation to use biologics as a front-line treatment.

The biologic Cimzia (certolizumab pegol), a TNF-alpha inhibitor, is approved for the treatment of moderate-to-severe plaque psoriasis in adults.

The biologic Ilumya (tildrakizumab-asmn) is approved for the treatment of adults with moderate-to-severe plaque psoriasis. Ilumya is designed to block cytokine IL-23.

2019

The American Academy of Dermatology and NPF finish the first update of psoriasis treatment guidelines in a decade. The first three guidelines – for biologics, comorbidities and phototherapy – are released to health care providers, insurers, patients, and caregivers via the Journal of the American Academy of Dermatology. Still to come: guidelines of care for the management of psoriasis: in pediatric patients, with non-biologics, with topicals.

The topical Duobrii (halobetasol propionate and tazarotene) is approved for the treatment of plaque psoriasis. Duobrii is the first and currently only lotion for adults with plaque psoriasis that contains this combination of active ingredients.

Skyrizi (risankizumab), an IL-23 inhibitor, is approved for the treatment of adults with moderate-to-severe plaque psoriasis.

LITE, the clinical trial to study the effectiveness and safety of home-based versus office-based phototherapy for the treatment of psoriasis, launches. The LITE study is a patient-centered trial that will enroll approximately 1,000 people of all skin types. It is federally funded by the Patient-Centered Outcomes Research Institute and will hopefully increase access to phototherapy. LITE is a collaboration among NPF, the University of Pennsylvania, and the University of Utah.

2020

F.D.A. approves the use of Taltz® (ixekizumab) for use in pediatric patients, six years of age or older, with moderate to severe plaque psoriasis, who are candidates for systemic therapy or phototherapy.

F.D.A. approves the use of Otezla® (apremilast) for use in patients with moderate to severe plaque psoriasis of the scalp.