In an interview with MD Magazine®, Brad Glick, DO, a dermatologist and principal investigator with GSI Clinical Research, detailed the most promising up-and-coming therapies in psoriasis and atopic dermatitis—and how they improve various aspects of patients’ conditions.
MD Mag: What are upcoming therapies for psoriasis and atopic dermatitis?
Glick: There's always a lot. I think right now—and as we'll talk abouttoday—we have 11 drugs that aretargeted therapies for treatingpsoriasis. So I think we have that downpretty pat. We certainly need to providemore education, not only to our patients, but also to our colleagues. I thinkthat we need cost-effective agents. Ithink we need oral systemic agents thatare almost, if not equally, as effectiveas biologics, with really nice safetyprofiles. Hopefully we can get those.
Andcertainly, not every patient who haspsoriatic skin disease is going to get asystemic therapy. Certainly, patients withmild psoriasis who don't have a numberof comorbidities, who don't havebackground psoriatic arthritis, areappropriate candidates for topicaltherapies.
And we have new ones on thehorizon. For instance, there is somethingcalled an arrow hydrocarbon receptoragonist, a new generation productcalled tapinarof, which I think isunique. And what's unique about is, in theskin it actually decreases cytokines. Itdecreases the inflammation that we seeassociated with psoriatic skin disease.
So there are other topical therapies. There are new combination therapies thatinclude topical vitamin D and topicalcorticosteroids that are on the horizon. Wereceived a drug just this past yearwhich is a unique agent, which includes aretinoid which is effective forpsoriasis, but it can be a little bitirritating. And at the same time, in thatfixed combination therapy it has a topical corticosteroid to balance out the consequences of both agents.
And so I think that is extremely unique to have in our topical therapy armamentarium.
Moreover, what I think is important on the horizon are even more targeted therapies. We’re getting close to, if you will the neck of the inflammation, so to speak, where we can really decrease those cytokines more specifically.
There's a drug that is coming to market called bimekizumab—it should be available hopefully to us in the next year or 2—which is specifically targeted to the component of the interleukin 17 group of cytokines. And so far, the preliminary data in its early trials appears to be quite, quite exceptional.
MD Mag: Is the benefit of these drugs the best-case outcome for patients with psoriasis or eczema?
Glick: I say to my patients and I say to mycolleagues: the biologic therapies arefantastic, but they don't clear 100% ofthe patients, 100% of the time. But I mustadmit that we really are getting closer.
We used to say in the earlier days ofour biologic therapies, getting closeto about 20 years ago when they weremost active in clinical trials—when theycame out we would say, ‘we can get your skin clearer.’ But now we can say that, ‘we can get your skin clear.’
And we have agents right now that more than 50% of the time in the clinical trials have individuals with completely clear skin at the end of 1 year, and some of the even newer agents, the numbers are even more specific, where we're close to 70% of the patients being 100% percent clear at the end of 1 year.
And I have these conversations with my patients because we've really come a long way, and I think it provides a great deal of confidence for patients that are particularly down and out about their condition. As you know, anxiety and depression are very important parts of psoriatic disease. And we can really give patients a lot of hope that they can have significant improvement.
So the future looks bright.
Copyright® ConsultantLive 2019 Intellisphere, LLC. All Rights Reserved.