Psoriasis: generalities and research trends

Psoriasis is a skin disease that causes itching and painful plaques or parches of skin, where it becomes thicker and it also becomes reddened. It can appear in several parts of the body, such as the scalp, shoulders, knees, back, face, hands and feet. Psoriasis is an autoimmune inflammatory disease. This means that the immunological system of a person attacks the body’s own cells. In patients with psoriasis, the immunological system causes that the cells of the last layer of skin, the keratinocytes, grow much faster than the normal rate (from 3 to 4 days instead of every 28 days). This causes the formation of psoriatic plaques.

What causes psoriasis?

Psoriasis is most commonly present in adults and there may be some underlying causes, such as hereditary and environmental factors. Psoriasis can last for a very long time. In some people, it can be present for their entire lives. The symptoms usually come and go, and it is important to take into account that there are some factors that can trigger them, such as stress, dry skin, certain kinds of medications, bacterial or viral infections, the weather, among others. In Mexico, approximately 2.5 million people suffer from psoriasis.

What treatments are available for psoriasis?

Psoriasis has no cure for now, but there are several treatment options that can maintain the symptoms under control. Basically, there are three kinds of treatments. The first one is non-systemic treatment, which includes topical medications and phototherapy. The second one is systemic treatment, which are oral medications or injections that help reduce the inflammation. The last one is biologic treatment or also known as immunotherapy. These last treatments are usually administered as subcutaneous injections or intravenous infusions. Patients should always notice if their current treatment is no longer working and communicate this to their treating physician so he or she can indicate the next treatment scheme to follow. Not every patient responds the same way to treatments.

It is estimated that in 8 years from now, the psoriasis therapeutic market is going to grow at a rate of 10.5%. Research is mainly focusing on biological treatments, whose mechanisms of action include IL blockers, PDE4 inhibitors, TNF inhibitors, among others. Some success examples are Lilly’s Ixekizumab, which got its approval on 2016 and Novartis’s Secukinumab, which got approved on 2015. Sun Pharma’s Tildrakizumab also got its approval recently on March 2018 after presenting phase 3 studies that met the primary efficacy endpoints.  Another example is Abbvie, which just recently filed Risankizumab for approval after meeting its endpoints with no safety concerns in a phase 3 program. At Althian, we are witnesses of the increase in the interest on psoriasis research because of the number protocol invitations we receive from sponsors to participate in these specific trials. We hope to be part of this research movement so we can get to help a lot of patients and eventually help them get a better quality of life.