Abstract
Over the last decade, the management of psoriasis has witnessed a paradigm shift. Thanks to the increasing knowledge about the pathogenesis of psoriasis, targeted treatments with monoclonal antibodies have been developed. These antibodies, which target the pathogenic TNF/IL-23/IL-17-pathway, were shown to be safe and efficacious in the management of most patients with moderate to severe chronic plaque psoriasis. Recently, molecular and genetic studies in pustular and erythrodermic psoriasis have identified additional inflammatory pathways, providing evidence that psoriasis is a heterogeneous disease and highlighting the requirement for personalized disease characterization for treatment optimization. In this article, we will review these advances and provide an update on the currently available treatment arsenal. We discuss the efficacy and safety profile of these individual therapeutic agents and describe their use in special indications. We will also describe the current understanding of psoriasis as a systemic disease associated with multiple comorbidities and illustrate its impact in the management of psoriatic patients. Finally, we discuss ongoing therapeutic developments as well as unmet needs and future perspectives in the field of psoriasis.
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Abbreviations
- TNF:
-
Tumor necrosis factor
- IL:
-
Interleukin
- CD:
-
Cluster of differentiation
- Th:
-
T helper cell
- Tc:
-
T cytotoxic
- ADAMTSL5:
-
A disintegrin and metalloproteinase with thrombospondin motifs like 5
- TNFAIP3:
-
Tumor necrosis factor alpha-induced protein 3
- NFKBIA:
-
Nuclear factor kappa B
- HLA-Cw6:
-
Human histocompatibility antigen Cw6
- ERAP1:
-
Endoplasmic reticulum aminopeptidase 1
- ETS1:
-
E26 Transformation-specific transcription factor 1
- SOCS1:
-
Suppressor of cytokine signaling 1
- TNFRSF9:
-
Tumor necrosis factor receptor superfamily member 9
- SNP:
-
Single nucleotide polymorphism
- PPPP:
-
Palmoplantar pustular psoriasis
- GPP:
-
Generalized pustular psoriasis
- ACH:
-
Acrodermatitis continua of Hallopeau
- IL-36RN:
-
Interleukin-36 receptor antagonist
- type I IFN:
-
Type 1 interferon
- pDC:
-
Plasmaytoid dendritic cells
- PASI:
-
Psoriasis area and severity index
- IFNAR:
-
Interferon alpha receptor
- TLR:
-
Toll-like receptors
- PDE-4:
-
Phosphodiesterase-4
- NAPSI:
-
Nail Psoriasis Severity Index
- JAK:
-
Janus kinase
- PSOLAR:
-
Psoriasis Longitudinal Assessment and Registry
- NMSC:
-
Non-melanoma skin cancer
- MACE:
-
Major adverse cardiac events
- BMI:
-
Body mass index
- CVD:
-
Cardiovascular disease
- RA:
-
Rheumatoid arthritis
- HIV:
-
Human immunodeficiency virus
- UVB:
-
Ultraviolet B rays
- LCE3B:
-
Late cornified envelope 3B
- siRNA:
-
Small interfering ribonucleic acids
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Conrad, C., Gilliet, M. Psoriasis: from Pathogenesis to Targeted Therapies. Clinic Rev Allerg Immunol 54, 102–113 (2018). https://doi.org/10.1007/s12016-018-8668-1
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DOI: https://doi.org/10.1007/s12016-018-8668-1