Small molecules under development for psoriasis: on the road to the individualized therapies

Arch Dermatol Res. 2020 Nov;312(9):611-627. doi: 10.1007/s00403-020-02056-3. Epub 2020 Mar 14.

Abstract

Psoriasis is an incurable cutaneous illness characterized by the presence of well-delimited reddish plaques and silvery-white dry scales. So far, there is a limited understanding of its pathogenesis, though recent discoveries on the immunological, genetic and molecular aspects of this disease have significantly contributed to the identification of new targets and the development of novel drugs. Despite these advances, many patients are still dissatisfied, so to improve patient satisfaction, reliability, and clinical outcomes, the individualization of the treatments for this disease becomes a necessity. This review summarizes recent findings related to psoriasis pathogenesis and describes new small molecules and targets recently identified as promising for treatments. Additionally, the current status, challenges and the future directions for achieving individualized therapy for this disease and the need for more collaborative studies are discussed. The individualization of treatments for psoriasis, rather than a goal, is analyzed as a process where a dynamic integration between the needs and characteristics of the patients, the pharmacological progress, and the clinical decisions takes place.

Keywords: Individualized medicine; Pathogenesis; Psoriasis; Small molecules; Targets; Therapy.

Publication types

  • Review

MeSH terms

  • Calcium Release Activated Calcium Channels / antagonists & inhibitors
  • Cathepsins / antagonists & inhibitors
  • Cathepsins / genetics
  • Dermatologic Agents / pharmacology*
  • Dermatologic Agents / therapeutic use
  • Drug Development*
  • Gene Expression Regulation / drug effects
  • Gene Expression Regulation / immunology
  • Humans
  • Nuclear Receptor Subfamily 1, Group F, Member 3 / antagonists & inhibitors
  • Nuclear Receptor Subfamily 1, Group F, Member 3 / genetics
  • Patient Satisfaction
  • Precision Medicine / methods*
  • Psoriasis / drug therapy*
  • Psoriasis / genetics
  • Psoriasis / immunology
  • Purine-Nucleoside Phosphorylase / antagonists & inhibitors
  • Purine-Nucleoside Phosphorylase / metabolism
  • STAT3 Transcription Factor / antagonists & inhibitors
  • STAT3 Transcription Factor / metabolism

Substances

  • Calcium Release Activated Calcium Channels
  • Dermatologic Agents
  • Nuclear Receptor Subfamily 1, Group F, Member 3
  • RORC protein, human
  • STAT3 Transcription Factor
  • STAT3 protein, human
  • Purine-Nucleoside Phosphorylase
  • Cathepsins
  • cathepsin S