Figure 1.

Targets of new biologics and small molecules in psoriasis.

New biologics and small molecules under development for the treatment of plaque psoriasis. Dendritic cells produce IL-12 and IL-23, implicated in Th1 and Th17 lymphocyte differentiation, respectively. IL-1, produced by activated macrophages is an important mediator of the inflammatory response. TNF-α, IL-17, IL-22, and IL-26 stimulate keratinocyte production of cytokines, chemokines, and adhesion molecules, which, in turn, attract neutrophils and T lymphocytes, leading to amplification of inflammation. Blocking targets of the new biologics are IL-23 (tildrakizumab and guselkumab), IL-17 (secukinumab and ixekizumab), and IL-17 receptor (brodalumab). Blocking targets of the small molecules are phosphodiesterase 4 (apremilast) and JAK (tofacitinib and ruxolitinib).

Source: Adapted from Kofoed K, Skov L, Zachariae C. New drugs and treatment targets in psoriasis. Acta Derm Venereol. 2014;95(2):133-139.