Opzelura cream is a topically applied JAK inhibitor indicated for the treatment of atopic dermatitis and for nonsegmental vitiligo in patients over the age of 12. The package insert contains the same boxed warnings that have been applied to oral JAK inhibitors and include warnings about malignancy, major adverse cardiovascular events, thrombosis, serious infections, and death; but there is no evidence that these are increased with topical application of Opzelura cream.  The package insert recommends against using in combination with biologics, other JAK inhibitors, or immunosuppressive drugs such as azathioprine and cyclosporine; but in clinical practice, Opzelura cream is often used in combination with other treatments for atopic dermatitis such as biologic therapies.

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Opzelura (ruxolitinib) cream 1.5%

Taltz (ixekizumab) is a monoclonal antibody biologic therapy administered by subcutaneous injection indicated for the treatment of moderate-to-severe plaque psoriasis in adults and pediatric patients aged 6 years and older, adults with active psoriatic disease, adults with active ankylosing spondylitis, and adults with active nonradiographic axial spondyloarthritis with objective signs of inflammation. It targets interleukin 17A, a cytokine involved in the inflammatory process of psoriasis, helping to reduce symptoms and achieve clearer skin. The package insert specifically mentions the following adverse events: injection site reaction, upper respiratory infections, nausea, and tinea infection. It is recommended to avoid combining Taltz with other immunosuppressive therapies such as other biologics or live vaccines. Taltz can be used as part of a broader treatment strategy for psoriasis, often used alongside topical or other systemic therapies to optimize patient outcomes, and is a safe and effective long-term therapy option for the treatment of psoriasis in both adults and children. 

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Taltz (ixekizumab) 

Bimzelx (bimekizumab-bkzx) is a dual humanized interleukin 17A and F antagonist biologic therapy administered by subcutaneous injection. It is indicated for the treatment of adults with moderate to severe plaque psoriasis, active psoriatic arthritis, moderate to severe hidradenitis suppurativa, active nonradiographic axial spondyloarthritis with objective signs of inflammation, and active ankylosing spondylitis.
Bimzelx targets IL-17A and IL-17F, cytokines involved in inflammatory and immune processes, particularly in conditions like psoriasis and hidradenitis suppurativa. By inhibiting both IL-17A and IL-17F, Bimzelx suppresses the release of proinflammatory cytokines and chemokines. 
For psoriasis and hidradenitis suppurativa, the package insert specifically mentions the following adverse reactions: upper respiratory tract infections, oral candidiasis, headache, injection site reactions, tinea infections, gastroenteritis, Herpes simplex infections, acne, folliculitis, other candida infections, and fatigue. 
For psoriatic arthritis, it mentions upper respiratory tract infections, oral candidiasis, headache, diarrhea, and urinary tract infections. 
In clinical practice, candidiasis is likely to be one of the most encountered adverse events with Bimzelx in patients treated for psoriasis, psoriatic arthritis, or hidradenitis suppurativa.
Other notable adverse reactions include suicidal ideation and behavior, liver biochemical abnormalities, and inflammatory bowel disease. Clinicians should monitor patients closely for these events.
As with other biologics, combining Bimzelx with additional immunosuppressive therapies, such as other biologics or live vaccines, is not recommended.
Bimzelx can be used as part of a comprehensive treatment plan for dermatologic conditions, often combined with topicals to optimize patient outcomes. Its dual mechanism of action can offer an effective approach to addressing complex inflammatory pathways in psoriasis, psoriatic arthritis, and hidradenitis suppurativa. 


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Bimzelx (bimekizumab-bkzx)

VTAMA (tapinarof) cream 1% is an aryl hydrocarbon receptor (AhR) agonist indicated for the topical treatment of plaque psoriasis in adults and atopic dermatitis in adults and pediatric patients 2 years and older. VTAMA cream is applied as a thin layer to affected areas once daily.
The active ingredient, tapinarof, works by supporting natural pathways regulated by AhR receptors. This includes suppressing Th17 cell differentiation and production of key cytokines, such as IL-17 and IL-22, which play a central role in the inflammatory process of psoriasis; upregulating skin barrier proteins to help restore skin barrier function; and inducing the Nrf2 transcription factor pathway to increase antioxidant activity.
VTAMA does not have any contraindications. For plaque psoriasis, the package insert specifically mentions the following adverse reactions (incidence ≥ 1%) in patients treated with VTAMA cream: folliculitis, nasopharyngitis, contact dermatitis, headache, pruritus, and influenza. For atopic dermatitis, it mentions upper respiratory tract infection, folliculitis, lower respiratory tract infection, headache, asthma, vomiting, ear infection, pain in extremities, and abdominal pain.
As a nonsteroidal topical treatment, VTAMA offers an alternative to traditional corticosteroids for the management of plaque psoriasis and atopic dermatitis. Its unique mechanism of action and absence of contraindications make it a potential option for long-term use. VTAMA may be used as monotherapy or in combination with systemic therapies, offering clinicians an additional choice for addressing the chronic and inflammatory nature of plaque psoriasis and atopic dermatitis.

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VTAMA (tapinarof) cream 1%

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