Mark Lebwohl, MD kicked off a summary of the newest developments in the world of psoriasis with a review of two newly approved therapeutics: bimekizumab and spesolimab. In the BE VIVID trial (n=567), bimekizumab, the IL-17A and IL-17F inhibitor, was superior to both placebo and ustekinumab with 85% of patients achieving PASI 90 at Week 16, compared to 5% and 50%, respectively. Even more remarkable is that almost 60% of patients on bimekizumab achieved a PASI 100 at Week 16. In the BE ACTIVE trial, all bimekizumab dosing arms achieved significant improvements in ARC scores, a marker of psoriatic arthritis, as early as week 12. Spesolimab, the newest biologic on the market for generalized pustular psoriasis, is an IL-36 receptor inhibitor that demonstrated rapid pustular clearance at one week in 54% of patients, compared to 6% treated with placebo. Further, research has demonstrated that high-dose spesolimab may be the key to preventing flares of this recalcitrant disease in a 48 week study. Dr. Lebwohl encouraged us to keep on the lookout for data from another IL-36 receptor inhibitor, imsidolimab, which was also recently trialed for use in GPP.
The next part of his presentation covered exciting updates on more established biologic therapies for psoriasis: anti IL-23, anti IL-17, and anti-TNF molecules. Oral formulations of these inhibitors are now in trials, such as an oral IL-23 receptor antagonist that demonstrated significant efficacy in a phase 2 dose-ranging trial, FRONTIER 1. An oral IL-17A inhibitor is also on the horizon, with the higher 800mg BID dose causing a 40% improvement in PASI within one month in a small phase 1c trial for mild-to-moderate psoriasis. Lastly, an oral anti-TNF that inhibits only the TNFR1 signal by binding soluble TNFα, which is more involved in inflammation, demonstrated PASI improvements by week 2.
Ending with other oral options for your psoriasis patients, Dr. Lebwohl reviewed new data on the TYK-2 inhibitor, deucravacitinib, and the PDE4 inhibitors, apremilast, roflumilast, and orismilast. Extension trials on deucravacitinib show maintenance of PASI and sPGA in week 16 PASI 75 responders over a 3 year observation period without notable laboratory trends, serious infections, or herpes zoster activation compared to placebo. Apremilast was also shown to be as safe as placebo in a large pooled analysis of patients with psoriasis, psoriatic arthritis, and Behcet’s syndrome in addition to being efficacious in a 16 week pediatric psoriasis trial. Lastly, Dr. Lebwohl covered cardiovascular implications in psoriasis, in particular data from a trial with roflumilast that showed a significant decrease in cardiometabolic parameters, including BMI, by week 12. This may provide an important added benefit for obese patients struggling with weight loss and psoriatic disease control.
In the first DermInsider - A Virtual Grand Rounds Series session of the year, join leading experts Dr. Bhutani and Dr. Serota for a dynamic deep dive into one of the most exciting frontiers in psoriatic disease management. Dr. Del Rosso moderates this 45-minute activity that explores the rapidly emerging role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and their potential impact beyond metabolic disease. Don't miss out on this opportunity to catch up on breakthrough insights and emerging evidence on this hot topic!“We have some really interesting data on the horizon that’s going to hopefully help more providers feel confident about using [GLP-1] medications in conjunction with their psoriasis medications that they are used to using.” – Tina Bhutani, MD MASBest of FC25: GLP-1RAs in Psoriasis – Catching Up on The ScienceThis activity is supported by an educational grant from Lilly.
Got a few minutes? Join our expert faculty for their rapid-fire tips on getting started with GLP-1 receptor agonists for patients with psoriasis and obesity.“When we are treating patients with obesity and psoriasis in weight management, really focus on the health gains. It’s not about what people are losing, it’s about what they are gaining in this process.” – Angela Fitch, MDPlease visit the “Educational Resources” page to access the handouts developed by faculty on GLP's in psoriatic disease mentioned in this activity.This activity is supported by an educational grant from Lilly.
In this 20-minute Seminar in Depth from the 2025 Fall Clinical Dermatology Conference, the faculty explore what differentiates TYK2 inhibitors from traditional JAK inhibitors, as well as how to identify patients with psoriasis who may benefit from oral small molecule therapy.“When thinking about a medication, you need to take a number of things into consideration: location of disease, disease severity, and age. Age plays a big role when I think about what medication I’m going to choose for a patient – Are they of child-bearing age? Are they young and they live in group housing or a dorm?” – Benjamin Lockshin, MDFC25: Encapsulating Progress With New and Emerging TYK2 Inhibitors for Psoriasis: An Online ActivityThis activity is supported by an educational grant from Bristol Myers Squibb.