title: Current investigational drugs in psoriasis.
abstract: BACKGROUND
  The advent of biologic therapies has revolutionized the treatment of psoriasis. Increased understanding of immunogenetic pathways has allowed for the development of more selective targeted biologic therapies. Multiple new treatments are currently in development for the treatment of psoriasis. Preliminary data for many of these agents, particularly with regard to agents targeting the IL-23/Th17 pathway, are promising. Proven long-term safety, however, is an absolute necessity with newly developed drugs, and should, therefore, still be considered second-line agents to current established treatments with long-term safety data.
  
  
  METHODS
  This review details the mechanisms of action of drugs currently in development or in clinical trials for the treatment of psoriasis, using clinical trial registries and associated publications. Readers will gain a comprehensive overview about the mechanism of action of emerging treatments targeting various immune pathways deeply involved in psoriasis. Pathogenesis, clinical efficacy and safety data for these treatments are discussed where available.
  
  
  CONCLUSIONS
  Psoriasis remains a heavily undertreated systemic immune-mediated disease despite increased understanding of immunopathogenesis of the disease and advent of a multitude of novel therapeutic agents with potentially improved bioavailability and safety profiles. Limitations, however, remain in the realm of topical agents for treatment of mild to moderate psoriasis, which has seen little progress over the years. A concerted effort will need to be made among researchers, clinicians and patient advocacy groups to ensure new therapeutic agents are developed and gain proper exposure.
authors.affiliation: Department of Dermatology, Baylor University Medical Center, 3900 Junius Street, Suite 125, Dallas, TX 75204, USA. caitriona.ryan@baylorhealth.edu
authors.forename: Caitriona
authors.initials: C
authors.lastname: Ryan
authors.forename: Amanda
authors.initials: A
authors.lastname: Abramson
authors.forename: Mahir
authors.initials: M
authors.lastname: Patel
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
mesh_terms: D002986:Clinical Trials as Topic; D015507:Drugs, Investigational / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D007107:Immune System / Q000187:drug effects* / Q000276:immunology; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D015507:Drugs, Investigational