Identification of key research needs for topical therapy treatment of psoriasis – a consensus paper by the International Psoriasis Council

Abstract

In this age of expanding choices of therapy for psoriasis, topical therapies still play an important part in the management of patients. There are many knowledge gaps in topical therapy for psoriasis with regard to efficacy and safety as well as various combinations including topical therapy with phototherapy or with systemic agents. Councillors of the International Psoriasis Council comprised a topical therapy working group to describe these gaps in order to help direct future research endeavours. Herein, we present the results of this analysis, discuss topical agents in clinical development and the attributes of the ideal topical treatment for psoriasis.

Topical treatment of psoriasis: questionnaire results on topical therapy accessibility and influence of body surface area on usage

“…Only a few published evidence-based studies have examined the efficacy of adding topicals to systemic drug treatments, yet the finding obtained in this survey is not unexpected. Indeed, our findings support the needs recently expressed by Wu et al 15 for further studies on this matter. In this study, disease severity has been defined according to BSA.…”

Efficacy and safety of HAT1 compared with calcipotriol in the treatment of patients with mild to moderate chronic plaque psoriasis: results from an open‐label randomized comparative pilot clinical study

“…1 Topical treatments, such as vitamin D analogues and tar products, have various limitations including poor efficacy, tachyphylaxis, skin atrophy, irritation and difficulty with application. 2 Treatments such as biological drugs, methotrexate and ciclosporin provide an affordable long-term management option, but also have limited efficacy and potential adverse effects (AEs), such as liver toxicity, hyperlipidaemia and immune suppression. 3 Despite the plethora of treatment options, a large-scale survey of patients with psoriasis, which was sponsored by the National Psoriasis Foundation, suggested that inadequately controlled disease is common and many patients are undertreated.…”

“…Psoriasis, the most prevalent autoimmune skin disease, is a multifactorial systemic disease, and is a significant cause of physical and psychosocial morbidity . Topical treatments, such as vitamin D analogues and tar products, have various limitations including poor efficacy, tachyphylaxis, skin atrophy, irritation and difficulty with application . Treatments such as biological drugs, methotrexate and ciclosporin provide an affordable long‐term management option, but also have limited efficacy and potential adverse effects (AEs), such as liver toxicity, hyperlipidaemia and immune suppression .…”

A randomized, double‐blind, placebo‐controlled, dose‐escalation first‐in‐man study (phase 0) to assess the safety and efficacy of topical cytosolic phospholipase A2 inhibitor, AVX001, in patients with mild to moderate plaque psoriasis

“…For patients presenting with mild to moderate psoriasis, topical therapy with glucocorticoids and phototherapy is the primary treatment modalities and their usefulness is limited by side‐effects and lack of compliance . Hence, there is a high medical need for new and safe topical drugs for psoriasis …”

“…3 Hence, there is a high medical need for new and safe topical drugs for psoriasis. 4 Phospholipase A2 (PLA2) has been investigated as a potential drug for various inflammatory diseases including skin inflammation. 5,6 PLA2 is a superfamily consisting of more than 20 enzymes with different structures and mechanisms of action.…”