New Drugs Of Psoriasis Treatment - Ponesimod
Although many traditional systemic drugs or biological agents are available for the treatment of psoriasis, there is an unmet medical need for this disease. Recently, Dr. Yiu ZZN from the University of Manchester in England introduced the new oral psoriasis therapy approved or still under development. The review, published in Am J Clin Dermatol, is summarized as follows:
Ponesimod is a selective, reversible sphingosine 1-phosphate (SIP) receptor modulator.
Sphingosine-1 -phosphate is a lysophospholipid whose activity is regulated by 5 G-protein coupled sphingosine-1 -phosphate receptors, which can induce the production of T lymphocytes and It enters the circulatory system from the secondary lymphoid tissue, playing an immunomodulatory function. Therefore, sphingosine-1-phosphate has become a new target for the treatment of psoriasis.
A phase II RCT showed that Ponesimod (20 or 40 mg qd) had significantly better psoriatic skin lesions than placebo. After 16 weeks of treatment, the rates of PASI 75 at 20 mg, 40 mg, and placebo were 46 %, 48.1% and 13.4%. There is no evidence of efficacy of tofacitinib in the treatment of PsA.
Common adverse reactions to Ponesimod were Grade II heart block (4 patients), elevated ALT and AST levels, and dyspnea.
Given that Ponesimod has not yet been implemented for stage III RCT and that heart, liver and respiratory adverse effects of the drug are considered, only a small number of young patients are expected to be eligible for Ponesimod treatment.