Emerging oral drugs for psoriasis

Introduction: Psoriasis is a chronic, immune-mediated inflammatory disease that classically presents with well-demarcated, scaly, erythematous plaques on the extensor surfaces of the extremities, scalp, and trunk. Nails and joints are frequently affected as well. Whereas a significant number of patients maintain adequate control with topical therapy, up to 25% of patients will require phototherapy, oral systemic medication, or biologic therapy. Areas covered: The majority of recent advances in therapeutic options for moderate-to-severe psoriasis have been in biologic therapies whereas development of new oral agents has lagged behind. Currently, oral agents are largely confined to methotrexate, acitretin, cyclosporine and most recently apremilast. This article reviews emerging oral treatments for moderate-to-severe psoriasis. Expert opinion: Despite the recent FDA approval of apremilast, the development of new oral treatments for moderate-to-severe psoriasis has not kept pace with biologic therapies. There continues to be a need for safe and effective long-term oral therapies.