An overview of developing TNF-α targeted therapy for the treatment of psoriasis

Introduction: Three biologic drugs targeting TNF-alpha are approved to treat moderate-to-severe cutaneous psoriasis. These are adalimumab, etanercept and infliximab. These drugs are given by subcutaneous injection or intravenous infusion, and while generally safe and effective, they are expensive with potential for side effects. Thus, numerous new drug candidates are under development that also target TNF-alpha. Areas covered: In this review, the authors detail several drugs under development that target TNF-alpha, focusing on those drugs in preclinical, Phase I and II trials. The authors describe emerging biologic psoriasis therapies, including biosimilars and novel biologics, in addition to several synthetic and naturally derived small-molecule drug candidates. Expert opinion: The currently approved TNF-alpha antagonists benefit from over 10 years of safety and efficacy data. The expense and method of administration of these biologics, however, can be cumbersome, and less expensive alternatives have the potential to benefit patients with psoriasis. It is inevitable, despite the introduction of new anti-IL-17 therapies, that established TNF-alpha targeted therapies, as well as newcomers targeting TNF-alpha, will continue to play an important role in the lifelong management of psoriasis.