New medications being investigated for psoriasis and psoriatic arthritis include JAK inhibitors. Upadacitinib, for example, is being studied for use in psoriasis, psoriatic arthritis, atopic dermatitis, and other autoimmune diseases like Crohn's, says Morris. The once-a-day medication is now in phase 3 trials, he says. "It's an interesting medicine. We want to see what pro-inflammation markers are there and direct against that."
The issue with the psoriasis family of diseases and other autoimmune conditions, he says, is finding balance between toning down the immune system response to pathogens that trigger the conditions, without damaging the immune system too much. "Every one of these medicines is playing with your immune system."
Rheumatologists need to look at a patient's individual symptoms and condition to determine the best medications for them. For example, ustekinumab works well for psoriasis, but is not the first choice for patients with joint problems. Adalimumab, on the other hand, is approved for both, says Morris. “The more different approaches we have, the better.”
Rachael Zimlich, RN, is a writer in Columbia Station, Ohio.