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Psoriasis Treatment Pipeline Features Innovative, First-in-Class Molecules

Targeted therapies lead the way

Despite mostly targeting established molecules, the current psoriasis pipeline is showing a high level of innovation in first-in-class molecules, including novel angiogenic drugs, growth factors, chaperone proteins, and cytokines, according to a new market analysis from Reportstack, a global pharma and health care research firm.

The new report states that first-in-class programs constitute an estimated 27% of the current psoriasis pipeline, and are predominantly composed of targeted therapies, including cytokine and receptor modulators, nuclear receptor modulators, and intracellular kinase inhibitors. A company analyst says: “There are several novel therapies targeting first-in-class T cell antigens, thanks to a growing understanding of the signaling pathways underlying the psoriasis pathophysiology, in which T cells have been shown to play a substantial role in disease progression.”

Therapies that can selectively modulate specific subsets of immune cells, without compromising the entire immune system, have become increasingly desirable, according to the report. One such treatment is tregalizumab, a humanized cluster of differentiation 4 (CD4)-specific monoclonal antibody. The analyst continues: “In contrast to other anti-CD4 antibodies, tregalizumab is able to activate the suppressive properties of regulatory T cells. It is currently in phase II clinical trials for the treatment of rheumatoid arthritis and in preclinical development for treating psoriasis.”

The report states that although no preclinical or clinical efficacy data have been disclosed for the antibody, it has been involved in a co-development deal worth $480 million between Biotest and Abbott Laboratories.

Several promising first-in-class therapies can selectively modulate specific subsets of immune cells without compromising the entire immune system, the report says. In particular, biologics that target a subset of T cells, which are strongly implicated in autoimmune pathophysiology, could allow targeted immune suppression, thereby reducing adverse side effects. Based on clinical trials, interleukin-17–targeted therapies have demonstrated superiority over currently established treatments in achieving advanced clinical endpoints.

Other promising psoriasis therapies target angiogenic signaling molecules at the psoriatic plaque level, as topical treatments. This has been validated in a small-scale, double-blind, randomized clinical study, according to the report. “With further validation in larger-scale clinical studies, insulin receptor substrate-1 inhibitors may prove to be a novel localized therapy for psoriasis, which can be used in conjunction with systemic treatments,” analysts conclude.

Despite this progress, significant unmet needs remain, including safety concerns regarding immunomodulation, the report says. This is a particularly important issue for the long-term clinical success of psoriatic therapeutics, especially for emerging biologics. Another unmet need is the ease of drug application as biologic drug delivery is invasive and painful.

Sources: PR Newswire; July 9, 2014; and Reportstack; 2014.

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