Tofacitinib: A New Oral Therapy for Psoriasis

Psoriasis is a common, chronic, immune-mediated disease associated with several comorbidities. Biologic therapy revolutionized the treatment of moderate-to-severe psoriasis, improving physical and emotional burden of the disease. Still, there are unmet needs in the treatment of psoriasis regarding long-term efficacy, tolerability, safety, route of administration, and cost. The increased knowledge of the pathogenesis of the intracellular metabolic pathways allowed the development of new compounds that inhibit certain intracellular proteins involved in the immune response. Tofacitinib is an oral small molecule that inhibits JAK/STAT pathway, which is then unable to upregulate the pro-inflammatory genes implicated in psoriasis. Data from phase II and III trials reveal that tofacitinib is a well-tolerated treatment for moderate-to-severe chronic plaque psoriasis with sustained efficacy for up to 2 years. With a convenient oral administration in the absence of organ toxicity associated with conventional oral treatments, tofacitinib may represent an important therapeutic to be included in the treatment algorithms of psoriasis.