Focus 1-2 (FS 1-2) : New therapeutics in psoriasis: new paradigm and new concerns = Focus 1-2 (FS 1-2) : New therapeutics in psoriasis: new paradigm and new concerns

다국어 초록 (Multilingual Abstract)

Psoriasis treatment paradigm has changed gradually but clearly over the past decades. Core concept of the new paradigm is ‘high potency’ ‘rapid escalation’ and ‘continuity’ of treatment. The advent of the new paradigm was ushered in by biologics and small peptide molecules. Biologics not only proved their enhanced efficacies but they also demonstrated safety on a long-term treatment. Despite eye-catching advances, psoriasis management is far from being complete. Psoriasis, a systemic inflammatory disorder involving multi-systems as well as skin needs all-faceted approaches. The most pressing question is whether biologics can be alleviating or aggravating CV risk. Only TNF-αinhibitors showed their potential in addressing this issue. Although longer-term safety data of biologics look good, these are not truly long-term in light of chronic nature of psoriasis. Truly long-term administration of biologics can substantially increase risks of malignancies and serious infections. From a socioeconomic perspective, biologics is a very expensive treatment for which not only insurers but the whole members of a society should agree to pay. We do not know whether it could remain as a sustainable solution in the long-term. The key is how many of psoriasis patients on biologics can return to their productive lives which in turn contribute to productivity of a society as a whole.