[Skip to Navigation]
Views 557
Citations 0
Editorial
October 13, 2021

Targeting Immune Checkpoints and Cytokines to Protect From Psoriasis Relapse

Author Affiliations
  • 1Department of Dermatology, Venereology and Allergology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
JAMA Dermatol. Published online October 13, 2021. doi:10.1001/jamadermatol.2021.3491

In contrast to the state of the field 10 years ago, the understanding of disease pathogenesis and the treatment goals for patients with psoriasis have changed enormously. A 75% improvement in the Psoriasis Area and Severity Index (PASI 75) is no longer the desirable treatment goal for dermatologists or for disease-experienced patients with plaque-type psoriasis. Physicians and patients now demand a PASI 90 or even a PASI 100. Identification of interleukin (IL)–17 and IL-23 as key mediators in the pathogenesis of psoriasis and the development of new biologics that target these pathways are major steps toward disease control.1 By targeting cytokines, a clear or almost clear disease status became an achievable goal in a substantial number of patients. The molecular and cellular mechanisms that underlie disease milestones in psoriasis treatment have not yet been fully elucidated, and we remain far from a permanent cure. In particular, we are missing the biomarkers and molecular indicators of forthcoming psoriasis flares in patients who show no or minimal disease activity. This is critical information for identifying the appropriate point in time to discontinue a systemic medication in an individual who has achieved disease control.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×