Pipeline treatments on psoriatic disease.

Abstract

Psoriatic disease is a heterogeneous and multifaceted disease affecting musculoskeletal, dermatologic, and systemic domains, with low sustained remission rates despite advances in therapy. Current treatments, primarily targeting TNF, IL-17, IL-23, PDE4 inhibitors and JAK-STAT pathways, remain insufficient for many patients, highlighting the need for novel therapeutic approaches. This review explores pipeline treatments in psoriatic disease, including new JAK-STAT inhibitors (TYK2, JAK1), next-generation IL-17 inhibitors, IL-23-targeted therapies, and novel immune-modulating agents. The emerging role of combination therapy is also discussed, with dual biologic and small-molecule approaches showing potential in refractory disease. Additionally, microbiome-targeted therapies and metabolic interventions, including probiotics and GLP-1 receptor agonists, are being investigated as adjunctive strategies to improve disease control. While these innovations offer exciting opportunities for personalized medicine, challenges remain regarding long-term safety, optimal treatment sequencing, and combination strategies. Further randomized controlled trials and real-world data are necessary to define the most effective and sustainable treatment approaches for psoriatic disease.