Zasocitinib and Plaque Psoriasis
Featured Student: Demi Elrod
Demi Elrod is a fifth-year student in the B.A./M.D. program at the University of Missouri-Kansas City. She enjoys crafting, babysitting, and exploring Kansas City's vast food scene in her spare time. Her favorite research subjects are underserved populations and psoriasis treatment developments. She enjoys keeping up with recent publications in dermatology so that she can gain more experience with evaluating the quality and clinical applications of studies.
Introduction
Plaque psoriasis is a chronic autoimmune skin condition that can have a significant impact on both physical and emotional well-being. While biologic treatments have been a game-changer for many patients, there’s still a need for effective oral therapies, especially for those who prefer not to use injections. Zasocitinib, a TYK2 inhibitor, offers a promising approach by targeting specific inflammatory pathways involved in psoriasis. This study explored its potential to address the gap in oral treatment options for moderate to severe plaque psoriasis.
Methodology
In this Phase 2 trial, adults aged 18–75 with moderate to severe plaque psoriasis were randomly assigned to receive different doses of zasocitinib or a placebo for 12 weeks. The main goal was to see how many participants achieved a 75% reduction in their psoriasis severity (PASI 75) by week 12. Researchers also looked at higher levels of improvement (PASI 90), quality of life changes, and monitored for any side effects. The trial’s design helped ensure reliable comparisons between the treatment and placebo groups.
Findings
The results showed a clear benefit for zasocitinib, especially at higher doses. A significant number of participants in the high-dose group achieved PASI 75, and many even saw improvements beyond that. Quality of life scores improved as well, reflecting the treatment’s
impact on daily living. The medication was generally well-tolerated, with side effects mostly mild and similar to those seen in the placebo group. These findings suggest that zasocitinib could be an effective oral option for managing moderate to severe psoriasis.
Strengths and Weaknesses
Strengths: The study was well-structured, with randomization and blinding to ensure reliable results. Using multiple doses allowed the researchers to understand how well the drug worked at different levels, and the use of PASI scores provided a standard way to measure improvement.
Weaknesses:
However, the trial was relatively short at just 12 weeks, so we don’t know much about how the drug performs in the long term. The study size, typical of early-phase trials, was smaller, and it didn’t compare zasocitinib directly with established therapies like biologics. These factors make it harder to fully understand how it fits into current treatment options.
Applications for Future Practice
If further studies confirm its benefits, zasocitinib could be a valuable option for patients who want an effective oral treatment for psoriasis. It may also be useful for those who can’t or don’t want to use injectable therapies. Future research should focus on longer-term safety and
effectiveness, as well as comparing zasocitinib with other treatments to clarify its role in clinical practice. Expanding oral options would help meet a real need for patients and improve overall care.
Reference
Novartis Institutes for BioMedical Research, Stieglitz, E., et al. (2024). Zasocitinib, an oral TYK2 inhibitor, in patients with moderate-to-severe plaque psoriasis: A phase 2 randomized clinical trial. Journal of the American Academy of Dermatology, 91(6), 1157-1167.
