Topical medications represent the most commonly used drugs in the treatment of
psoriasis. However, topical
steroids are mainly limited to short-term or intermittent use, and traditional non-steroidal topicals such as
vitamin D analogues, topical
calcineurin inhibitors, and topical
retinoids are limited by low efficacy and poor local skin tolerability.
Tapinarof (GSK2894512, DMVT-505) is a novel, topical
aryl hydrocarbon receptor (AHR) agonist, which was recently approved by the FDA for the treatment of plaque
psoriasis in adults.
Tapinarof acts to improve
psoriasis through diminished
IL-17A production by CD4+ T cells, increased barrier gene expression in keratinocytes, and reduced production of
reactive oxygen species. Both short-term and long-term efficacy and safety have been evaluated in two Phase II and two Phase III (PSOARING 1 and 2) clinical trials in addition to a long-term extension study (PSOARING 3). Overall, the
drug has shown beneficial effects in achieving clear skin in adults with moderate-to-severe
psoriasis, good local tolerability, and also a long duration of effect even after discontinuation of the
drug. Therefore, this
therapy provides a new, highly effective and safe non-steroidal option to add to our
psoriasis treatment toolbox for both initial clearance and long-term maintenance of disease.