The choice of therapeutic agents for patients with moderate-to-severe psoriasis has expanded significantly in the past decade. With new understanding of the immunologic basis of psoriasis, multiple new potential targets for therapy have been identified. It is likely that a series of new medications to focus on the newly identified pathways is on the horizon. The first pathway targeted by new medications focuses on the p40 subunit that is shared by interleukin (IL)-12 and IL-23. Two human anti-p40 antibodies have been used therapeutically in psoriasis to date, ustekinumab (CNTO-1275, Stelara, Centocor, Horsham, PA) and briakinumab (ABT-874, Abbott, Abbott Park, IL). Ustekinumab was recently approved by the United States Food and Drug Administration, making it the first medication approved in the United States to work by this pathway while briakinumab is currently in phase III clinical trials.
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