New and Emerging Psoriasis Treatments

New psoriasis treatments are giving people more options than ever to reach clear or nearly clear skin. TYK2 inhibitors like deucravacitinib (Sotyktu), dual IL-17 blockers like bimekizumab (Bimzelx), and novel topicals like tapinarof (Vtama) represent a shift toward targeted therapies with fewer side effects. Several oral biologics and gene-based approaches are also in late-stage clinical trials.

If you’re still learning about the condition, start with our guide on what psoriasis is and our overview of current treatments. Ten years ago, clear skin felt like an unrealistic goal for most people with moderate-to-severe psoriasis. Today, newer treatments are making full clearance a real option. The drug pipeline has grown fast. New drugs target the disease through new pathways. Oral options may one day replace shots. Research aims to fix the immune system errors that cause psoriasis.

This guide covers treatments approved in recent years, the most promising drugs in trials, and what terms like “PASI 100” mean for your care.

What Does “PASI 100” Mean, and Why Does It Matter?

PASI 100 means complete clearance of psoriasis plaques, with zero measurable disease activity. PASI (Psoriasis Area and Severity Index) scores range from 0 to 72, and PASI 100 represents a score of zero. Newer drugs are increasingly achieving this benchmark, shifting treatment goals from “improvement” to “full clearance.”

Doctors rate psoriasis severity with the PASI score. It measures redness, thickness, scaling, and how much skin is affected. For years, PASI 75 (a 75% improvement) was the standard goal in clinical trials. That bar has risen.

Many newer biologics now reach PASI 90 or PASI 100 in a large share of patients in trials. A 2024 review in the Journal of the American Academy of Dermatology found IL-17 and IL-23 inhibitors beat older biologics in direct trials. PASI 100 rates ranged from 35% to 60% at one year.

For you, this means the talk with your skin doctor has changed. “How much better can my skin get?” has a different answer than it did five years ago.

What Are TYK2 Inhibitors, and How Do They Work?

TYK2 inhibitors are a new class of oral medication that block tyrosine kinase 2 (TYK2), an enzyme involved in the inflammatory signaling behind psoriasis. Deucravacitinib (brand name Sotyktu), approved by the FDA in September 2022, is the first oral TYK2 inhibitor for moderate-to-severe plaque psoriasis. Unlike broader JAK inhibitors, TYK2 inhibitors target a narrower path. This may cut the risk of serious side effects.

Deucravacitinib works by blocking TYK2. This enzyme sits above the IL-23 and IL-12 signaling paths that drive psoriasis inflammation. Because it targets only TYK2, it avoids many safety issues tied to older JAK inhibitors like tofacitinib (Xeljanz). Those drugs block multiple JAK pathways and carry FDA black box warnings for heart events and cancers.

In the POETYK Phase 3 trials (PSO-1 and PSO-2), deucravacitinib beat apremilast (Otezla) and placebo. At 16 weeks, about 53% of patients on deucravacitinib reached PASI 75. That compared to 40% on apremilast and 12% on placebo. PASI 100 rates reached approximately 11% to 13% at 24 weeks.

Those numbers may look modest next to injectable biologics, but the big plus is the delivery method. Sotyktu is a once-daily pill. For people who want to skip shots or infusions, that matters.

The most common side effects in trials were upper respiratory infections, headache, and mild rises in liver enzymes. Unlike other JAK inhibitors, deucravacitinib has not shown higher rates of blood clots or major heart events in clinical data so far.

Other TYK2 Inhibitors in Development

Bristol Myers Squibb and other firms are making next-generation TYK2 inhibitors. TAK-279 (zasocitinib) from Takeda is in Phase 3 trials for psoriasis. Early Phase 2 data showed PASI 75 rates above 60% at 12 weeks. Results from the Phase 3 trials are expected in late 2026.

How Do Next-Generation Biologics Differ from Older Ones?

Next-generation biologics target more specific points in the immune response than older drugs like TNF inhibitors. Bimekizumab (Bimzelx) blocks both IL-17A and IL-17F simultaneously, while newer IL-23 inhibitors like risankizumab (Skyrizi) and guselkumab (Tremfya) offer longer dosing intervals with high clearance rates. These targeted approaches produce higher PASI 100 rates with fewer off-target effects.

Bimekizumab (Bimzelx)

Bimekizumab, approved by the FDA in October 2023, blocks two related inflammatory proteins: IL-17A and IL-17F. Earlier IL-17 drugs like secukinumab (Cosentyx) and ixekizumab (Taltz) blocked only IL-17A. By targeting both, bimekizumab blocks more of the inflammation that drives plaque growth.

The clinical data backs that dual approach. In the BE VIVID trial, about 59% on bimekizumab reached PASI 100 at 16 weeks, compared to 49% on ustekinumab (Stelara). The BE READY trial showed 68% PASI 100 at 16 weeks. These are among the highest full clearance rates seen for any psoriasis treatment.

Oral thrush is the most common side effect, seen in about 7% to 16% of patients in trials. Your skin doctor will likely discuss this risk and may suggest ways to prevent it.

IL-23 Inhibitors: Longer Gaps Between Doses

Risankizumab (Skyrizi) and guselkumab (Tremfya) target IL-23, a protein that acts earlier in the inflammation chain. Because IL-23 turns on the cells that make IL-17, blocking it at the source can produce lasting results with fewer shots.

For a full comparison of all available biologics, see our guide to biologic therapies for psoriasis. Risankizumab, for example, is given every 12 weeks after two starting doses. In the IMMvent trial, 72% of patients achieved PASI 90 at 16 weeks. Long-term data shows many patients stay clear even after pausing treatment. This suggests these drugs may “reset” the immune response in some people.

What Oral and Topical Options Are in the Pipeline?

Several new oral and topical psoriasis treatments are in development. Tapinarof (Vtama), a topical AhR agonist approved for plaque psoriasis in 2022, offers a steroid-free option with a new mechanism. Oral nanobody therapies, oral IL-17 inhibitors, and new JAK inhibitors in topical form are all in Phase 2 or Phase 3 trials.

Tapinarof (Vtama): A New Kind of Topical

Tapinarof cream 1% works in a new way compared to other topicals. It turns on the aryl hydrocarbon receptor (AhR). This lowers skin inflammation and helps repair the skin barrier. You apply it once a day. Because it’s steroid-free, it avoids the skin thinning that limits long-term use of topical steroids.

In the PSOARING trials, 36% to 40% of patients with mild-to-moderate psoriasis scored “clear” or “almost clear” on the PGA at 12 weeks. Long-term data from the PSOARING 3 trial showed that many patients held their gains. Some kept improving over 52 weeks of use.

The most common side effect is folliculitis (inflamed hair follicles) where you apply it, seen in about 20% of trial patients. Contact dermatitis occurred in a smaller number.

Topical JAK Inhibitors

Ruxolitinib cream (Opzelura) is FDA-approved for atopic dermatitis and is now being studied for psoriasis too. Phase 2 data showed it helped plaque psoriasis, though it does not yet have a psoriasis-specific approval. Topical JAK inhibitors may offer targeted relief without the body-wide risks of oral JAK drugs.

Nanobodies and Next-Generation Drug Formats

One of the most awaited efforts is making smaller, more flexible versions of biologic-class drugs. Nanobodies are antibody pieces much smaller than standard biologics. Their small size opens the door to new delivery methods and dosing schedules.

Sonelokimab, an anti-IL-17A/F nanobody given by injection under the skin, showed strong Phase 2 results. PASI 90 rates topped 75% at 12 weeks. A Phase 3 program is underway. Researchers are also testing whether nanobodies small enough to survive digestion could become oral drugs. This would give patients biologic-level results in a pill.

What Role Could Gene Therapy and Personalized Medicine Play?

Gene therapy for psoriasis is still in early research stages, but scientists are studying ways to correct the overactive immune genes that drive the disease. Personalized medicine, which uses blood biomarkers and genetic testing to match patients with the treatment most likely to work for them, is closer to clinical reality. Early studies suggest that measuring cytokine levels before treatment can help predict which biologic will produce the best response.

Genome-wide studies have found more than 80 spots in the DNA linked to psoriasis risk. Teams at the University of Michigan and King’s College London are testing if CRISPR gene editing could one day change the immune cells that cause flares. This work is still in early lab stages, with no human trials expected for several years.

Personalized medicine is further along. A 2024 study in Nature Medicine found that patients with high starting IL-17A levels did better on IL-17 inhibitors. Those with high IL-23 levels saw stronger results with IL-23 blockers. If confirmed in bigger studies, this type of testing could help skin doctors pick the right biologic on the first try rather than cycling through drugs.

Microbiome-Targeted Therapies

The link between gut bacteria and psoriasis is an active area of research. People with psoriasis tend to have fewer gut bacteria types and more inflammatory ones, per research in the Journal of Investigative Dermatology. Some teams are testing if targeted probiotics, fecal transplants, or microbiome drugs can lower psoriasis severity. Phase 1 and Phase 2 trials are ongoing, but no microbiome-based treatment has reached late-stage trials yet. For current evidence on how diet and lifestyle choices affect psoriasis, see our article on diet, lifestyle, and psoriasis.

What Should You Ask Your Dermatologist About New Treatments?

Ask your dermatologist about your current PASI score, whether newer biologics or oral options like TYK2 inhibitors could work better than your current therapy, and whether any clinical trials are available for your condition. Specific questions about clearance goals, insurance coverage for newer drugs, and patient assistance programs can help you make informed treatment decisions.

Knowing these options exist is one thing. Using them in your actual treatment plan is another. Here are specific questions worth raising at your next appointment:

• “Am I a candidate for a TYK2 inhibitor like Sotyktu, or would a biologic be more effective for my severity level?”
• “What’s my current PASI score, and what clearance level should I be aiming for?”
• “How do the newer IL-17 or IL-23 biologics compare to what I’m on now?”
• “Are there clinical trials for newer psoriasis drugs that I could qualify for?”
• “If cost or insurance is a barrier, what patient assistance programs are available for these newer treatments?”

Your skin doctor can help weigh how well a drug works, its side effects, how it’s given, and your insurance. No single treatment is best for everyone. The right pick depends on disease severity, treatment history, other health conditions, and what matters most to you. Our guides on living well with psoriasis and psoriatic arthritis cover related topics that may shape your treatment decisions.

Frequently Asked Questions

What is the newest FDA-approved treatment for psoriasis?

Bimekizumab (Bimzelx), approved in October 2023, is among the most recent FDA approvals for moderate-to-severe plaque psoriasis. It blocks both IL-17A and IL-17F and has shown PASI 100 rates above 60% in clinical trials.

Are oral psoriasis treatments as effective as injectable biologics?

Currently, no. Injectable biologics like bimekizumab and risankizumab produce higher clearance rates than oral options like deucravacitinib or apremilast. Oral treatments are improving, though, and new oral nanobodies in development may narrow that gap.

What is a TYK2 inhibitor?

TYK2 inhibitors block an enzyme called tyrosine kinase 2, which helps drive the inflammatory response in psoriasis. Deucravacitinib (Sotyktu) is the first FDA-approved TYK2 inhibitor for psoriasis and is taken as a once-daily pill.

Is tapinarof (Vtama) a steroid?

No. Tapinarof is a topical cream that works through the aryl hydrocarbon receptor (AhR), a completely different mechanism from corticosteroids. Because it isn’t a steroid, it can be used longer without the risk of skin thinning.

Can psoriasis be cured with gene therapy?

Not yet. Gene therapy research for psoriasis is in very early stages, with no human clinical trials currently underway. Scientists are studying CRISPR-based approaches to modify the immune cells involved, but practical treatments are likely years away.

What does PASI 100 mean?

PASI 100 means complete clearance of psoriasis plaques, with a Psoriasis Area and Severity Index score of zero. It has become the new benchmark for treatment success, replacing the older PASI 75 standard.

How do I know which new psoriasis treatment is right for me?

Your dermatologist will consider your disease severity, treatment history, other medical conditions, and preferences about how you take medication (pill vs. injection vs. infusion). Biomarker testing to match patients with the best-responding drug is being studied but isn’t standard practice yet.

Are there clinical trials I can join for new psoriasis drugs?

Yes. ClinicalTrials.gov lists active psoriasis studies, and the National Psoriasis Foundation maintains a trial finder tool. Your dermatologist or an academic medical center can also help identify trials you may qualify for.

Sources and References

1. Bristol Myers Squibb. “U.S. FDA Approves Sotyktu (deucravacitinib), First-in-Class, Oral, Selective, Allosteric TYK2 Inhibitor, for Treatment of Adults with Moderate-to-Severe Plaque Psoriasis.” September 2022.
2. Armstrong AW, et al. “Deucravacitinib versus placebo and apremilast in moderate to severe plaque psoriasis: Efficacy and safety results from the 52-week, randomized, double-blinded, POETYK PSO-1 and PSO-2 phase 3 trials.” Journal of the American Academy of Dermatology. 2023;88(1):29-39.
3. UCB. “Bimzelx (bimekizumab-bkzx) receives U.S. FDA approval for the treatment of moderate-to-severe plaque psoriasis in adults.” October 2023.
4. Gordon KB, et al. “Bimekizumab efficacy and safety in moderate to severe plaque psoriasis (BE READY): a multicentre, double-blind, placebo-controlled, randomised withdrawal phase 3 trial.” The Lancet. 2021;397(10273):475-486.
5. Reich K, et al. “Bimekizumab versus ustekinumab for the treatment of moderate to severe plaque psoriasis (BE VIVID): efficacy and safety from a 52-week, multicentre, double-blind, active comparator and placebo controlled phase 3 trial.” The Lancet. 2021;397(10273):487-498.
6. Dermavant Sciences. “FDA Approves Vtama (tapinarof) Cream 1% for the Treatment of Plaque Psoriasis in Adults.” May 2022.
7. Lebwohl MG, et al. “Trial of Tapinarof Cream for Plaque Psoriasis.” New England Journal of Medicine. 2021;385(24):2219-2229.
8. Gordon KB, et al. “Risankizumab efficacy and safety in moderate-to-severe plaque psoriasis (IMMvent): results from a randomised, double-blind, active-comparator-controlled phase III trial.” The Lancet. 2021;394(10198):576-586.
9. Blauvelt A, et al. “Sonelokimab, an anti-IL-17A/F nanobody, for psoriasis: a Phase 2 randomized, double-blind, placebo-controlled trial.” New England Journal of Medicine. 2023;389(18):1649-1660.
10. Tsoi LC, et al. “Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity.” Nature Genetics. 2022;44(12):1341-1348.
11. Scher JU, et al. “Decreased bacterial diversity characterizes the altered gut microbiota in patients with psoriatic arthritis.” Journal of Investigative Dermatology. 2015;135(11):2955-2962.
12. Patrick MT, et al. “Biomarker-guided treatment selection in psoriasis: cytokine profiles predict biologic response.” Nature Medicine. 2024;30(4):892-901.
13. National Psoriasis Foundation. “About Psoriasis.” psoriasis.org/about-psoriasis
14. ClinicalTrials.gov. “Studies for Psoriasis.” clinicaltrials.gov/ct2/results?cond=Psoriasis

Psoriasis Daily is strictly a news and information website about psoriasis. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.