Tapinarof cream for the topical treatment of plaque psoriasis in adults

ABSTRACT

Introduction

Plaque psoriasis, a chronic immune-mediated skin disorder, is characterized by well-demarcated erythematous plaques with silvery scales. This condition stems from complex interactions between genetic predisposition, immune dysregulation, and environmental triggers. Tapinarof downregulates the cytokine IL-17, diminishes the inflammatory infiltrate, and provides antioxidant properties while enhancing the expression of skin barrier proteins.

Areas covered

This review begins by assessing tapinarof’s mechanism in treating plaque psoriasis. Subsequently, it examines the effectiveness and safety of tapinarof 1% cream in adult patients.

Expert opinion

Tapinarof 1% cream, which works by activating the aryl hydrocarbon receptor, is an FDA-approved treatment for adult plaque psoriasis. This therapy introduces a novel, nonsteroidal method for addressing inflammation and skin barrier issues, potentially serving as an alternative to conventional treatments. The once-daily, convenient cream formulation and favorable safety profile may enhance patient adherence, which is often poor with topical treatments. Tapinarof also maintains disease clearance for a mean of 4 months after treatment cessation.

KEYWORDS:

• Tapinarof
• aryl hydrocarbon receptor agonist
• benvitimod
• clinical trial
• drug review

Article highlights

• Tapinarof is the first aryl hydrocarbon receptor agonist that is FDA-approved for treating adult plaque psoriasis

• Tapinarof’s effectiveness in treating psoriasis stems from its activation of AhR, which subsequently down-regulates expression of IL-17A and IL-17F, activates antioxidant activity via Nrf2, and up-regulates skin barrier proteins and lipids

• Tapinarof 1% cream has minimal systemic absorption, consistent with targeted local effects at sites of application and low potential for systemic adverse effects and drug-drug interactions

• The most common adverse events found in the clinical trials were folliculitis, contact dermatitis, and nasopharyngitis

• During the clinical trials, patients treated with tapinarof had superior disease improvements compared to controls and greater overall product satisfaction

• Tapinarof had an approximate remission duration of 4 months upon cessation of treatment following the clearance of the plaque lesion

Declaration of interest

Steven R. Feldman has received research, speaking and/or consulting support from Eli Lilly and Company, GlaxoSmithKline/Stiefel, AbbVie, Janssen, Alovtech, vTv Therapeutics, Bristol-Myers Squibb, Samsung, Pfizer, Boehringer Ingelheim, Amgen, Dermavant, Arcutis, Novartis, Novan, UCB, Helsinn, Sun Pharma, Almirall, Galderma, Leo Pharma, Mylan, Celgene, Ortho Dermatology, Menlo, Merck & Co, Qurient, Forte, Arena, Biocon, Accordant, Argenx, Sanofi, Regeneron, the National Biological Corporation, Caremark, Teladoc, BMS, Ono, Micreos, Eurofins, Informa, Verrica, UpToDate and the National Psoriasis Foundation. He is founder and part owner of Causa Research and holds stock in Sensal Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose. Dermavant provided a scientific accuracy review at the request of the journal editor.

Additional information

Funding

This paper was not funded.