An overview of benvitimod for the treatment of psoriasis: a narrative review

ABSTRACT

Introduction

The most frequently prescribed first-line treatment for limited (mild-to-moderate) psoriasis is topical corticosteroids, which are associated with several adverse effects with long term use. Benvitimod is an aryl hydrocarbon receptor immunomodulator that is both efficacious and tolerable for use in patients with mild to severe psoriasis with a body surface area (BSA) range of 1–20%.

Areas covered

In this review, the authors conducted a PubMed and Google Scholar search of key words and a review of clinical trials. They discuss the targeted mechanism of action for psoriasis, efficacy and safety profile of topical benvitimod, and its indications. Benvitimod affects key regulators of psoriasis, including proinflammatory markers and skin barrier proteins. Benvitimod is well-tolerated in patients with mild to severe plaque psoriasis. Treatment-emergent adverse events (TEAEs) include pruritus, contact dermatitis, and folliculitis; however, the majority of TEAEs were mild to moderate in severity, and most resolved without further treatment. A limitation of this study includes a small number of trials due to the dr’ novelty.

Expert opinion

Benvitimod may serve as a good alternative for psoriatic patients who desire a nonsteroidal topical option. The usefulness of benvitimod may be limited by prior authorizations that discourage healthcare providers from prescribing the medication and poor outcomes.

KEYWORDS:

• Efficacy
• safety
• psoriasis
• benvitimod
• nonsteroidal
• adherence
• management

Article Highlights

• Benvitimod is an aryl hydrocarbon receptor immunomodulator that is both efficacious and tolerable for use in patients with mild to severe psoriasis with a body surface area (BSA) range of 1-20%.

• Benvitimod leads to improvements in Physician Global Assessment (PGA) and Psoriasis Area and Severity Index (PASI) scores compared to vehicle, placebo, and positive controls. ^8−10,12,15

• Benvitimod is well tolerated in clinical trials for patients with psoriasis.

• Benvitimod may face similar struggles as its competitors when it reaches the market due to limitations from prior authorization, particularly medication adherence issues with patients who meet criteria.

• Some methods to increase medication adherence in this population include increasing follow up visits, strengthening the doctor-patient relationship, providing customized physician training sessions, and addressing unresolved medication concerns or beliefs about alternative forms of medicine.

Declaration of Interest

S 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 Inc, Dermavant, Arcutis, Novartis, Novan, UCB, Helsinn, Sun Pharma, Almirall, Galderma, Leo Pharma, Mylan, Celgene, Valeant, Menlo, Merck & Co, Qurient Forte, Arena, Biocon, Accordant, Argenx, Sanofi, Regeneron, the National Biological Corporation, Caremark, Advance Medical, Suncare Research, Informa, UpToDate and the National Psoriasis Foundation. He is also the founder and majority owner of www.DrScore.com and founder and part owner of Causa Research. 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 Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.