World Psoriasis Day | ACRO Partnering with You to Advance Skin Health

October 29 is recognized as World Psoriasis Day, a day dedicated to raising global awareness and promoting accurate understanding of psoriasis (PsO)—a chronic, recurrent autoimmune disease often associated with comorbidities that affect both the skin and systemic organs. PsO impacts over 125 million people worldwide, and its complex immune pathogenesis and substantial disease burden highlight the urgent clinical need for more effective and safer targeted therapies.

https://doi.org/10.1007/s40259-022-00569-z

Summary of systemic treatment options and comorbidities in PsO

PsO manifests not only as scaly skin lesions, erythema, and itching but also as a systemic inflammatory disease that can affect the joints, cardiovascular system, and metabolism. Among its clinical types, plaque psoriasis is the most common, accounting for over 80% of all cases, with patients often experiencing severe itching, burning, and pain. If inadequately controlled, about 30% of patients may progress to psoriatic arthritis (PsA), which can lead to irreversible joint damage. Confronting this serious challenge requires innovative therapeutic strategies that target the underlying immune mechanisms to precisely interrupt the inflammatory cascade.

At the Center of Immune Storm: From Genetic Triggers to Cytokine Crossfire

PsO is more than just a skin condition—it represents a chronic, immune-driven storm powered by the interplay between the innate and adaptive immune systems. At the heart of this storm lies the IL-23/IL-17 axis, a key pathway that fuels inflammation and tissue damage. In genetically susceptible individuals, everyday triggers like skin injury or infection can set off the immune cascade. Damaged skin cells release danger signals (DAMPs) that alert dendritic cells (DCs) and other antigen-presenting cells. Once activated, these DCs produce IL-23, which in turn stimulates TH17 and γδ T cells to release potent inflammatory mediators—IL-17A, IL-17F, and IL-22. Among these, IL-17 plays the role of the “final enforcer,” acting directly on keratinocytes to cause excessive growth and abnormal differentiation. The result is a feedback loop: keratinocytes release more chemokines and antimicrobial peptides, attracting immune cells that further amplify the inflammation. Together with TNF-α, IFN-γ, and other cytokines, this network forms a tightly woven inflammatory circuit that drives the hallmark plaques of psoriasis—and, in many cases, spills beyond the skin to trigger systemic inflammation.

https://doi.org/10.1007/s12016-024-08991-7

Dysregulation of immune response in PsO

PsO Treatment: From TNF-α Inhibitors to Precision Biologics Targeting IL-23 and IL-17

The treatment landscape for PsO has transitioned from the era of traditional systemic drugs and TNF-α inhibitors into a new era of precision medicine, dominated by emerging targets such as IL-23 and IL-17. This shift has driven target diversification, faster drug iteration, and the rise of homegrown innovative therapies, fundamentally altering the market dynamics.

In the early days of biologics, TNF-α inhibitors—such as AbbVie’s adalimumab, Johnson & Johnson’s infliximab and golimumab, and Amgen/Pfizer’s etanercept—were dominant in the market due to their broad anti-inflammatory effects. However, with patent expirations and the rise of biosimilars, their market share has been steadily declining.

A breakthrough came with Johnson & Johnson’s ustekinumab, the world’s first biologic targeting the p40 subunit of IL-12/IL-23, which proved the IL-23 pathway’s central role in PsO pathogenesis and opened the door for more precise therapies. As understanding of PsO’s mechanisms deepens, the focus has shifted toward IL-23 inhibitors that target upstream cytokines and IL-17 inhibitors that act directly on downstream inflammation. These therapies have become the primary treatment options on the market today.

IL-23 inhibitors, such as Johnson & Johnson’s guselkumab (projected global sales of $3.6 billion in 2024, +16.6% YoY), AbbVie’s risankizumab, and Eli Lilly’s mirikizumab, selectively target the p19 subunit of IL-23, offering exceptional efficacy and long-lasting remission, setting the gold standard for new treatments. On the other hand, IL-17 inhibitors, like Novartis’ secukinumab (2024 sales exceeding $6.2 billion), Eli Lilly’s ixekizumab (>$3.6 billion), and UCB’s bimekizumab, act by neutralizing IL-17A, achieving rapid onset of action and high skin clearance rates. These drugs have established a powerful market presence with high clinical response rates, forming a strong barrier to competition.

Approved originator biologics for PsO (Source: Pharmacodia)

Against the backdrop of a market traditionally dominated by leading international companies, emerging targeted therapies are accelerating breakthroughs and diversifying the treatment landscape. A prime example is Boehringer Ingelheim’s pemafostat, the first IL-36R inhibitor globally approved for generalized pustular psoriasis (GPP). This novel drug fills a critical gap in the targeted treatment of this rare and severe condition, highlighting the industry's growing trend toward precision therapies tailored for specific patient populations.

At the same time, several biopharmaceutical companies have made significant strides in innovative drug development in recent years, with multiple products receiving global or regional market approvals, demonstrating increasingly mature R&D capabilities. For instance, Zhixiang’s secukinumab and Hengrui’s furenikizumab both received market approval in August 2024, targeting IL-17A and entering the mainstream market to compete in this high-demand area.

Kangfang Bio’s irukizumab was approved in April 2025, offering a unique dual-target mechanism by simultaneously inhibiting IL-12 and IL-23’s p40 subunit, similar to the mechanism of the early global blockbuster ustekinumab. This novel approach suggests strong clinical potential and promising market prospects.

ACROBiosystems Pioneers PsO Therapeutics with Innovative Solutions

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