Researchers proposed that psoriasis could be curable through early therapeutic intervention and a personalized medicine approach, according to a new paper.

In the paper, published in the Journal of Investigative Dermatology, researchers from St John's Institute of Dermatology and the University of Manchester defined cure as being treatment-free and disease-free for at least 5 years, similar to cancer remission criteria. Their approach combined early biologic therapy, advanced therapeutics, and lifestyle modifications.

The paper cited studies showing patients receiving the interleukin (IL)-23p19 inhibitor guselkumab demonstrated better outcomes when treated within 2 years of diagnosis compared with longer disease duration. Patients given the IL-17A inhibitor secukinumab showed similar results when treated within their first year.

The researchers outlined several therapeutic approaches. In the KNOCKOUT trial, 43% of patients treated with high-dose risankizumab achieved complete clearance at week 52 with significant reduction in TRM-17 cells.

Case reports showed complete clearance lasting over 5 years with mesenchymal stromal cell treatment, associated with increased regulatory T cells and decreased T-helper 17 cells.

The researchers called for new clinical trial designs focused on measuring treatment-free disease clearance. They suggested 2035 as a target date for achieving cure in patients with psoriasis.

The hypothesis built on recent advances in understanding psoriasis pathogenesis, particularly the role of the IL-23/type 17 T-cell axis and tissue-resident memory T cells in disease recurrence. The researchers specified their definition of cure pertained to skin disease, as psoriasis can affect multiple organ systems.

Potential conflict of interest disclosures can be found in the paper.