NEJM: The effect of Tapinarof cream in the treatment of plaque psoriasis

Tapinarof cream is a topical aromatic hydrocarbon receptor modulator, which is being studied for the treatment of psoriasis
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Tapinarof cream can regulate the expression of interleukin 17 and skin barrier proteins filaggrin and loricrin

Recently, the top medical journal NEJM published a research article in which researchers conducted two identical phase 3 randomized trials in patients with mild to severe plaque psoriasis
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Patients with a baseline physician’s overall assessment (PGA) score of 2 (mild) to 4 (severe) (range 0 to 4, the higher the score, the more severe the psoriasis) and the area of ​​the disease that accounts for 3 to 20% of the total surface area is 2 The ratio of 1: 1 was randomly assigned to use 1% tapinarof cream or control cream once a day for 12 weeks of continuous treatment

The primary endpoint of the study was the PGA response, that is, a PGA score of 0 (cleared) or 1 (almost cleared) and a decrease of at least 2 points from baseline at week 12
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The secondary efficacy endpoint of the study is a reduction of at least 75% in the Psoriasis Area and Severity Index (PASI) score, a PGA score of 0 or 1, the average change in the percentage of affected body surface area from baseline, and a reduction in the PASI score of at least 90 %

In trials 1 and 2, the study screened a total of 692 and 674 patients, respectively, of which 510 and 515 patients were included
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In trial 1, 35.

It can be seen that in the 12-week treatment period, 1% Tapinarof cream once a day is better than the control ointment in reducing the severity of plaque psoriasis, but it is related to local adverse events and headaches
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Compared with existing treatments for psoriasis, larger and longer-term trials are needed to evaluate the efficacy and safety of Tapinarof cream