Shalabh Singhal, executive director, development program lead, Rheumatology
The Impact of Psoriatic Disease
Psoriatic arthritis and psoriasis, together known as psoriatic disease, are chronic, immune-mediated diseases in which the immune system mistakenly attacks the body, leading to chronic inflammation of the skin and/or joints. Psoriatic arthritis is a heterogenous disease that presents with diverse joint, muscle and skin symptoms, including inflammatory arthritis, enthesitis (which occurs when the connective tissue between tendons or ligaments and bone becomes inflamed), dactylitis (inflammation of the finger and toe joints), and psoriatic skin and nail lesions. Psoriasis is widely prevalent, with up to 90 percent of patients having psoriasis vulgaris or plaque psoriasis, characterized by distinct, round or oval plaques on the skin, typically covered by silvery white scales. Up to 30 percent of patients with psoriasis will develop psoriatic arthritis.
Patients living with psoriatic disease are at an increased risk of developing serious comorbidities, including cardiovascular disease, metabolic syndrome, inflammatory bowel disease and depression. Additionally, the burden of psoriatic disease extends beyond the physical symptoms of pain, itching, and loss of physical function and can lead to significant psychological distress, impacting quality of life and work productivity.
Current therapies for immune-mediated diseases, including psoriatic disease, can help to manage symptoms and include anti-inflammatory treatments, corticosteroids, oral therapies and biologics. Despite the availability of these therapies, many patients with psoriatic arthritis and psoriasis struggle to control their disease because they are inadequately treated and/or undertreated. The need exists for safe, effective therapies that offer significant clinical improvement and are well-tolerated by patients.
A New Approach to Psoriatic Disease
At Bristol Myers Squibb, we are exploring selective inhibition of TYK2 (tyrosine kinase 2). TYK2 is a naturally occurring enzyme in the body, known as an intracellular signaling kinase, that has been shown to play a key role in several immune-mediated diseases, including psoriasis and psoriatic arthritis. TYK2 facilitates signaling of IL-23, IL-12 and Type I IFN, which are naturally occurring cytokines, or substances secreted by certain cells of the immune system that have an effect on other cells, involved in inflammatory and immune responses.
By selectively inhibiting TYK2, we are targeting underlying disease pathways that are critical in the cycle of chronic inflammation and contribute to psoriatic disease, without targeting kinases that may lead to unwanted side effects in patients. By pursuing TYK2 inhibition, our hope is to offer a new approach to address a broad number of immune-mediated diseases, including psoriatic arthritis and psoriasis.
At BMS, one of our goals is to contribute as much as possible to the understanding of the diseases we are studying in order to transform patients’ lives through science. By advancing research on the TYK2 pathway, our hope is that we are furthering our understanding of immune-mediated diseases to ultimately improve care for patients.
