Psoriasis Treatment in 2025: New Approvals, Expanded Indications, and a Push Toward Remission

At Fall Clinical 2025, April Armstrong, MD, provided an overview of key regulatory approvals, clinical data, and evolving treatment goals that are shaping the current landscape of psoriasis management during her session, “What Did 2025 Bring to the Table in Dermatology? Psoriasis.” The focus included both topical and systemic therapies, with a strong emphasis on clinical outcomes and real-world applicability.

Among the most significant regulatory updates, roflumilast 0.3% topical foam received US Food and Drug Administration approval for plaque psoriasis of the scalp and body in patients aged 12 years and older. This builds on its previous approval for seborrheic dermatitis in children aged 9 years and above. On the systemic side, guselkumab, the first IL-23-specific monoclonal antibody, has been approved for pediatric patients aged 6 years and up, covering both plaque psoriasis and psoriatic arthritis.

Dr Armstrong also highlighted a major milestone from the National Psoriasis Foundation: the consensus definition of on-treatment remission. This was the result of a Delphi exercise, now defining remission as a body surface area of 0% or an Investigator’s Gobal Assessment score of 0 (clear) that is maintained for at least 6 months. “As we have more and more efficacious psoriasis therapies, this is something I hope that we all will strive [to achieve] for our patients,” Dr Armstrong stated.

In the oral therapy space, several developments were noted. Apremilast is now available in a 75 mg extended-release daily tablet for patients weighing 50 kg or more, offering simplified dosing. New long-term data for the TYK2 inhibitor deucravacitinib showed 70% of patients maintaining Psoriasis Area and Severity Index (PASI) 75 over 5 years, with no new safety signals and stable adverse events. In psoriatic arthritis, 1-year data for deucravacitinib also demonstrated continued efficacy.

Looking ahead, Dr Armstrong noted the promise of pipeline agents, including axitinib, ESK-001, and the oral peptide icotrokinra, which achieved PASI 90 in 65% of patients in recent trials.

Finally, guselkumab became the first IL-23 agent shown to inhibit radiographic progression, expanding its clinical relevance in long-term joint protection.

Dr Armstrong concluded by emphasizing 2025 as a pivotal moment for patients and providers, underscoring the clinical momentum and growing possibilities for remission in psoriasis care.

Reference
Armstrong A. What did 2025 bring to the table in dermatology? Psoriasis. Presented at: 2025 Fall Clinical Dermatology Conference. October 23–26, 2025; Virtual.