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Small molecules, apremilast, and TYK2

Prof. Richard Langley, Dalhousie University, Canada
SPIN 2019

Prof. Richard Langley (Dalhousie University, Canada) contended that the value of small molecules will persist during the era of biologics [1]. Tailored use, careful patient selection, and patient preference are all important determining factors when choosing apremilast or TYK2 inhibition.

Many small molecules are being developed for psoriasis. They are small (<700 Da), chemically synthesised, generally simpler, well-defined, stable, and can be orally administered. Often, they are less expensive as well. Biologics, on the other hand, are generated in cell culture, are larger (>700 Da), and have complex tertiary structures with post-translational modifications; and the targets for biologics are usually extracellular (like anti-IL-17/-23) not intracellular (like small molecules). Currently, 3 (in some places 4) anti-TNF biologics are available: 1 anti-IL-12/23, 3 anti-IL-17s, and 4 anti-IL-23s, and many new molecules are coming out. In total, there are ...

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