Evaluating Zasocitinib as an oral therapy for moderate to severe plaque Psoriasis

INTRODUCTION: Psoriasis is a chronic inflammatory disease with significant physical and psychosocial burden. Although biologic therapies targeting IL-17 and IL-23 are highly effective, their cost, injection burden, and variable response highlight the need for convenient oral alternatives. TYK2, a key mediator of the IL-23/IL-17 axis, represents a promising therapeutic target. Our objective is to evaluate the pharmacology, clinical efficacy, safety, and potential role of zasocitinib in plaque psoriasis. AREAS COVERED: We conducted a narrative review of preclinical and clinical studies of zasocitinib, focusing on early-phase trials and comparisons with existing therapies. Zasocitinib is a highly selective oral TYK2 inhibitor that targets IL-12, IL-23, and interferon signaling. Adverse events were generally mild to moderate, with no major safety signals or laboratory abnormalities. EXPERT OPINION: Psoriasis varies widely, but treatment is mainly based on whether topicals are enough or stronger therapy is needed. Although better treatment options are still needed, especially for mild disease, new drugs like zasocitinib may have a role, but could face challenges competing with existing highly effective and well-established therapies.