New drugs translate to the advancement of health care in the United States, and each year the CDER approves a wide range of new drugs and biological products. In 2015 and 2016, the FDA approved 45 and 29 new therapies, respectively. This year, the FDA is on pace to approve about 38 new medications. Additions to the drug market this year cover a variety of diseases and ailments, providing prescribers with more options and the ability to optimize drug therapy.

The FDA approved Rhofade on January 19, 2017, to treat erythema associated with rosacea. Erythema is one of the primary signs of rosacea that may resemble a blush or sunburn that does not go away. Persistent erythema may be the source of psychosocial issues for many patients. Rhofade is a cream that is to be applied in a thin layer that covers the entire face once a day. Like topical brimonidine, Rhofade is an a1receptor agonist that causes vasoconstriction to reduce redness associated with rosacea.

However, Rhofade is selective for the alpha1A subtype. This selectivity allows it to exhibit fewer adverse effects than brimonidine. The FDA approved brodalumab on February 15, 2017 to treat moderate to severe plaque psoriasis. It is intended for patients who are candidates for systemic therapy/phototherapy for plaque psoriasis and have failed to respond or have stopped responding to other systemic therapies.

Brodalumab is an anti-interleukin 17 receptor-antibody (monoclonal IgG2 antibody) that binds to a protein that causes inflammation, which inhibits the inflammatory response that plays a role in the development of plaque psoriasis. There are additional psoriasis drugs that work similarly, but instead they bind to the protein itself. The most common adverse effects of brodalumab include joint pain, fatigue, increased risk of infection, headache, muscle pain, and injection site reactions.

This medication also contains a black box warning for suicidal ideation, and is therefore available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the SILIQ REMS Program. Guselkumab is a new interleukin-23 (IL-23) inhibitor that the FDA approved on July 13, 2017. Guselkumab is the first and only approved treatment that selectively inhibits IL-23 to treat plaque psoriasis, and it is indicated for those with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy. 

The most common adverse effects are increased risk of infection (>10%), as well as headache, injection site reactions, arthralgia, diarrhea, gastroenteritis, tinea infections, and herpes simplex virus (>1%). Patients should also be counseled to avoid live vaccines when being treated with guselkumab.