{"id":6607,"date":"2026-07-10T11:58:01","date_gmt":"2026-07-10T11:58:01","guid":{"rendered":"https:\/\/www.london-dermatology-centre.co.uk\/blog\/?p=6607"},"modified":"2026-07-21T05:01:48","modified_gmt":"2026-07-21T05:01:48","slug":"select-pso-study","status":"publish","type":"post","link":"https:\/\/www.london-dermatology-centre.co.uk\/blog\/select-pso-study\/","title":{"rendered":"The SELECT-PsO Clinical Trials: A New Era for Oral Psoriasis Treatments"},"content":{"rendered":"\n

Psoriasis treatment has changed significantly over the past few decades. If you are living with psoriasis, you may know that managing the condition often involves more than simply treating visible patches on your skin. Earlier approaches mainly focused on creams, light therapy and traditional medicines that suppress immune activity, but advances in research have introduced newer options, including biologic medicines and targeted therapies that work on specific inflammatory pathways.<\/p>\n\n\n\n

For people with moderate-to-severe psoriasis, achieving good disease control can have a positive impact on many areas of life. You may want treatment that not only reduces plaques but also improves discomfort, confidence, daily activities and your overall quality of life. As scientists continue to study new approaches, the focus is increasingly on developing treatments that provide effective control while also being practical and convenient for long-term use.<\/p>\n\n\n\n

The SELECT-PsO clinical trials explored upadacitinib, an oral targeted therapy designed to affect specific immune pathways involved in psoriasis-related inflammation. The research helped improve understanding of how oral medicines may provide another treatment option for people who need more advanced approaches to managing their condition.<\/p>\n\n\n\n

In this article, you will learn more about the SELECT-PsO study programme, how upadacitinib works, what researchers discovered and what these findings could mean for the future of psoriasis treatment. By understanding these developments, you can gain a clearer picture of how modern research is shaping more personalised care options for people with psoriasis.<\/p>\n\n\n\n

Understanding Psoriasis as an Inflammatory Condition<\/strong><\/h2>\n\n\n\n

Psoriasis is a long-term inflammatory skin condition that happens when your immune system becomes overactive and speeds up the process of skin cell production. Normally, your skin renews itself gradually, but with psoriasis, new skin cells develop too quickly. This can cause thick, raised and scaly patches known as plaques to appear on the skin.<\/p>\n\n\n\n

If you have psoriasis, you may notice these plaques developing on areas such as your elbows, knees, scalp and lower back, although the condition can affect almost any part of your body. For some people, psoriasis can also involve the nails or joints, which may lead to additional symptoms such as nail changes or joint discomfort.<\/p>\n\n\n\n

Although psoriasis is not contagious, it can have a significant effect on your physical and emotional wellbeing. You may experience itching, irritation, visible skin changes or flare-ups that are difficult to predict. These challenges can affect your confidence, daily activities and overall quality of life, which is why finding an effective management approach is so important.<\/p>\n\n\n\n

How Psoriasis Treatment Has Changed<\/strong><\/h2>\n\n\n\n

In the past, psoriasis treatment mainly focused on reducing symptoms rather than addressing the specific immune processes that cause inflammation. If you have mild psoriasis, you may have been offered topical treatments such as corticosteroid creams or vitamin D-based treatments to help reduce redness, scaling and irritation.<\/p>\n\n\n\n

For people with more widespread or persistent psoriasis, treatment options expanded to include approaches such as phototherapy and traditional systemic medicines. These treatments have helped many people manage their symptoms, but you may find that they can have limitations, including the need for regular monitoring, variable effectiveness or challenges with long-term use.<\/p>\n\n\n\n

The introduction of biologic medicines brought a significant change in psoriasis care. These treatments allow doctors to target specific immune molecules and pathways involved in psoriasis inflammation. As a result, you now have access to more targeted treatment options that aim to provide better disease control and a more personalised approach to managing psoriasis.<\/p>\n\n\n\n

The Rise of Targeted Oral Therapies<\/strong><\/h2>\n\n\n\n

While biologic medicines have transformed the way psoriasis is treated, researchers have continued to explore effective oral options that may provide greater flexibility for people managing the condition. If you prefer taking tablets over injections, targeted oral therapies could offer you an alternative approach that fits more easily into your lifestyle and treatment preferences.<\/p>\n\n\n\n

Targeted oral therapies work by affecting specific signalling pathways involved in the inflammatory processes behind psoriasis. Unlike older systemic treatments that may influence wider areas of your immune system, these newer medicines are designed to act more precisely on the pathways linked to disease activity.<\/p>\n\n\n\n

The development of targeted oral treatments represents an important step towards more personalised psoriasis care. As research continues, you may have access to a wider range of treatment options that are chosen based on your symptoms, health needs and individual response to therapy.<\/p>\n\n\n\n

What Is Upadacitinib?<\/strong><\/h2>\n\n\n\n

Upadacitinib is an oral medicine that belongs to a group of treatments known as Janus kinase (JAK) inhibitors. If you are exploring psoriasis treatment options, you may come across this type of targeted therapy as researchers continue to investigate new ways to manage inflammation more precisely.<\/p>\n\n\n\n

JAK proteins play an important role in sending signals inside your cells that help regulate immune activity and inflammation. Upadacitinib works by blocking certain JAK pathways, which may help reduce the inflammatory responses involved in some immune-related conditions, including inflammatory skin diseases.<\/p>\n\n\n\n

The medicine has been studied in several inflammatory conditions, including dermatological disorders. Through ongoing research, scientists are continuing to understand how targeted oral therapies like upadacitinib may contribute to more personalised treatment approaches for people who need additional options for managing chronic inflammatory conditions.<\/p>\n\n\n\n

SELECT-PsA Research: Key Facts<\/strong><\/h2>\n\n\n\n
    \n
  • SELECT-PsA 1 and SELECT-PsA 2 were Phase III clinical trials evaluating upadacitinib in adults with active psoriatic arthritis.<\/li>\n\n\n\n
  • SELECT-PsA 1 included patients whose disease had responded inadequately to, or who could not tolerate, at least one non-biologic disease-modifying anti-rheumatic drug.<\/li>\n\n\n\n
  • SELECT-PsA 2 included patients with an inadequate response or intolerance to at least one biologic disease-modifying anti-rheumatic drug.<\/li>\n\n\n\n
  • The studies assessed multiple aspects of psoriatic arthritis, including joint symptoms, physical function and skin psoriasis outcomes.<\/li>\n\n\n\n
  • PASI skin responses were assessed in participants who had at least 3% body surface area affected by psoriasis at baseline.<\/li>\n\n\n\n
  • These studies should not be described as dedicated clinical trials of upadacitinib for standalone plaque psoriasis.<\/li>\n<\/ul>\n\n\n\n

    Why Were the SELECT-PsO Trials Developed?<\/strong><\/h2>\n\n\n\n

    The SELECT-PsO clinical trials were developed to explore whether upadacitinib could help people with moderate-to-severe plaque psoriasis achieve better control of their symptoms. If you are living with psoriasis, you may understand how important it is to find a treatment that can reduce flare-ups, improve skin changes and support your everyday quality of life.<\/p>\n\n\n\n

    Researchers wanted to find out how effective upadacitinib was compared with other treatment approaches and whether it could provide meaningful improvements for people with active psoriasis. During the studies, they also looked closely at safety, tolerability and how patients responded to treatment over time.<\/p>\n\n\n\n

    The aim of the SELECT-PsO programme was to determine whether a targeted oral therapy could become a useful addition to the range of psoriasis treatments available. By investigating new options, researchers hoped to provide you with more choices when considering long-term psoriasis management.<\/p>\n\n\n\n

    How the SELECT-PsO Clinical Trials Were Designed<\/strong><\/h2>\n\n\n\n

    Clinical trials like SELECT-PsO are carefully planned studies that help researchers understand how well a treatment works and how safe it is. If you are considering a newer psoriasis treatment, these studies provide important evidence about whether an option may be suitable for people with moderate-to-severe disease.<\/p>\n\n\n\n

    During the trials, participants were monitored over specific periods, and researchers assessed changes in psoriasis severity, improvements in symptoms and any possible side effects. These detailed evaluations help you and your healthcare team understand the potential benefits and risks of a treatment.<\/p>\n\n\n\n

    By comparing treatment results with other approaches or placebo groups, clinical trials can show whether a medicine provides meaningful improvements. This research process helps ensure that new therapies are thoroughly evaluated before they become part of wider psoriasis care.<\/p>\n\n\n\n

    Research Insight: What Did the SELECT-PsA Trials Show About Skin Psoriasis?<\/strong><\/p>\n\n\n\n

    Although SELECT-PsA 1 and SELECT-PsA 2 were designed for people with active psoriatic arthritis, the researchers also assessed skin responses in participants who had psoriasis affecting at least 3% of their body surface area at the start of the studies.<\/p>\n\n\n\n

    At Week 16 of SELECT-PsA 1, 63% of participants receiving upadacitinib 15 mg achieved PASI 75, compared with 21% receiving placebo. In SELECT-PsA 2, the corresponding PASI 75 response rates were 52% with upadacitinib 15 mg and 16% with placebo.<\/p>\n\n\n\n

    For you as a reader, the distinction is important. These findings show that skin psoriasis improved in a subgroup of people being treated for psoriatic arthritis, but they should not be presented as results from a dedicated plaque psoriasis trial programme.<\/p>\n\n\n\n

    Clinical trial percentages describe outcomes across groups of participants and cannot predict exactly how one person will respond.<\/p>\n\n\n\n

    Measuring Psoriasis Improvement in Clinical Research<\/strong><\/h2>\n\n\n\n

    When you take part in psoriasis research, doctors and scientists use carefully developed scoring systems to measure how your condition changes over time. These tools help researchers assess whether a treatment is reducing symptoms and improving the overall severity of psoriasis in a consistent way.<\/p>\n\n\n\n

    One commonly used measurement is the Psoriasis Area and Severity Index (PASI), which looks at factors such as redness, thickness, scaling and the amount of skin affected. By using this scoring system, researchers can understand how much improvement you may experience after receiving a particular treatment.<\/p>\n\n\n\n

    Another important tool is the Investigator Global Assessment (IGA), which allows clinicians to assess the overall appearance and severity of psoriasis. Together, these measurements help researchers determine how effectively a treatment controls psoriasis and whether it could provide meaningful benefits for people managing the condition.<\/p>\n\n\n\n

    The Importance of Skin Clearance Outcomes<\/strong><\/h2>\n\n\n\n

    For many people living with psoriasis, achieving clearer skin is an important treatment goal. If you are managing psoriasis, you may want more than a small reduction in symptoms you may hope for noticeable improvement that helps you feel more comfortable and confident in your daily life.<\/p>\n\n\n\n

    Modern clinical trials increasingly focus on higher levels of skin clearance because researchers recognise that you may be looking for meaningful results rather than only partial symptom relief. These outcomes help doctors understand how well a treatment can reduce visible plaques and improve the overall impact of psoriasis.<\/p>\n\n\n\n

    The SELECT-PsO research has contributed to a better understanding of how targeted oral therapies may support improved disease control. As new treatments continue to be studied, you may have access to more options that aim to provide greater skin improvement and better long-term management of psoriasis.<\/p>\n\n\n\n

    The Role of Patient Quality of Life<\/strong><\/h2>\n\n\n\n
    \"\"<\/figure>\n\n\n\n

    Psoriasis can affect much more than the appearance of your skin. If you are living with the condition, you may experience emotional challenges such as stress, reduced confidence or worries about how others view your skin. These effects can influence your daily activities, relationships and overall wellbeing.<\/p>\n\n\n\n

    Modern clinical studies now recognise that quality of life is an important part of measuring treatment success, alongside improvements in physical symptoms. Researchers consider how treatments affect your comfort, confidence and ability to manage everyday life, not just how much your skin improves.<\/p>\n\n\n\n

    A successful psoriasis treatment approach should focus on both visible results and the wider impact of the condition on you. By addressing symptoms while also supporting your emotional and personal wellbeing, treatments can help you achieve better overall disease management and an improved quality of life.<\/p>\n\n\n\n

    Safety Monitoring During SELECT-PsO Research<\/strong><\/h2>\n\n\n\n

    Safety monitoring is a vital part of clinical trials, especially when you are being studied with medicines that affect immune pathways. Researchers carefully assess how treatments work in the body and monitor participants to identify any possible side effects during the study period.<\/p>\n\n\n\n

    Throughout the SELECT-PsO trials, researchers collected safety information to understand the potential benefits and risks of upadacitinib. This helps doctors and scientists evaluate whether a treatment provides meaningful improvements while maintaining an appropriate safety profile for people with psoriasis.<\/p>\n\n\n\n

    Long-term monitoring continues to be important even after new therapies become available in routine care. By continuing to study these medicines, healthcare professionals can better understand how they perform over time and help ensure that you receive treatment that is both effective and safe.<\/p>\n\n\n\n

    Clinical Tip: Targeted Oral Treatment Still Requires Careful Assessment<\/strong><\/p>\n\n\n\n

    An oral treatment is not automatically a low-risk or simple treatment option. Before starting upadacitinib for an approved indication, your specialist will consider your medical history, infection risk and other relevant health factors.<\/p>\n\n\n\n

    UK prescribing information recommends screening for tuberculosis before treatment. The medicine also has important safety considerations involving infection risk and certain cardiovascular and blood-clot risks, particularly in people with specific risk factors.<\/p>\n\n\n\n

    Do not start, stop or alter treatment yourself. Your specialist should explain the expected benefits, relevant risks and any monitoring needed for your individual circumstances.<\/p>\n\n\n\n

    Understanding JAK Inhibitors in Dermatology<\/strong><\/h2>\n\n\n\n

    JAK inhibitors represent an important development in the treatment of inflammatory conditions, including some skin diseases. If you are exploring newer psoriasis treatment options, you may come across these medicines as researchers continue to investigate how they can help manage inflammation more precisely.<\/p>\n\n\n\n

    These medicines work by affecting communication pathways inside your cells that are involved in immune activation and inflammation. Unlike some older treatments that can influence broader areas of immune function, JAK inhibitors are designed to target specific pathways linked to inflammatory activity.<\/p>\n\n\n\n

    Research into JAK inhibitors is continuing across a range of dermatological conditions. As scientists learn more about how these medicines work, you may see new possibilities emerging for more targeted and personalised approaches to managing inflammatory skin diseases.<\/p>\n\n\n\n

    Comparing Oral Treatments With Biologic Therapies<\/strong><\/h2>\n\n\n\n

    Biologic therapies continue to be an important treatment option for many people with moderate-to-severe psoriasis. If you are considering advanced treatment, you may know that biologics work by targeting specific immune proteins involved in psoriasis inflammation, helping to reduce symptoms and improve disease control.<\/p>\n\n\n\n

    Oral targeted treatments offer another approach by providing a tablet-based option with a different way of working inside your body. For some people, taking an oral medicine may be a more convenient choice, while others may prefer treatments delivered in different ways depending on their needs and circumstances.<\/p>\n\n\n\n

    Choosing between oral treatments and biologic therapies is a decision you should make with your healthcare professional. Your dermatologist will consider factors such as the severity of your psoriasis, previous treatments, overall health and personal preferences to help you find the most suitable option for your long-term care.<\/p>\n\n\n\n

    UK Guidance Note: How Is Upadacitinib Used in UK Psoriatic Disease Care?<\/strong><\/h2>\n\n\n\n

    In the UK, upadacitinib is authorised for active psoriatic arthritis in adults who have responded inadequately to, or cannot tolerate, one or more disease-modifying anti-rheumatic drugs.<\/p>\n\n\n\n

    NICE also recommends upadacitinib for selected adults with active psoriatic arthritis after inadequate response to DMARD treatment, within defined eligibility criteria.<\/p>\n\n\n\n

    This is different from having a licensed indication for standalone plaque psoriasis. If your main concern is skin psoriasis without psoriatic arthritis, your dermatologist will consider treatments that are specifically supported and authorised for that clinical situation.<\/p>\n\n\n\n

    The Move Towards Personalised Psoriasis Care<\/strong><\/h2>\n\n\n\n
    \"\"<\/figure>\n\n\n\n

    Modern psoriasis treatment is becoming increasingly personalised, meaning your care plan is based on your individual needs rather than a standard approach for everyone. If you are living with psoriasis, your treatment choices may depend on many different aspects of your condition and your overall health.<\/p>\n\n\n\n

    When recommending a therapy, your dermatologist will consider factors such as where your psoriasis appears, how severe your symptoms are, how you have responded to previous treatments, your lifestyle and any other health conditions you may have. These details help your healthcare team understand which options may work best for you.<\/p>\n\n\n\n

    This personalised approach aims to improve the chances of finding a suitable long-term treatment plan that fits your needs. By considering your symptoms, preferences and treatment goals, your dermatologist can help you make informed decisions and manage psoriasis more effectively over time.<\/p>\n\n\n\n

    Factors That Shape a Personalised Psoriasis Treatment Plan<\/strong><\/h2>\n\n\n\n
    Factor<\/strong><\/td>Why It Matters<\/strong><\/td>What Your Specialist May Consider<\/strong><\/td><\/tr><\/thead>
    Disease severity<\/td>More extensive or severe psoriasis may require a different treatment approach from limited disease<\/td>The extent, severity and activity of your psoriasis<\/td><\/tr>
    Areas affected<\/td>Psoriasis affecting areas such as the face, scalp, palms, soles, genitals or nails may have a substantial impact even when the total affected area is relatively small<\/td>The location of your psoriasis as well as the total area involved<\/td><\/tr>
    Quality-of-life impact<\/td>Two people with similar visible psoriasis can experience very different effects on everyday life<\/td>Physical discomfort, emotional wellbeing, relationships, work and social activities<\/td><\/tr>
    Joint symptoms<\/td>Psoriasis can occur alongside psoriatic arthritis<\/td>Symptoms such as joint pain, stiffness or swelling that may require further assessment<\/td><\/tr>
    Previous treatment response<\/td>Earlier treatments may have been ineffective, poorly tolerated or unsuitable<\/td>Which topical, phototherapy or systemic treatments you have previously used and how you responded<\/td><\/tr>
    Other health conditions<\/td>Comorbidities can influence whether particular treatments are suitable<\/td>Your wider medical history and individual treatment risks<\/td><\/tr>
    Treatment preferences<\/td>Different people have different priorities concerning treatment route, frequency and practical burden<\/td>Your preferences and the practical implications of each suitable option<\/td><\/tr>
    Ability to follow the treatment plan<\/td>Consistent treatment use and follow-up are important for assessing response<\/td>Whether the proposed treatment and monitoring schedule is manageable for you<\/td><\/tr>
    Long-term treatment goals<\/td>Psoriasis is a chronic condition, and treatment needs may change over time<\/td>The level of disease control you hope to achieve and how the plan should be reviewed as circumstances change<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

    Personalised psoriasis care means considering the whole picture rather than selecting treatment from a skin score alone. Your dermatologist can combine clinical findings, previous treatment experience, wider health considerations and your individual priorities when discussing the most appropriate options.<\/p>\n\n\n\n

    Why Specialist Guidance Matters<\/strong><\/h2>\n\n\n\n

    Advanced psoriasis treatments require careful assessment to ensure they are suitable for your individual needs. If you are considering a targeted therapy, your dermatologist can review your symptoms, medical history and previous treatments to help determine which options may be most appropriate for you.<\/p>\n\n\n\n

    A specialist can explain the different therapies available and help you understand the potential benefits, possible risks and what you can expect during treatment. This allows you to make informed decisions about your psoriasis care and choose an approach that aligns with your health goals.<\/p>\n\n\n\n

    Specialist guidance is particularly important when considering treatments that affect immune pathways, as these medicines require appropriate monitoring and follow-up. With ongoing support from your healthcare team, you can ensure your treatment remains safe, effective and suitable for your long-term management of psoriasis.<\/p>\n\n\n\n

    Future Research Into Oral Psoriasis Treatments<\/strong><\/h2>\n\n\n\n

    Research into oral psoriasis therapies is continuing to advance, creating new possibilities for people looking for effective and convenient treatment options. If you are living with psoriasis, these developments may provide you with more choices in the future, particularly if you are looking for alternatives to injectable treatments.<\/p>\n\n\n\n

    Scientists are exploring new medicines that aim to improve effectiveness, enhance safety and make long-term treatment easier to manage. These advances could help you achieve better control of your symptoms while offering treatment options that fit more naturally into your daily routine.<\/p>\n\n\n\n

    Future developments may allow doctors to select therapies that are more closely matched to your individual needs. By considering factors such as your symptoms, health history and response to previous treatments, personalised psoriasis care may become even more precise in the years ahead.<\/p>\n\n\n\n

    The Importance of Long-Term Disease Control<\/strong><\/h2>\n\n\n\n

    Psoriasis is a long-term condition, which means managing it often requires ongoing care and regular treatment decisions. If you are living with psoriasis, your goal may not only be to manage flare-ups when they appear but also to maintain better control and reduce how much the condition affects your daily life.<\/p>\n\n\n\n

    Effective treatment aims to provide lasting improvement by reducing symptoms, preventing frequent flare-ups and supporting your overall wellbeing. Finding the right approach can help you feel more comfortable and confident while making it easier to manage psoriasis over time.<\/p>\n\n\n\n

    Regular follow-up appointments allow your dermatologist to monitor your progress and make changes if your needs develop. As your symptoms, lifestyle or health circumstances change, your treatment plan can be adjusted to ensure it continues to provide the best possible support for you.<\/p>\n\n\n\n

    How Clinical Trials Shape Future Treatment<\/strong><\/h2>\n\n\n\n

    Clinical trials such as SELECT-PsO play an important role in shaping the future of psoriasis care. If you are living with psoriasis, the treatments available to you today are the result of years of careful research that helps doctors understand which therapies are effective and safe.<\/p>\n\n\n\n

    Through clinical trials, researchers can study how new treatments work, which people may benefit most and how these options compare with existing therapies. This information helps healthcare professionals make better-informed decisions when recommending treatments based on your individual needs.<\/p>\n\n\n\n

    This ongoing research process is essential for improving psoriasis management in the future. As scientists continue to explore new medicines and treatment approaches, you may benefit from more effective, personalised options that provide better long-term control of the condition.<\/p>\n\n\n\n

    The Future of Psoriasis Management<\/strong><\/h2>\n\n\n\n

    The future of psoriasis care is moving towards more personalised and precise treatment. Researchers are developing approaches that consider your individual disease pattern, medical history, and response to previous therapies. This may help doctors choose treatments that are better matched to your needs.<\/p>\n\n\n\n