Morning coffee with the experts in psoriasis and PsA: where are we in 2022?

Episode overview

Every physician is faced with the challenge of assigning the right therapy to the right patient. In this episode, our faculty will discuss the recent updates and practical experience on the comorbidity spectrum in psoriatic disease, the overlap between psoriasis and PsA, and also the different aspects such as nail psoriasis, inflammatory bowel disease (IBD), and metabolic syndrome. Which aspects are the most important in choosing therapy? How do patient and disease characteristics affect treatment decisions? Who should sit in the driving seat to determine the treatment? Watch these videos to find out.

The conversation is spread over five chapters:

1. Making the right diagnosis for psoriasis
2. New and emerging treatments for psoriasis and PsA
3. Where are we on nail psoriasis?
4. Where are we on IBD in psoriasis and PsA?
5. Where are we on metabolic syndrome in psoriasis and PsA?

Faculty

Podcast co-hosts:

Dr Alexander Egeberg
Associate professor of dermatology, and head of the psoriasis clinic at Bispebjerg Hospital in Copenhagen, Denmark

Professor Carlo Selmi
Professor and head of the Rheumatology and Clinical Immunology Unit at the Humanitas Hospital in Milan, Italy

Expert speaker:

Professor Ulrich Mrowietz
Head and founder of the Psoriasis Center in the Department of Dermatology at the University Medical Center Schleswig-Holstein in Kiel, Germany

Part 1: Making the right diagnosis for psoriasis

Making the right diagnosis is critical for clinical decision making. Is there any rule of thumb when diagnosing psoriasis in the rheumatology clinic? Who should make the diagnosis of psoriasis? Tune in to find out.

Reference:

Wilson FC, Icen M, Crowson CS, et al. Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study. Arthritis Rheum. 2009;61:233-9.

Part 2: New and emerging treatments for psoriasis and PsA

The latest generation of biologics has achieved the goal of having a long-term disease control with favourable efficacy and safety profile. Tune in to hear what new treatments have emerged for patients with psoriasis or PsA. What is the clinical consideration for selecting these treatments?

References:

Iznardo H, Puig L. Dual inhibition of IL-17A and IL-17F in psoriatic disease. Ther Adv Chronic Dis. 2021;12:20406223211037846.

McInnes IB, Rahman P, Gottlieb AB, et al. Long‐term efficacy and safety of guselkumab, a monoclonal antibody specific to the p19 subunit of interleukin‐23, through two years: results from a phase III, randomized, double‐blind, placebo‐controlled study conducted in biologic‐naive patients with active psoriatic arthritis. Arthritis Rheumatol. 2022;74:475-85.

Reich K, Warren RB, Lebwohl M, et al. Bimekizumab versus secukinumab in plaque psoriasis. N Engl J Med. 2021;385:142-52.

Part 3: Where are we on nail psoriasis?

In this segment, our faculty discuss the management of and the recommendations for treating nail psoriasis. What new treatments have emerged? How would Prof. Mrowietz approach his patient with nail psoriasis and select from the armament of systemic medications? Do not miss this podcast to help you nail it!

References:

Bardazzi F, Starace M, Bruni F, et al. Nail psoriasis: an updated review and expert opinion on available treatments, including biologics. Acta Derm Venereol. 2019;99:516-23.

Ji C, Wang H, Bao C, et al. Challenge of nail psoriasis: an update review. Clin Rev Allergy Immunol. 2021;61:377-402.

Thomas L, Azad J, Takwale A. Management of nail psoriasis. Clin Exp Dermatol. 2021;46:3-8.

Part 4: Where are we on IBD in psoriasis and PsA?

Psoriatic disease has a known association with IBD. What should you consider in managing psoriatic patients with Crohn’s disease? Is there any class of biologics that should be used with caution? Make sure to tune in.

References:

Antonelli E, Bassotti G, Tramontana M, et al. Dermatological manifestations in inflammatory bowel diseases. J Clin Med. 2021;10:364.

Ogdie A, Coates LC, Gladman DD. Treatment guidelines in psoriatic arthritis. Rheumatology (Oxford). 2020;59:i37-i46.

Schmitt H, Neurath MF, Atreya R. Role of the IL23/IL17 pathway in Crohn’s disease. Front Immunol. 2021;12:622934.

Part 5: Where are we on metabolic syndrome in psoriasis and PsA?

In this segment, our faculty discuss the strategies for selecting treatment options for patients with obesity and psoriatic disease, as well as patients at risk from cardiometabolic disease. Hear how Prof. Mrowietz takes a different approach for patients with psoriasis and obesity in terms of treatment.

References:

Campanati A, Marani A, Martina E, et al. Psoriasis as an immune-mediated and inflammatory systemic disease: from pathophysiology to novel therapeutic approaches. Biomedicines. 2021;9:1511.

Enos CW, Ramos VL, McLean RR, et al. Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: a prospective analysis in Corrona Psoriasis Registry. J Am Acad Dermatol. 2022;86:68-76.