Myth busting in psoriasis

Episode overview

Having psoriatic disease is a difficult journey as it affects more than just the skin. Patients have questions or concerns in each step of disease progression, and they seek advice on managing their condition. In this episode our expert speaker and co-hosts bust some common myths about psoriasis. Take the next step with us!

Tune in to find out how the experts debunk five myths:

Myth 1: Achieving clearance is a mission impossible
Myth 2: Long-term treatment may cause more harm than benefit for patients
Myth 3: Biologics are for later lines of treatment
Myth 4: Biologics can cause cancer
Myth 5: Biologics are only for young patients

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:

Dr Stefano Piaserico
Associate Professor of Dermatology at the University of Padua, Italy. Chief of the Regional Centre for Psoriasis and Head of Day Surgery at the Dermatology Unit at the University Hospital of Padua. 

Myth 1: Achieving clearance is a mission impossible
Psoriasis is a lifelong disease with long-term management. The question is: Is it realistic to get Psoriasis Area and Severity Index (PASI) 100 or absolute PASI zero? What is the patient expectation after years of treatment? Join Dr Piaserico as he recaps his clinical experience on this mission to achieve skin clearance.

References:
Blauvelt A, Papp KA, Griffiths CEM, et al. J Am Acad Dermatol. 2017;76:406-17.
Blauvelt A, Tsai T-F, Langley RG, et al. J Am Acad Dermatol 2022;86:827-34.
Leonardi C, Reich K, Foley P, et al. Dermatol Ther (Heidelb). 2020;10:431-47.
Papp KA, Lebwohl MG, Puig L, et al. Br J Dermatol. 2021;185:1135-45.
Reich K, Gordon KB, Strober BE, et al. Br J Dermatol. 2021a;185:1146-59.
Thaçi D, Piaserico S, Warren RB, et al. Br J Dermatol. 2021;185:323-34.
Warren RB, See K, Burge R, et al. Dermatol Ther (Heidelb). 2020;10:73-86.

Myth 2: Long-term treatment may cause more harm than benefit for patients
Effectiveness of any treatment depends on the patient’s severity of symptoms combined with their adherence. What should you discuss with your patient concerning stopping or continuing  a treatment? Which patient populations require special attention? What are the additional benefits of treatment with biologics? Make sure you watch this video to find out!

References:
Bissonnette R, Luger T, Thaçi D, et al. J Eur Acad Dermatol Venereol. 2018;32:1507-14.
Dohos D, Hanák L, Szakács Z, et al. Aliment Pharmacol Ther. 2021;53:220-33.
Egeberg A, Gisondi P, Carrascosa JM, et al. J Eur Acad Dermatol Venereol. 2020;34:1695-706.
Gisbert JP, Marín AC, Chaparro M. Am J Gastroenterol. 2016;111:632‐47.
Puig L, Costanzo A, Muñoz-Elías EJ, et al. Br J Dermatol. 2022;186:773-81.
Reich K, Gordon KB, Strober BE, et al. Br J Dermatol. 2021a;185:1146-59.

Myth 3: Biologics are for later lines of treatment
Treat early, treat right. Is there a difference treating early psoriatic patients that were defined with onset of disease before two years and chronic psoriatic patients? What are the potential candidates to stop the “psoriatic march”? How can early intervention with biologics by dermatologists impact in future development of PsA? Tune in to find out what are the challenges our experts are facing in their clinics.

References:
Boehncke W-H, Boehncke S, Tobin A-M, Kirby B. Exp Dermatol. 2011;20:303-7.
Eyerich K, Weisenseel P, Pinter A, et al. BMJ Open. 2021;11:e049822.
Gisondi P, Altomare G, Ayala F, et al. J Eur Acad Dermatol Venereol. 2017;31:774-90.
McGonagle DG, Zabotti A, Watad A, et al. Ann Rheum Dis. 2022;81:7-10.
Scher JU, Ogdie A, Merola JF, Ritchlin C. Nat Rev Rheumatol. 2019;15:153-66.
Zabotti A, Giovannini I, McGonagle D, et al. Dermatol Ther (Heidelb). 2022;12:5-8.

Myth 4: Biologics can cause cancer
“You’re not telling me, but I know, and I’ve read on the web that biologics cause cancer.” What considerations should physicians have for patients with higher risk of developing or with a history of cancer? Listen to our experts’ personal experience.

References:
Burmester GR, Panaccione R, Gordon KB, et al. Ann Rheum Dis. 2013;72:517-24.
Greuter T, Vavricka S, König AO, et al. Digestion. 2020;101 Suppl 1:136-45.
Kaushik SB, Lebwohl MG. J Am Acad Dermatol. 2019;80:27-40.
Nadeem MS, Kumar V, Al-Abbasi FA, et al. Semin Cancer Biol. 2020;64:51-60.
Peleva E, Exton LS, Kelley K, et al. Br J Dermatol. 2018;178:103-13.
Vaengebjerg S, Skov L, Egeberg A, Loft ND. JAMA Dermatol. 2020;156:421-9.
White MC, Holman DM, Boehm JE, et al. Am J Prev Med. 2014;46:S7-15.

Myth 5: Biologics are only for young patients
In this segment, our experts talk about the efficacy and safety of biologics in different age groups. Curious about which treatment would Dr Piaserico recommend for elderly patients? Don’t miss this video!

References:
Di Lernia V, Goldust M. Expert Opin Biol Ther. 2018;18:897-903.
Piaserico S, Conti A, Lo Console F, et al. Acta Derm Venereol. 2014;94: 293-7.
Ricceri F, Bardazzi F, Chiricozzi A, et al. J Eur Acad Dermatol Venereol. 2019;33:143-6.