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Psoriasis and Psoriatic Arthritis.

Psoriasis and psoriatic arthritis (PsA), while closely linked, have differences in outcomes with various systemic and biologic agents. Psoriasis is a lifelong disease, so maintaining long-term quality improvement is an important goal, with attention paid to therapeutic safety profiles and the multiple comorbidities of psoriasis.

The articles in this supplement provide us with information that includes 4-year data on secukinumab, and an important study comparing adalimumab with methotrexate for treating severe plaque psoriasis in children and adolescents. Another article draws attention to the critical need for psoriasis education to help diagnose PsA at an early stage, and an important review of screening for comorbidities in children with psoriasis also is presented.

A significant new finding of an increased risk of bone fractures across the full spectrum of psoriasis is discussed, as is an excellent study about the effect of gastric bypass surgery on psoriasis. There also are reports on psoriasis and PsA in pregnancy, as well as the first-known study linking higher rates of PsA in psoriasis patients with depression.

BY ALAN MENTER, MD

Dr. Menter is the chairman of dermatology at Baylor University Medical Center, and clinical professor of dermatology at the University of Texas Southwestern Medical School, both in Dallas. He is also cochair of the American Academy of Dermatology's Psoriasis Guideline Work Group. He is on the advisory board, is a consultant, is an investigator, and/or speaker for, and has received grants and/or honoraria from companies that include AbbVie, Allergan, Amgen, Anacor, Boehringer Ingelheim, Celgene, Dermira, Eli Lilly, Galderma, Janssen Biotech, LEO Pharma, Menlo, Novartis, Pfizer, Promius, and Regeneron.

Currently, more than 8 million people in the United States live with psoriatic disease, according to the National Psoriasis Foundation. The burden of psoriasis ranges from mild forms that may respond to topical therapy alone to moderate and severe disease that potentially require systemic therapy.

The stories on psoriasis in this year's supplement reflect the advances in our understanding of psoriasis that have led to more directed therapies and increased knowledge of associated inflammatory conditions. These include an expert analysis of the growing list of comorbidities associated with psoriasis, phase III data on a TNF-alpha inhibitor not yet approved for psoriasis, a monoclonal antibody that targets IL23 recently approved for psoriasis, and data on biosimilars.

Topical treatments remain an important mainstay for a significant proportion of patients, and another story focuses on an effective combination topical therapy with a favorable side-effect profile. Methotrexate remains a cornerstone for systemic therapy, and one of the articles in the supplement reviews a study that evaluated a new mode of administration for methotrexate. Moving on, we expect more developments over the next year, including more data on new topical therapies, as well as on biologies and biosimilars.

BY LINDA STEIN GOLD, MD

Dr. Stein Gold is director of dermatology research at Henry Ford Health System in Detroit. She has received honoraria and/or has served as an investigator for companies that include AbbVie, Actavis, Allergan, Aqua, Ferndale Laboratories, Galderma, La Roche-Posay, LEO Pharma, Lilly ICOS, Medicis Pharmaceutical, Merz Pharmaceuticals, Novartis, Pfizer, Promius, Stiefel, Taro Pharmaceuticals, and Valeant, and has served as an independent contractor for Roche.
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Author:Menter, Alan; Gold, Linda Stein
Publication:Dermatology News
Date:Oct 1, 2017
Words:526
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