Dermatology

Elmets, C. A., C. L. Leonardi, D. M. R. Davis, J. M. Gelfand, J. Lichten, N. N. Mehta, A. W. Armstrong, C. Connor, K. M. Cordoro, B. E. Elewski, K. B. Gordon, A. B. Gottlieb, D. H. Kaplan, A. Kavanaugh, D. Kivelevitch, M. Kiselica, N. J. Korman, D. Kroshinsky, M. Lebwohl, H. W. Lim, A. S. Paller, S. L. Parra, A. L. Pathy, E. F. Prater, R. Rupani, M. Siegel, B. Stoff, B. E. Strober, E. B. Wong, J. J. Wu, V. Hariharan and A. Menter (2019). “Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities.” J Am Acad Dermatol 80(4): 1073-1113.

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Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations on the basis of available evidence.

Abramovits, W., A. Wiqas, K. D. Vincent, S. G. Versteeg and A. K. Gupta (2019). “Tremfya (Guselkumab).” Skinmed 17(1): 36-38.

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Tremfya™ is the first biologic in the class of anti-IL-23 antibodies to be marketed. There are two other promising options pending for approval and about to enter the market. Being first to market has afforded guselkumab uncontested prescription competitiveness when a biologic of this class is desired. Theoretical superiority of this and other anti-IL-23 biologics over anti-IL-17, anti-IL-12/23, or anti-TNF¬ biologics is being contested with head-to-head studies. Some studies have proved the superiority of anti-IL-23 antibodies in some parameters. Clinicians have the opportunity to choose the best performing and safest treatment, individualizing the needs and risks, which sometimes depend on comorbidities, like inflammatory bowel disease, for their patients with psoriasis and psoriatic arthritis. (Excerpt from text, p. 38; no abstract available.)

Reich, K., P. Rich, C. Maari, R. Bissonnette, C. Leonardi, A. Menter, A. Igarashi, P. Klekotka, D. Patel, J. Li, J. Tuttle, M. Morgan-Cox, E. Edson-Heredia, S. Friedrich and K. Papp (2019). “Efficacy and Safety of Mirikizumab (LY3074828) in the Treatment of Moderate-to-Severe Plaque Psoriasis: Results from a Randomised Phase 2 Study.” Br J Dermatol Feb 7. [Epub ahead of print].

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BACKGROUND AND OBJECTIVES: Inhibiting the interleukin (IL)-23 cytokine in patients with psoriasis has demonstrated high levels of skin clearance. In this Phase 2 (AMAF, NCT02899988), multicentre, double-blind trial, we investigated the efficacy and safety of three dose groups of mirikizumab (LY3074828), a p19-directed IL-23 antibody, compared to placebo in patients with moderate-to-severe plaque psoriasis. METHODS: Adult patients were randomised 1:1:1:1 to receive placebo (N=52), mirikizumab 30 mg (N=51), 100 mg (N=51), or 300 mg (N=51) subcutaneously at Weeks 0 and 8. The primary objective was to evaluate superiority of mirikizumab to placebo in achieving a 90% improvement in the Psoriasis Area and Severity Index (PASI 90) response at Week 16. Comparisons were done using logistic regression analysis with treatment, geographic region and previous biologic therapy in the model. Missing data were imputed as nonresponse. RESULTS: Ninety-seven percent of patients completed the first 16 weeks of Study AMAF. The primary endpoint was met for all mirikizumab dose groups versus placebo, with PASI 90 response rates at Week 16 of 0%, 29.4% (p=0.009), 58.8% (p<0.001) and 66.7% (p<0.001) for patients receiving placebo, mirikizumab 30 mg, 100 mg and 300 mg, respectively. There were 2 (1.3%) serious AEs in mirikizumab-treated patients compared to 1 (1.9%) placebo-group patient. CONCLUSIONS: At Week 16, 66.7% of patients treated with mirikizumab 300 mg at 8-week intervals achieved PASI 90. The percentage of patients reporting at least one treatment-emergent adverse event was similar among patients treated with placebo or mirikizumab.

Menter, A. and R. Warren (2019). “A Summary of 2018 and What Lies Ahead for Dermatology and Therapy in 2019.” Dermatol Ther (Heidelb) 9(1): 1-3.

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[A review of the year 2018 by the editors of the journal Dermatology and Therapy; no abstract available.]

Menter, A., B. E. Strober, D. H. Kaplan, D. Kivelevitch, E. F. Prater, B. Stoff, A. W. Armstrong, C. Connor, K. M. Cordoro, D. M. R. Davis, B. E. Elewski, J. M. Gelfand, K. B. Gordon, A. B. Gottlieb, A. Kavanaugh, M. Kiselica, N. J. Korman, D. Kroshinsky, M. Lebwohl, C. L. Leonardi, J. Lichten, H. W. Lim, N. N. Mehta, A. S. Paller, S. L. Parra, A. L. Pathy, R. N. Rupani, M. Siegel, E. B. Wong, J. J. Wu, V. Hariharan and C. A. Elmets (2019). “Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics.” J Am Acad Dermatol Feb 13. [Epub ahead of print].

Full text of this article.

Psoriasis is a chronic, inflammatory multisystem disease that affects up to 3.2% of the US population. This guideline addresses important clinical questions that arise in psoriasis management and care, providing recommendations based on the available evidence. The treatment of psoriasis with biologic agents will be reviewed, emphasizing treatment recommendations and the role of the dermatologist in monitoring and educating patients regarding benefits as well as associated risks.