Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics

Menter, Alan; Strober, Bruce; Kaplan, Daniel H.; Kivelevitch, Darío; Prater, Elizabeth Farley; Stoff, Benjamin K.; Armstrong, April W.; Connor, Cody; Cordoro, Kelly M.; Davis, Dawn M.; Elewski, Boni E.; Gelfand, Joel M.; Gordon, Kenneth B.; Gottlieb, Alice B.; Kavanaugh, Arthur; Kiselica, Matthew; Korman, Neil J.; Kroshinsky, Daniela; Lebwohl, Mark; Leonardi, Craig L.; Lichten, Jason; Lim, Henry W.; Mehta, Nehal N.; Paller, Amy S.; Parra, Sylvia L.; Pathy, Arun L.; Rupani, Reena; Siegel, Michael; Wong, Emily; Wu, Jashin J.; Hariharan, Vidhya; Elmets, Craig A.

doi:10.1016/j.jaad.2018.11.057

Cited by 676 publications

(779 citation statements)

References 300 publications

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“…According to published NPF (Menter et al, ; Rosenbach et al, ), French (Amatore et al, ), and Canadian (S. Hsu, ) guidelines.…”

Section: Treatment Strategies For Specific Types Of Psoriasismentioning

confidence: 99%

“…Etanercept has been used more than the other TNF inhibitors(Amatore et al, ; Burden & Kirby, ). Secukinumab is recommended for palmoplantar pustulosis in AAD and NPF guidelines (Menter et al, ).…”

Section: Treatment Strategies For Specific Types Of Psoriasismentioning

confidence: 99%

“…Certolizumab, tildrakizumab, and risankizumab are used for plaque type of psoriasis. Secukinumab is used for palmoplantar pustulosis as well (Menter et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…If the targeted response is not achieved within 12 weeks, either escalation of the dosage by more frequent administration (as in infliximab given every 4–6 weeks instead of every 8), or giving the upper dose limit (as in ustikenumab at a dose of 90 mg instead of 45 mg), or combination with other therapies topical, phototherapy or systemic (Menter et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Biologics are usually given in a loading phase followed by a maintenance phase. In cases of readministration of a biologic after discontinuation for more than 3–4 half‐lives, or flaring of the disease while receiving a biologic, loading doses are repeated (Menter et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Practical compendium for psoriasis management

Ibrahim

Amer

Nofal

et al. 2020

Dermatologic Therapy

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Psoriasis management is complex and challenging. It should be tailored for each patient. Treatment strategy differs according to patient's age, sex, disease type, disease severity, burden on patient's quality of life, comorbidities, involvement of specific sites, and pregnancy. The choice of the appropriate therapeutic must take into consideration the availability, the price, and the patient's preferences. It is very important that the chosen treatment is not more unpleasant, intolerable, or dangerous than the disease itself. According to the disease type, severity, and effect on patient's quality of life, dermatologist chooses whether to start with topical therapy, phototherapy or systemic therapy, or a combination of two or more of them. Under each category, there are different types of therapies that can be the first line therapeutics, second line, or even contraindicated. In this compendium, we provide dermatologists with different treatment plans considering all the mentioned variables so that a dermatologist can choose the optimum plan for the patient.

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“…According to published NPF (Menter et al, ; Rosenbach et al, ), French (Amatore et al, ), and Canadian (S. Hsu, ) guidelines.…”

Section: Treatment Strategies For Specific Types Of Psoriasismentioning

confidence: 99%

Section: Treatment Strategies For Specific Types Of Psoriasismentioning

confidence: 99%

“…Certolizumab, tildrakizumab, and risankizumab are used for plaque type of psoriasis. Secukinumab is used for palmoplantar pustulosis as well (Menter et al, ).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Practical compendium for psoriasis management

Ibrahim

Amer

Nofal

et al. 2020

Dermatologic Therapy

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Pathophysiology, Clinical Presentation, and Treatment of Psoriasis

Armstrong

Read

2020

JAMA

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1,378

1,105

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ImportanceApproximately 125 million people worldwide have psoriasis. Patients with psoriasis experience substantial morbidity and increased rates of inflammatory arthritis, cardiometabolic diseases, and mental health disorders.ObservationsPlaque psoriasis is the most common variant of psoriasis. The most rapid advancements addressing plaque psoriasis have been in its pathogenesis, genetics, comorbidities, and biologic treatments. Plaque psoriasis is associated with a number of comorbidities including psoriatic arthritis, cardiometabolic diseases, and depression. For patients with mild psoriasis, topical agents remain the mainstay of treatment, and they include topical corticosteroids, vitamin D analogues, calcineurin inhibitors, and keratolytics. The American Academy of Dermatology-National Psoriasis Foundation guidelines recommend biologics as an option for first-line treatment of moderate to severe plaque psoriasis because of their efficacy in treating it and acceptable safety profiles. Specifically, inhibitors to tumor necrosis factor α (TNF-α) include etanercept, adalimumab, certolizumab, and infliximab. Other biologics inhibit cytokines such as the p40 subunit of the cytokines IL-12 and IL-13 (ustekinumab), IL-17 (secukinumab, ixekizumab, bimekizumab, and brodalumab), and the p19 subunit of IL-23 (guselkumab, tildrakizumab, risankizumab, and mirikizumab). Biologics that inhibit TNF-α, p40IL-12/23, and IL-17 are also approved for the treatment of psoriatic arthritis. Oral treatments include traditional agents such as methotrexate, acitretin, cyclosporine, and the advanced small molecule apremilast, which is a phosphodiesterase 4 inhibitor. The most commonly prescribed light therapy used to treat plaque psoriasis is narrowband UV-B phototherapy.Conclusions and RelevancePsoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients’ quality of life. Topical therapies remain the cornerstone for treating mild psoriasis. Therapeutic advancements for moderate to severe plaque psoriasis include biologics that inhibit TNF-α, p40IL-12/23, IL-17, and p19IL-23, as well as an oral phosphodiesterase 4 inhibitor.

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Roflumilast for Chronic Plaque Psoriasis

Cordoro

2022

JAMA

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Plaque psoriasis is a multisystem inflammatory disease that affects children and adults. Skin lesions are the most prominent manifestation, appearing as localized or widespread red plaques with silvery scale. Psoriasis may be associated with arthritis, obesity, metabolic syndrome, psychiatric disease, impaired quality of life, and increased risk of cardiovascular disease. 1 The etiology and precise pathogenesis of psoriasis remain unclear. Treatment selection depends on body surface area affected, lesion characteristics (thickness, location), symptoms such as itch and pain, and comorbidities. Topical medications are prescribed in almost all cases, alone or in combination with other therapies. 2 Complex topical regimens using several drugs are often prescribed because different body sites have unique characteristics (skin thickness, hair, skin-to-skin occlusion) that require different vehicle formulations (cream, ointment, oil, foam) and alternating treatment schedules to increase effectiveness and reduce toxicity. 3 As opposed to new systemic agents, few new topical treatments for psoriasis have been identified in the recent past. Prior to 2022, when the US Food and Drug Administration (FDA) approved tapinarof (in May), an aryl hydrocarbon receptor modulating agent for adults, and roflumilast, a PDE4 inhibitor for adults and children 12 years and older (in July), there has not been a new topical mechanism approved for psoriasis in more than a decade. A topical PDE4 inhibitor, crisaborole, and an oral PDE4 inhibitor, apremilast, are currently FDA approved for treatment of atopic dermatitis in patients aged 3 months and older and treatment of psoriasis in patients aged 18 years and older, respectively.In this issue of JAMA, Lebwohl and colleagues 4 present data from the PDE4 Inhibition with Roflumilast for the Management of Plaque Psoriasis (DERMIS-1 and -2) clinical trials. These identically designed, randomized, double-blind, vehicle-controlled phase 3 trials randomized a total of 881 patients to test the safety, efficacy, and patient-reported outcomes of the PDE4 inhibitor roflumilast cream, 0.3%, compared with vehicle, applied once daily to plaque psoriasis for 8 weeks. Participants were aged 2 years and older (mean age, 47.5 years) with plaque psoriasis involving the face, extremities, trunk, or intertriginous areas affecting 2% to 20% of body surface area (BSA) and a minimum of mild disease as defined by the Investigator Global Assessment 5 (IGA) and the Psoriasis Area and Severity Index 6 (PASI). The IGA and PASI are investigator-reported scales used in clinical trials to measure severity and extent from 0 (clear) to 4 (severe) and 0 (no disease) to 72 (maximal disease), respectively. Itch and other patient-reported symptoms and experiences are captured with Worst Itch Numerical Rating Score 7 (WI-NRS) and

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Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics

Cited by 676 publications

References 300 publications

Practical compendium for psoriasis management

Practical compendium for psoriasis management

Pathophysiology, Clinical Presentation, and Treatment of Psoriasis

Roflumilast for Chronic Plaque Psoriasis

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