Dr. Melinda Gooderham practices dermatology in Peterborough, Ontario, and is a well-known lecturer, speaker, and researcher with a special interest in atopic dermatitis, psoriasis, and skin cancer. She is also involved in clinical research, and is an investigator with Medical Probity Research, and has numerous contributions to dermatology, both as author and reviewer.
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Topical Roflumilast for Plaque Psoriasis
Targeting PDE4 with the selective inhibitor roflumilast, specifically through topical cream at a concentration of 0.3%, has proven to be an effective and well-tolerated strategy for treating plaque psoriasis.
A Practical Guide to Advanced Topical Drug Delivery Systems in Dermatology
This guide will help you navigate the benefits of recent advancements in topical drug formulations and delivery systems. These innovations address limitations seen in older formulations, ensuring efficient and uniform delivery of active ingredients to target areas, improving patient acceptability, and enhancing treatment outcomes.
Selective TYK2 Inhibition in the Treatment of Moderate to Severe Chronic Plaque Psoriasis
Moderate to severe chronic plaque psoriasis may be difficult to control using current therapies, which has led to development of a novel class of therapy, selective tyrosine kinase 2 (TYK2) inhibitors, to address this unmet need.
IL-23s: Psoriasis therapy overview
Biologics are protein-based medications that target specific parts of the immune system. IL-23 inhibitor specifically targets a type of cytokine called IL-23 and blocks cellular activity, which results in reduced inflammation that causes psoriasis.
Selecting from IL-23s
Tildrakizumab (Ilumya) is a brand-name biologic medication that’s used to treat moderate to severe plaque psoriasis. This drug is an interleukin (IL-23) inhibitor that’s very effective and works long-term to control the symptoms of psoriasis.
Tildrakizumab candidates
Unlike many other psoriasis treatments, tildrakizumab can be used in higher-risk populations, such as in the elderly or those with psoriasis in addition to other health conditions like inflammatory bowel disease (IBD) or psoriatic arthritis.
Tildrakizumab effectiveness related to trial results
After 12 weeks of treatment with tildrakizumab (Ilumya), over 50 percent of patients can be cleared of their psoriasis. This biologic drug was approved in Canada in October 2021.
Tildrakizumab effectiveness
People with psoriasis are frequently frustrated over treatments that are ineffective for them, such as tumor necrosis factor biologics, phototherapy, or systemic drugs (such as methotrexate). IL-23 inhibitors, like tildrakizumab, can be an important and effective therapeutic option when patients do not respond to other treatments.
Tildrakizumab long-term effectiveness
Research has shown high levels of effectiveness are maintained for 5 years and beyond with tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor.
Managing patients on Tildrakizumab
Tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor offers a convenient dosing schedule. Treatment is administered by subcutaneous injection at start of treatment, after 4 weeks, followed by every 12 weeks thereafter.
General thoughts on Tildrakizumab
With the availability of tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor, dermatologists are very optimistic about the continued success of this biologic drug used to treat psoriasis patients.
Tildrakizumab: the Patient Journey
Unlike many other psoriasis treatments, tildrakizumab can be used in higher-risk populations, such as in the elderly or those with psoriasis in addition to other health conditions like inflammatory bowel disease (IBD) or psoriatic arthritis.
Transition of Topical Therapy Formulation in Psoriasis: Insights from a Canadian Practice Reflective
The benefits of transitioning from Cal/BD ointment or gel to aerosol foam formulation in this Canadian patient population were similar to those reported in clinical studies and were seen consistently among patients with a range of treatment priorities and with differing history of psoriasis severity and treatment history.
Risankizumab, an IL-23p19 Inhibitor for Psoriasis: A Review of the Current Literature
The addition of biologics that target IL-23p19 (Risankizumab) to our therapeutic armamentarium has succeeded in improving outcomes in patients with moderate-to-severe plaque psoriasis.
A Closer Look at the Data Regarding Suicidal Ideation and Behavior in Psoriasis Patients: The Case of Brodalumab
There is no clear evidence that monoclonal antibodies influence neurological function and modulate behavior in humans. More research in this area is necessary in order to begin to understand the potential effects of..
A Closer Look at the Data Regarding Suicidal Ideation and Behaviour in Psoriasis Patients: The Case of Brodalumab...
When prescribing brodalumab, or any other biologic agent, physicians should screen patients for psychiatric comorbidities. Assessment of risk versus benefit, and having an honest conversation with patients regarding the label, will help provide better patient care for both physical and mental health.
Alitretinoin: An Update of Real-World Evidence in The Management of Chronic Hand Dermatitis
Alitretinoin is an oral retinoid which has proven efficacy and safety in the treatment of chronic hand dermatitis through randomized controlled trials.
Brodalumab: A Review of Safety
Interleukin (IL)-17 is important in the pathophysiology of psoriasis and has proven to be an effective therapeutic target. As brodalumab enters the marketplace, a review of this important biologic, its safety profile, and discussion of possible adverse effects is in order.
Chronic Hand Dermatitis: Case-based Approaches to Management
Practical guidelines for the management of Chronic Hand Dermatitis were published in the Skin Therapy Letter, Family Practice Edition (October 2016). This series of cases using Alitretinoin (Toctino®), is a follow on to that publication to put the guidelines into context.
Psoriasis, Depression, and Suicidality
Psoriasis is a chronic condition that affects the well-being and quality of life of patients. The disease is associated with an increased risk of depression and suicidality, which may not be fully understood by the general population.
Management of Adult Moderate-to-Severe Atopic Dermatitis: A Practical Guide for Primary Care
Atopic dermatitis (AD) is a chronic, relapsing, pruritic, inflammatory condition involving the skin which can have a significant impact on the quality of life. This article will guide the family practitioner on how to manage adults with moderate-to-severe AD and when to refer for specialist management.
Apremilast in the Treatment of Psoriasis and Psoriatic Arthritis (Family Practice)
Phosphodiesterase 4 (PDE4) is a key enzyme in the regulation of immune responses of inflammatory diseases through degradation of the second messenger, cyclic adenosine 3',5'-monophosphate (cAMP). Apremilast (APR), a selective PDE4 inhibitor, has been shown to reduce the production of pro-inflammatory cytokines.
Management of Chronic Hand Dermatitis: A Practical Guideline for the General Practitioner
Hand Dermatitis can have a significant impact on quality of life. It may interfere with activities both at work and in the home and can be associated with social and psychological distress. This article provides helpful practical guidance for the general practitioner in the management of patients with Hand Dermatitis.
Dupilumab, A Monoclonal Antibody for Atopic Dermatitis: A Review of Current Literature
Standard therapies for atopic dermatitis have fallen short, prompting efforts to discover novel therapeutics for this disease. Dupilumab, a fully human monoclonal antibody that inhibits the actions of both IL-4 and IL-13, has shown promise.
Apremilast in the Treatment of Psoriasis and Psoriatic Arthritis
Apremilast, a selective PDE4 inhibitor, has been shown to reduce the production of pro-inflammatory cytokines. A review of clinical trial data treating psoriasis, considering adverse effects, efficacy and tolerance.
Interleukin-17 (IL-17) Inhibitors in the Treatment of Plaque Psoriasis: A Review
Interleukin-17 (IL-17) is believed to be a potent driver of plaque psoriasis. This article reviews efficacy and safety results from Phase 2 and 3 trials with monoclonal antibodies targeting IL-17RA (brodalumab), and IL-17A (ixekizumab and secukinumab) for the treatment of plaque psoriasis.
Small Molecules: An Overview of Emerging Therapeutic Options in the Treatment of Psoriasis
While biologics changed the way psoriasis is treated by providing effective targeted therapy, they are not without limitations. Small molecules are emerging therapeutic options for the treatment of psoriasis.
Rosacea: Update on Management and Emerging Therapies
Rosacea is a common chronic skin disorder that has significant impact on the quality of life of affected individuals. Research interest has led to the development of other emerging therapies including topical ivermectin, brimonidine and oxymetazoline that hold promise for patients suffering from this condition.
Ingenol Mebutate: An Introduction
The incidence of nonmelanoma skin cancer continues to increase. This article discusses ingenol mebutate, its history, mechanism of action, and recent trial evidence for this emerging therapy are discussed.
Topical Vitamin D Analogues in Psoriasis Treatment (Pharmacist Editon)
This article focuses on topical D3 vitamin analogues for the treatment of psoriasis. Therapeutic efficacy, toxicity, patient adherence, combination therapy, and the family physician's role in psoriasis treatment are covered.
Topical Management of Psoriasis and the Role of Vitamin D3 Analogues
Psoriasis is a chronic, recurrent, immune-mediated, papulosquamous skin condition characterized by rapid proliferation of keratinocytes. This article focuses on the role of vitamin D analogues in the treatment of psoriasis.
Bedbugs: An Update on Recognition and Management
The common bedbug (Cimex lectularius) is increasingly prevalent and a source of concern and questions for patients. This article discusses entomology, clinical presentation, diagnostics and expedient identification.
Review of Management Options for Genital Herpes Infections
Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV). This article discusses an overview of HSV, diagnosis and workup, as well as treatment options for management of genital herpes.
Topical Management of Rosacea
This article reviews the various subtypes of rosacea, their clinical presentations, and the considerations in choosing the optimal therapeutic options. The importance of tailored treatment is discussed as well as topical therapies.
A Review of Therapeutic Options for Genital Warts
Condylomata acuminata (genital or venereal warts) pose a significant health concern, especially amongst young adults. External genital warts (EGWs) are caused by infection with the human papillomavirus (HPV), the same virus that causes the majority of cervical cancers.
Rosacea and Its Topical Management
Many options exist for the treatment of rosacea, including topical and systemic therapies, laser and light-based therapies, and surgical procedures. The goals of therapy include reduction of papules, pustules, erythema, physical discomfort, and an improvement in quality of life.