Bimekizumab is a novel treatment for moderate-to-severe plaque psoriasis that has shown promising efficacy and safety in clinical trials. By simultaneously targeting two components of the IL-17 pathway, IL-17A and IL-17F, the biologic can downregulate proinflammatory signaling and rapidly improve patients’ skin.
A fixed combination halobetasol propionate and tazarotene lotion (HP/TAZ) was launched in Canada in 2020, to treat moderate to severe plaque psoriasis in adults. With the use of polymeric emulsion technology, there is uniform distribution of HP and TAZ and excipients on the skin and improved skin moisturization.
Biologics are one of the more effective and relatively safe options for long-term control of psoriasis. They have reduced the time needed to clear the signs of chronic disease, and are effective in maintaining a disease-free state for longer durations. Biologics can safely be used with other treatment modalities (i.e., methotrexate, cyclosporine, acitretin and hydroxyurea).
In the past three decades, major advances have been made in understanding the pathogenesis of psoriasis. This review focuses on the role of IL-23 in psoriasis pathogenesis and the current therapies targeting IL-23 that are being studied in clinical trials.
In this review, we summarize the most common immunosuppressant medications currently used in dermatology, and provide recommendations for infection screening prior to initiating treatment.
If methotrexate were introduced as a new drug today, it would be hailed as a major advance in the management of psoriasis, as well as for a number of other conditions. When patients are properly screened and educated about the correct use of this drug, and appropriately monitored during treatment, MTX is often very safe, simple to use, inexpensive, and well-tolerated.
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..
The Impact and Treatment of Psoriasis in Manitoba Dermatology Clinics: The Case for Calcipotriol-Betamethasone Dipropionate Foam Formulation
In a small real-world patient case review study, dermatologists tested the efficacy, safety and patient preference of Enstilar®, a calcipotriol-betamethasone dipropionate (Cal/BD).
This article discusses the role that dermatologists can play in recognizing the cutaneous manifestations linked with some systemic conditions. Identifying the underlying disorder will contribute to appropriate diagnosis and improved management.
Psoriasis is thought to arise from a combination of pathogenic factors including genetic susceptibility and environmental exacerbation. This article reviews the current status of guselkumab as a therapy for moderate-to-severe plaque psoriasis.
Long-term Management of Psoriasis: Flexible Therapeutic Regimens Providing Safe and Effective Outcomes
Psoriasis is a chronic, inflammatory skin condition prone to periods of skin flaring. As our understanding of the etiology of psoriasis becomes clearer, the treatment regimes can be better tailored to control the disease and address psychological fears of patients.
Tildrakizumab is a promising therapeutic option for patients with moderate-to-severe chronic plaque psoriasis. The specificity of the drug in targeting the p19 subunit of IL-23 allows for the high efficacy and safety of long-term treatment as demonstrated in clinical trials.
A review of this list of agents that are presently undergoing clinical trial. Although only a few of the drugs on this list will gain regulatory approval, what is exciting is the likelihood that some new agents will be approved and will radically alter the way we treat psoriasis.
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.
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.
The exact role of biologics in the treatment of pediatric psoriasis remains undefined but evolving. This article will provide a summary of the cumulative pediatric safety and efficacy data for the anti-tumor necrosis factor-alpha (TNF-α) agents and interleukin (IL)-12 and IL-23 (IL12/23) pathway inhibitor.
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.
Biologics plays an important role in treating moderate to severe psoriasis. This article looks at combination treatment with traditional systemics and topicals, and the possible benefits of this approach.
Hand and foot psoriasis is a chronic and debilitating disease that manifests as plaque-type or pustular-type lesions. Although the palms and soles represent only 2% of the total body surface area, psoriasis of these regions may lead to physical dysfunctions that can greatly impair dexterity, mobility, and the quality of life.
Moderate-to-severe psoriasis is known to affect millions of people around the globe. This chronic disease substantially impacts patients by impairing their quality of life. The biologics are the newest and most effective therapeutic weapon in the treatment of moderate-to-severe psoriasis and psoriatic arthritis.
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.
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.
Patients suffering from scalp psoriasis frequently seek medical care because of the persistent discomfort due to itching and social embarrassment. This article explores some of the challenges that patients fact, current options and new advances in the topical management and strategies that may improve treatment outcomes.
Sirolimus, also known as rapamycin (SRL, Rapamune®), was approved in 1999 by the US Food and Drug Administration to prevent graft rejection in renal transplantation. This articles reviews Sirolimus, its pharmacokinetics, mechanism of action, and indication.
Chronic palmoplantar pustular psoriasis is a disabling condition characterized by recurrent crops of sterile pustules on a background of erythema, fissuring and scaling. Genetic and environmental factors have been implicated in its etiology.
Etanercept (Enbrel®, Amgen and Wyeth), a tumor necrosis factor (TNF) antagonist, was approved in January 2002, for the treatment of psoriatic arthritis (PsA). Etanercept was evaluated for the treatment of PsA and psoriasis in a preliminary study of 60 patients and in a confirmatory phase III study of 205 patients.
Biologic compounds are being used more frequently to treat a multitude of systemic inflammatory conditions. This article discusses the increased risk of opportunistic infections of tuberculosis, herpes zoster, Legionella pneumophila, and Listeria monocytogenes.
Approximately 50% of patients with psoriasis have nail psoriasis but the life time chance of nail changes must be much higher. Nail changes in psoriasis include pitting, thickening, onycholysis, discoloration, oily spots, splinter hemorrhages and paronychia. Treatment of choice depends on the form the psoriasis takes.
Psoriasis and eczema can at times be recalcitrant to conservative topical treatment. This article focuses on corticosteroid strength and their appropriate uses for various presentations.
Pregnancy is characterized by multiple physiologic changes. Herein, we review the complicated relationships between psoriasis and pregnancy.
Psoriasis is associated with comorbidities that include metabolic syndrome and increased cardiovascular risk. These conditions share etiologic features and health consequences that directly correlate with the severity of psoriatic disease.
Patients suffering from scalp psoriasis frequently seek medical care because of the persistent discomfort and social embarrassment caused by the visible flakes that are shed onto clothing. However, the presence of hair makes it challenging to apply medication to the scalp.
The scalp is involved in up to 80% of individuals with psoriasis. Topical treatment with corticosteroids with or without vitamin D3 analogues is the mainstay of treatment, but other therapies such as light treatment and systemic drugs including biologics are discussed.