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.
A Review of Ixekizumab, an Anti-Interleukin-17A Monoclonal Antibody, for Moderate-to-Severe Plaque Psoriasis
Recent advances in our understanding of the innate and adaptive immune systems have led to the identification of interleukin (IL)-17 as a key pro-inflammatory mediator in psoriasis. We review phase 1-3 clinical trials of ixekizumab, for treatment of moderate-to-severe plaque psoriasis.
Adherence to topical treatment for psoriasis remains a challenge as the daily application creates a significant treatment burden. New topical therapeutic options need to offer a combination of higher efficacy and better patient acceptability, including...
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.
Psoriasis, acne vulgaris and photoaging are common conditions. Tazarotene is a pro-drug of tazarotenic acid, a receptor-selective retinoid, which has shown efficacy in the treatment of these disorders. In the treatment of acne vulgaris, it has greater comedolytic activity than the currently available topical retinoids.
Pregnancy is characterized by multiple physiologic changes. Herein, we review the complicated relationships between psoriasis and pregnancy.
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.
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.
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.
Once Daily Application of a Combination of Calcipotriol and Betamethasone Dipropionate (Dovobet®, Daivobet®) for the Treatment of Psoriasis
This new compound product containing 50µg/gm calcipotriol and 0.5mg/gm betamethasone dipropionate was recently introduced in Canada for the treatment of psoriasis. Clinical trials demonstrated that this compound was more active than either agent used alone.
Psoriasis is a common dermatosis, affecting children in North America. Many papers have stressed the treatments available for adult psoriasis, but few have dealt with this disorder in children. Topical treatment modalities continue to be the first line therapy for childhood 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.
Calcipotriol and Betamethasone Dipropionate (Dovobet®, Daivobet®): A New Formulation for the Treatment of Psoriasis
A new compound product containing calcipotriol 50μg/gm and betamethasone dipropionate 0.5mg/gm (Dovobet*, LEO Pharma) in an ointment base was recently introduced in Canada for the treatment of psoriasis.
Psoriasis types and subtypes can influence preferred treatment modality. This article discusses the symptoms specific to the psoriasis subtype, and considerations for selecting treatment.
Etanercept is a tumor necrosis factor antagonist with anti-inflammatory effects. It is currently approved in the US for psoriasis, psoriatic arthritis, ankylosing spondylitis, rheumatoid arthritis and juvenile rheumatoid arthritis. Clinical trials have shown this agent to have an excellent safety profile and to be well tolerated by both adult and pediatric patients.
Alefacept (AMEVIVE™ or LFA3TIP, Biogen) is the newest systemic therapy for chronic plaque psoriasis and was approved by the US FDA in January 2003. Clinical studies have shown that alefacept, given via weekly IM or IV injections for 12 weeks, was well tolerated, with no reported serious adverse events.
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.
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.
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.
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.
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.
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.
The choice of treatment for psoriasis in children, as in adults, is determined by disease acuity, morphology, distribution, and severity. Part II of this 2-part series features an overview of systemic and light therapies including their varying degrees of effectiveness, potential side-effects and applications in clinical practice.
Although biologics are well-studied, expertise regarding their use is often lacking. Many biologics have been added to the market in recent years with distinctive characteristics. This study was designed to create a tool to assist physicians involved in the care of patients with psoriasis undergoing biologic treatment.
Dovobet®/ Daivobet®/ Taclonex® is a product combining two molecules, calcipotriol and betamethasone dipropionate, that may offer psoriatic patients with an option for maintenance therapy. The efficacy and safety of this combined formulation when used over a 4-week period is well documented.
For many years, clinicians have expressed ongoing concerns about treatment adherence by patients, especially pertaining to those with chronic skin disorders. Although crucial to effective therapeutic outcomes, the issue of patient adherence has been largely ignored in dermatologic disease management until recently.
Psoriasis represents a potentially life-altering disease that can profoundly impact physical, emotional and social functioning, and overall quality of life. Part I of this 2-part series will focus on topical agents, their varying degrees of effectiveness, potential side-effects and applications in clinical practice.
A novel fixed combination lotion containing the super-potent corticosteroid halobetasol propionate 0.01% and retinoid tazarotene 0.045% (Duobrii™) has recently been introduced and indicated for the treatment of moderate to severe plaque psoriasis in adults.
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.
Although PDT remains an investigational treatment modality in dermatology, several important areas of development may ultimately lead to official and practical acceptance of PDT for the skin. Various uses of PDT are evaluated.
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.
Etanercept has recently been approved for the treatment of moderate-to-severe plaque psoriasis at a dose of 50mg twice per week for 12 weeks followed by a maintenance dose of 50mg once weekly thereafter. Clinical studies have shown excellent efficacy and a good safety profile in patients with psoriasis.
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.