Breaking News
September 24, 2018 - EPA Plan Will Maintain Carbon Emissions From Power Plants
September 24, 2018 - Characterizing pig hippocampus could improve translational neuroscience
September 24, 2018 - Element3 Health reports social and mental engagement play key role in overall health
September 24, 2018 - Paralympic medalists support Fight for Sight’s unique virtual event
September 24, 2018 - ADCETRIS drug receives approval in Japan as frontline treatment option for Hodgkin lymphoma
September 24, 2018 - Public awareness of urological conditions found to be alarmingly low across Europe
September 24, 2018 - Fitter Folks Suffer Milder Strokes: Study
September 24, 2018 - Novel botulinum toxin compound relieves chronic pain
September 24, 2018 - CHMP recommends approval of Gilenya for treatment of multiple sclerosis in children, adolescents
September 24, 2018 - National Friendly’s private medical insurance is a hit with women living in the South East
September 24, 2018 - Academics receive prestigious awards for achievements in blood pressure research
September 24, 2018 - Obese pregnant women can restrict weight gain safely with proper nutrition guidance
September 24, 2018 - CHMP adopts positive opinion of Takeda’s ALUNBRIG for treatment of ALK+ non-small cell lung cancer
September 24, 2018 - China NMPA approves LENVIMA for treatment of unresectable hepatocellular carcinoma
September 24, 2018 - A new approach for finding Alzheimer’s treatments
September 24, 2018 - USC research uncovers previously unknown genetic risk factor for dementia
September 24, 2018 - Study examining mental health among students finds significant disparities in treatment across race
September 24, 2018 - Breakthrough discovery paves way for future test to identify drowsy drivers
September 24, 2018 - Transcatheter mitral-valve repair in patients with heart failure
September 24, 2018 - Study opens new avenues for treatment of Laing distal myopathy
September 24, 2018 - Stroke Facts | cdc.gov
September 24, 2018 - Sarcolipin tricks muscle cells into using more energy, burning fat
September 24, 2018 - Enrollment in opioid controlled substance agreement reduces primary care visits
September 24, 2018 - UTA researchers patent new smart seat cushion technology that helps prevent painful ulcers
September 24, 2018 - Second HPV-Related Primary Cancers Common in Survivors
September 24, 2018 - How a virus destabilizes the genome
September 24, 2018 - Old letters provide insight into Spanish flu pandemic horror
September 23, 2018 - Smart textile-based soft robotic exosuit helps wearers save energy and traverse difficult terrain
September 23, 2018 - New research hub to drive radical change in development and manufacturing of vaccines
September 23, 2018 - AHA: For Hispanics, Neighborhood May Be Key Factor in Heart Disease Risk
September 23, 2018 - Excessive airway nerves tied to more severe asthma symptoms, study finds
September 23, 2018 - Study highlights need to remain vigilant in maintaining key infection control processes
September 23, 2018 - Novel therapeutic strategy for blood vessel related disorders, such as cancer and retinopathy
September 23, 2018 - New naturally occurring antibiotic found effective against Mycobacterium tuberculosis
September 23, 2018 - First-in-human phase 0 study shows clinically-relevant activity of new drug in glioblastoma
September 23, 2018 - Removing tobacco product display from shops reduced number of children buying cigarettes
September 23, 2018 - Random fraction of specialized immune cells leads the charge in battling invaders
September 23, 2018 - Few minutes of sprinting exercise may be as effective as longer exercise sessions
September 23, 2018 - Researchers use neutrons to make first direct observations of water in lipid bilayers
September 23, 2018 - Researchers demonstrate pre-clinical success for universal flu vaccine in new paper
September 23, 2018 - Study reveals surprising gaps in some HIV medical providers’ knowledge of ACA
September 23, 2018 - Oxehealth secures European medical device accreditation for vital signs measurement software
September 23, 2018 - HTN Tx Intensification Common Upon Discharge in U.S. Vets
September 23, 2018 - Fibre can strengthen the intestinal barrier
September 23, 2018 - New platform examines infectious pathogens that may spread from animals to humans
September 23, 2018 - Demographers create detailed color map of population aging in Europe
September 23, 2018 - New type of fatty acid can slow down overreactive immune system
September 23, 2018 - Innovative procedure could provide breakthrough in treating early-stage lung cancer
September 23, 2018 - Research finds drop in number of measles cases in the EU/EEA since March 2018
September 23, 2018 - Researchers acquire new insights into DNA polymerases
September 23, 2018 - Alzheimer’s diagnosis might become simpler with new brain imaging method
September 23, 2018 - Reports Warn of Growing Opioid Crisis Among Seniors
September 23, 2018 - Researchers unravel why people with HIV suffer from more neurologic diseases
September 23, 2018 - Human brain structured to make best possible decision with limited resources
September 23, 2018 - KHN’s ‘What the Health?’ Health on the hill
September 23, 2018 - Bad air and inadequate data prove an unhealthy mix
September 23, 2018 - Regular bedtime and wake time important for heart, metabolic health even among adults
September 23, 2018 - HIV and a tale of a few cities
September 23, 2018 - NIH launches clinical trial to test infusions of combination antibodies in people with HIV
September 23, 2018 - Researchers develop new system to detect consumption of synthetic cannabinoids
September 23, 2018 - Vax-Hub to influenze radical change in development and manufacturing of vaccines
September 23, 2018 - People who have slept lesser than seven hours have higher risks of car crashes
September 23, 2018 - an ancient art may work best to prevent falls in old age
September 23, 2018 - Consumption of foods with lower nutritional quality related to increased cancer risk
September 23, 2018 - Patient Health Information Often Shared Electronically
September 23, 2018 - Can machine learning bring more humanity to health care?
September 23, 2018 - Body organs undergo structural changes in response to diet
September 23, 2018 - Genetic polymorphisms linked with muscle injury and stiffness
September 23, 2018 - As states try to rein in drug spending, feds slap down one bold Medicaid move
September 22, 2018 - Why Eczema Is Tougher to Treat for Black Patients
September 22, 2018 - Team reveals that human genome could contain up to 20 percent fewer genes
September 22, 2018 - USC research uncovers previously unknown genetic risk factor for Alzheimer’s disease
September 22, 2018 - Novel method achieves accurate and precise temperature estimation in fat-containing tissues
September 22, 2018 - BSI accredits Oxehealth’s vital signs measurement software as Class IIa medical device
September 22, 2018 - Evolution of psychiatric disorders and human personality traits
September 22, 2018 - Obesity in early puberty doubles asthma risk for boy’s future offspring
September 22, 2018 - World’s most advanced real-time patient monitoring platform receives key US patent
September 22, 2018 - Study explores connection between sexuality and cognitive status in older adults
September 22, 2018 - LSTM partners with TB Alliance to develop novel TB drug regimens
September 22, 2018 - Annual wellness visits improve delivery of preventive services in elderly population
Switching Biologics in Psoriasis Care

Switching Biologics in Psoriasis Care

image_pdfDownload PDFimage_print

With so many new and effective therapy options available for psoriasis, dermatologists need to focus on evaluating and adjusting treatments to help all patients achieve clear or almost clear skin, according to said Abby S. Van Voorhees, MD, of Eastern Virginia Medical School in Norfolk.

Special attention may be needed for patients who are obese, or who have psoriatic arthritis, inflammatory bowel disease (IBD), or a fear of injections, she said in a presentation at the American Academy of Dermatology annual meeting in San Diego.

“It’s critically important that we get more people clear,” said Van Voorhees, who chairs the National Psoriasis Foundation (NPF) Medical Board. In 2016, NPF published treatment targets for psoriasis.

She pointed out that as the number of options has grown, the key clinical question is no longer “‘What can I use?’ but instead, ‘Where to start?’ and then; ‘Which one to use next?’ We have so many therapies now, so if one drug doesn’t work, we should consider trying to switch to another to see if we can optimize response.”

While insurance considerations may dictate choices, physicians should consider comorbid diseases prior to selecting an initial treatment. For example, obesity can influence treatment choice. Treatment options that offer a weight-based dosing approach, or those that have demonstrated very high PASI 75 scores in clinical trials, may be appropriate in this case.

When one systemic agent fails, the next choice of therapy might depend upon the degree of response to initial therapy. For example, if a patient has any response to one tumor necrosis factor inhibitor (TNF) such as etanercept (Enbrel), it could be reasonable to consider another agent in the class, such as adalimumab (Humira), she said.

“If we had a patient who totally failed the [etanercept] and they had no response whatsoever, then I’d be a little concerned that they wouldn’t respond to another TNF inhibitor,” she added.

The NPF treat-to-target recommendations suggests that target response be a body surface area of ≥1%.

When targets aren’t met, new discussions about treatment options that take into account clinical, socioeconomic, and behavioral factors that could influence treatment outcomes. Switching treatments, dose escalation, or combination therapies may also be considered. “These discussions also need to take into account a continual assessment of patient satisfaction,” Van Voorhees said.

Fear of injections may also guide treatment choice. For patients with this concern, an oral therapy, or one that requires fewer doses, might be appropriate. Patient education to address fears associated with injections may also be necessary.

In Self Injections 101, the NPF suggests that patients consider rotating injection sites from right to left to help reduce injection site soreness and pain, and to avoid areas with active flare-ups.

The NPF recommends numbing the injection site with an ice cube, and warming up the drug, either by removing it from the refrigerator about 30 minutes prior to injection or by placing it under the arm until it reaches room temperature.

This article originally appeared on our partner’s website Dermatology Times, which is a part of UBM Medica. (Free registration is required.)

Van Voorhees disclosed relevant relationships with AbbVie, Allergan, Celgene, Derm Tech International, Dermira, Merck, Novartis, and WebMD.

2018-02-25T18:00:00-0500

Tagged with:

About author

Related Articles