Strategies and Pathways Targeting Domains in the Treatment of Psoriatic Disease
Release Date: 12/19/2022
Expiration Date: 12/19/2023
Time to Complete Activity: 1 hour
Mohamad Bittar, MD
College of Medicine
Department of Medicine
Division of Medicine—Rheumatology
The University of Tennessee Health Science Center
Alexis Ogdie, MD, MSCE
Associate Professor of Medicine and Epidemiology
Director, Penn Center for Clinical Epidemiology and Biostatistics
Director, Penn Psoriatic Arthritis and Spondyloarthritis Program
Perelman School of Medicine at the University of Pennsylvania
Hospital of the University of Pennsylvania
Cheryl Rosen, MD, FRCPC
Professor, Department of Medicine
University of Toronto
Head, Division of Dermatology
Toronto Western Hospital and University Health Network Hospitals
Toronto, Ontario, Canada
This activity has been designed to address the educational needs of rheumatology and dermatology clinicians. It may also be of benefit to other clinicians interested in the care of patients who have psoriatic disease.
This activity is provided by Paradigm Medical Communications, LLC.
In collaboration with Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).
This activity is supported by an educational grant from Janssen Biotech, Inc, administered by Janssen Scientific Affairs, LLC, and Novartis.
Psoriatic disease is a complex disease in which musculoskeletal and cutaneous inflammation occurs alongside hyperproliferation of both bone and skin. Patients have heterogeneous presentations of disease activity across 6 domains: Psoriasis, peripheral arthritis, enthesitis, dactylitis, spondylitis, and nail disease. Associated inflammatory processes give rise to additional conditions such as uveitis and inflammatory bowel disease, and comorbid metabolic diseases can further complicate disease management. Psoriatic arthritis (PsA) is frequently accompanied by fatigue, pain, and disability that negatively impact quality of life for patients and further challenge effective management. Aggressive targeted treatment started early in the disease process has demonstrated the best patient outcomes. New guidelines are available that provide treatment recommendations but are not concrete algorithms, so clinicians are left to make treatment decisions based on their understanding of agents’ mechanisms of action and personal experience without sufficient data because head-to-head data to inform decisions are lacking. In this roundtable discussion, rheumatologist and dermatologist faculty discuss the pathologic pathways targeted by biologic therapy, and screening to identify PsA in patients with psoriasis early. Cases are used to illustrate the complexities of psoriatic disease management, and as a springboard to show clinical application of recent guideline recommendations for treatment.
Upon completion of this activity, participants should be able to:
- Describe the mechanisms of action for targeted agents to treat psoriasis/PsA
- Develop treatment plans for patients with psoriasis/PsA based on clinical evidence, guideline recommendations, and individual disease manifestations and disease activity
- Make appropriate individualized treatment decisions based on assessment of patient phenotypes, disease activity, comorbidities, treatment experience, and preferences
Table of Contents
- Introduction to psoriatic disease domains
- Case 1: Axial PsA
- Case 2: Longstanding PsA and metabolic disease
- Discussion of treatment recommendations
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Mohamad Bittar, MD
Has no relevant financial relationships with ineligible companies to disclose
Alexis Ogdie, MD, MSCE
Consultant: AbbVie Inc.; Amgen Inc; Bristol-Myers Squibb Company; Celgene Corporation; CorEvitas; Eli Lilly and Company; Gilead Sciences, Inc.; Janssen Pharmaceuticals, Inc; Novartis AG; Pfizer Inc; UCB S.A.
Research Funding: AbbVie Inc. (paid to Penn); Amgen Inc (paid to National Databank for Rheumatic Disease and Forward Databank); Novartis AG (paid to Penn); Pfizer Inc (paid to Penn)
Cheryl Rosen, MD, FRCPC
Consultant: AbbVie Inc.; Amgen Inc; Novartis AG; UCB S.A.
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