Biologic therapy is a treatment that strives to modulate a patient's immune system to fight a given disease. In psoriasis, a skin disorder that is partly caused by a dysregulated immune system resulting in well-demarcated red areas of the skin with white scales, biologic therapy has the potential to vastly improve upon patient outcomes by minimizing the symptoms of this disease while maximizing the safety profile of the therapy. This book offers an up-to-date and comprehensive review on biologic therapy for the treatment of psoriasis. With over 10 FDA approved biologic agents for psoriasis (with more in the pipeline), confusion exists among providers regarding which agent is best for a particular patient. Chapters cover all FDA approved psoriasis biologic agents (including pipeline agents) for use in pediatric, adult, and geriatric patients. This book is unique in that it will not only cover cutting edge treatment principles based on the latest research, it will also be one of the most comprehensive reviews of psoriasis biologics in the COVID-19 era. Biologic Therapy for Psoriasis is a must-have resource for board certified dermatologists and rheumatologists, dermatology and rheumatology residents and fellows, dermatology physician assistants, nurse practitioners and medical students. The ultimate goal of this book is to improve patient care by making the busy practicing dermatology provider more adept with these particular therapies.
Dermatologists are being asked to understand the pathophysiology of a number of immune-mediated skin diseases. In addition, a number of new products have appeared on the market during the past decade which requires an understanding of the mechanisms of action of these drugs. Dermatologists, however, have no easily understood book to which they can refer to regarding the disease or the drug.
This book provides up-to-date coverage of selected topics in nucleic acid oxidation. The topics have been selected to cover everything from basic chemical mechanisms, repair of damage and the biological and pathological meaning of DNA oxidation. The chapters are authored by leading, research active, international experts in the respective topics.
Written by experts in the dermatology field, this new fourth edition of Moderate-to-Severe Psoriasis discusses the current use of biologics and other pharmacologic and phototherapy treatments for moderate-to-severe psoriasis. Illustrated with high quality color figures, this standalone text emphasizes safe and effective treatments for the psoriasis patient that are perfect for the dermatologist in daily practice. New to this edition are chapters on day treatment programs, new agents, erythrodermic and pustular psoriasis, special populations, and pharmacogenetics.
Using a practical and problem-focused approach, this updated, full-color Third Edition of Mild-to-Moderate Psoriasis equips dermatologists, internists, family practitioners, and residents with a state-of-the-art guide to the clinical management of mild-to-moderate psoriasis.Written by an international team of key opinion leaders, this resource explores new developments in treatments for the condition and provides clinicians with up-to-date strategies for optimal patient management.
This volume provides an in-depth overview of the current state of psoriasis and its management. It reviews the clinical manifestations of psoriasis as well as psoriatic arthritis and emphasizes the evolving paradigm of therapy. Coverage includes topical and ultraviolet therapies as well as traditional systemic therapy. In addition, a major focus of the volume is on biologic therapies. New agents in development are also reviewed.
In many areas of medicine physicians still face the great challenge of finding therapies that will meet the patients’ needs. In dermatology the challenge has arisen on multiple fronts through advances in the understanding of the immunopathogenesis of many inflammatory and malignant cutaneous disorders. Breakthroughs, combined with significant developments in targeted immunotherapy, have resulted in improved outcomes as these newer therapies are being used for both approved indications and as off-label therapies for various chronic inflammatory skin disorders and many forms of skin cancer. In the expectation that by truly understanding the safety profile of these targeted therapies patients’ outcomes will be significantly improved, this book offers insights into topics such as adverse reactions, infectious complications and the perioperative use of biologics in psoriasis, immunogenicity of biologic therapies, paradoxical reactions, safety of biologics used to treat autoimmune bullous diseases and primary cutaneous lymphomas, adverse reactions and skin manifestations of therapies targeting melanoma and non-melanoma skin cancer and other neoplastic diseases. Eminent researchers with extensive clinical experience have contributed to this publication, providing an in-depth overview of the latest knowledge in this field.
A brand-new title in the field of dermatology, Therapy for Severe Psoriasis provides the ultimate coverage of the treatment options available for today's most serious cases, including biologics and oral therapies. It features discussions of the newest drug therapies, recent FDA-approved biosimilars, and combination approaches to care, while an overview chapter was designed to aid those new to the field in understanding the nuances of difficult-to-treat subtypes of psoriasis. Comprehensive and focused, Therapy for Severe Psoriasis will be a welcome addition to the library of any dermatologist seeking in-depth information on the challenges of this condition. - Each of the 16 chapters includes either an in-depth focus on a single therapy or an overview of a unique aspect of psoriasis, including: UVB therapy, methotrexate, acitretin, cyclosporine, apremilast, etanercept, infliximab, adalimumab, ustekinumab, secukinumab, and ixekizumab. - Takes an evidence-based approach to hard-to-treat severe psoriasis. - Discusses the newest drug therapies (such as ixekizumab), plus recent FDA-approved biosimilars, a topic unique to this particular psoriasis text. - Presents combination approaches for instances when standard treatments are not successful. - Includes an overview chapter to help beginners understand the nuances of the disorder.
Psoriasis is a common, chronic, autoimmune inflammatory skin disease affecting 2 to 3 percent of the worldwide population. The onset of psoriasis predominantly occurs early in adulthood (between the ages of 15 and 25 years) but may affect individuals at any age. The course of psoriasis is marked by chronic and acute phases with a wide variety in relapse and clearance rates. Total health care costs of psoriasis are estimated at $11.25 billion annually. This economic burden, along with the clinically relevant reductions in quality of life experienced by many patients with psoriasis, underscores the need for prompt, effective, and sustained disease management. Among several clinical psoriasis phenotypes, chronic plaque psoriasis is the most frequent, accounting for all but 10 percent of cases. Chronic plaque psoriasis, also known as psoriasis vulgaris, often appears as well-demarcated, erythematous plaques covered with silvery white scales that vary in size up to several centimeters. Different parameters determine disease severity such as the degree of body surface area (BSA) involved, activity of the lesions, the location of lesions in sensitive areas, duration of disease, treatment failures, and the impact on quality of life. While disease localized to nonsensitive areas of skin may be managed effectively with topical agents, patients with more widespread disease often require systemic treatment. The American Academy of Dermatology has published guidelines for the treatment of psoriasis and suggest use of either biologic or nonbiologic systemic agents or phototherapy with ultraviolet B (UVB) or with psoralen plus ultraviolet A (PUVA) therapy in patients with widespread disease. Biologic therapies for psoriasis use genetically engineered drugs that target specific steps in the pathogenesis of psoriasis involving T cells and cytokines . Currently, three biologic TNF-alpha inhibitors (infliximab, etanercept, and adalimumab), and one anti-IL 12/23 agent (ustekinumab) have approval from the Food and Drug Administration (FDA) for psoriasis treatment. Nonbiologic systemic therapies may be effective but can be associated with significant short-term and longterm adverse events (hepatotoxicity, nephrotoxicity, hypertension, dyslipidemia, malignancy, and teratogenicity). Phototherapy, although considered to be one of the safer therapeutic options, requires strict compliance, and the long-term toxicity associated with it includes photocarcinogenesis. The objective of this comparative effectiveness review (CER) is to examine the benefits and harms of biologic systemic agents compared with nonbiologic systemic agents or phototherapy in patients with chronic plaque psoriasis. The Key Questions addressed in this review include: Key Question 1. In patients with chronic plaque psoriasis, what is the comparative effectiveness of systemic biologic agents and systemic nonbiologic agents (between-class comparisons on an individual drug level) or phototherapy when evaluating intermediate (plaque BSA measurement, PASI , Patient's Assessment of Global Improvement, PGA, and individual symptom improvement) and final health outcomes (mortality, HRQoL and other patient-reported outcomes, MACE, diabetes, and psychological comorbidities )? Key Question 2. In patients with chronic plaque psoriasis, what is the comparative safety of systemic biologic agents and systemic nonbiologic agents (between-class comparisons on an individual drug level) or phototherapy (hepatotoxicity, nephrotoxicity, hematologic toxicity, hypertension, alteration in metabolic parameters, injection site reaction, malignancy, infection, and study withdrawal)? Key Question 3. In patients with chronic plaque psoriasis treated with systemic biologic therapy, systemic nonbiologic therapy, or phototherapy, which patient or disease characteristics affect intermediate and final outcomes?
In this issue of Dermatologic Clinics, guest editor Dr. Jeffrey M. Cohen brings his considerable expertise to the topic of Psoriasis: Contemporary and Future Therapies. Top experts in the field discuss oral therapies for psoriasis; phototherapy for psoriasis in the era of biologics; the psoriasis treatment pipeline; psoriasis comorbidities and their impact on treatment; underdiagnosis and undertreatment of traditional cardiovascular risk factors in psoriasis; and much more. - Contains 14 relevant, practice-oriented topics including biologics for psoriasis; psoriasis genetics and the impact of genetics on comorbidities and treatment; psoriasis therapies in the pediatric population; disparities in psoriasis treatment; immune checkpoint inhibitor-induced psoriasis; and more. - Provides in-depth clinical reviews on psoriasis: contemporary and future therapies, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
