Registration benefits include: Access to CME/CE programs and certification Free subscription to Biologic Bulletin newsletter Reminders of new CME/CE activities REGISTER NOW This Web site is supported by an unrestricted educational grant from Genentech, Inc. Biologic Therapy Biologic Therapy Our understanding of the various biologic therapies for the treatment of psoriasis is constantly evolving as more clinical studies are completed and more physicians gain practical experience with these powerful new medications. This page is your guide to the most recent and comprehensive material on biologic therapies for psoriasis. Included are a presentation on the rationale for the use of biologic therapy in psoriasis, the most recent reviews of the latest clinical findings and safety evaluations, a discussion of the relevance of patient-reported outcomes in psoriasis, and a selection of expert accounts of practical considerations in biologic therapy by experienced users of these new medications. A more exhaustive list of publications, meeting reports, and CME activities relating to biologic therapy can be found on other pages of this Web site. Click on the links below to view complete articles Rationale for the Use of Biologic Therapy in Psoriasis Immunobiology of Psoriasis This article provides an overview of the latest advances in our understanding of the immunobiology of psoriasis and how this set the stage for the development of biologic therapies for psoriasis. Latest Clinical Findings and Safety Overviews Biologic Agents and Psoriasis: Highlights From the 65th Annual Meeting of the American Academy of Dermatology held February 1–6, 2007 in Washington, DC CME-Certified Meeting Report Edited by: Alan Menter, MD Psoriasis was the topic of more than 110 posters presented at the 65th Annual Meeting of the American Academy of Dermatology. Approximately 40 presentations focused on biologic agents used to treat psoriasis. Updates on efficacy and safety, as well as interim analysis of pivotal clinical trial data, were the subjects of several posters. Data examining the use of biologic agents in children, pregnant women, and difficult-to-treat cases were also presented. Meeting highlights presented in this report underscore the fact that although biologics are an accepted part of the therapeutic armamentarium for psoriasis, clinicians are still learning how to best manage their use in patients with moderate to severe disease. Biologic Therapy for Psoriasis: 18 Months of Clinical Experience Biologic Bulletin, January 2005 Editors: Jeffrey M. Sobell, MD; Stephen P. Stone, MD This article provides a comprehensive and concise review of clinical studies on biologic therapy for psoriasis that have been published (or presented at a professional dermatology meeting) as of November 2004. Patient-Reported Outcomes How Patient-Reported Outcomes Have Enhanced the Treatment of Psoriasis Expert Practice Pat McClelland, RN This article reviews how patient-reported outcomes have been employed in clinical research to alter our view of the impact of psoriasis on patients' lives and to help determine the efficacy of novel biologic therapies. The utilization of this data—and of these tools—in clinical practice is also discussed. Practical Considerations New Long-Term Efficacy Data on Biologics in Psoriasis: Impact on Patient Management CME Newsletter, May 2007 Dermatologists have learned how to optimize clinical response with biologics based on 3 years of experience with these agents. Emerging data have indicated differences in response over time. Some of these differences seem to be patient-specific, others seem to be related to the differences between T-cell and anti-TNF agents, and some seem to occur only within the anti-TNF class of agents. This newsletter will summarize a recent webcast including new and evolving data, practical implications to optimize therapy for each psoriasis patient, and questions and answers during the webcast. Managing Psoriasis in Overweight and Obese Patients: Evaluating Treatment Challenges and Addressing Special Needs Biologic Bulletin Newsletter, March 2007 Recent studies have further established that overweight and obesity are common among psoriasis patients, and that higher body weight is associated with increased psoriasis severity. Treatment of overweight and obese psoriasis patients is complicated by several factors, including disease severity, size and location of lesions, comorbidities that are often encountered in this patient population, and the decreased likelihood of satisfactory patient response with fixed-dose systemic therapies. Safe and effective management of overweight and obese psoriasis patients requires the clinician to recognize and avoid treatment strategies that risk exacerbating coexisting problems, adding to the patient’s overall health risk, or interacting adversely with other medications being taken. Biologic agents may be preferable for overweight and obese psoriasis patients, though these, too, carry risks and must be used carefully. The importance of correct dosing in overweight and obese psoriasis patients must also be kept in mind. Fixed-dose therapies across drug classes have been shown to be increasingly less effective as patient weight increases. Among the biologic agents for psoriasis, efalizumab and infliximab are dosed by weight, and both demonstrate comparable efficacy across all weight categories. Managing Psoriasis in Overweight and Obese Patients CME-Certified Expert Practice Mark Lebwohl, MD Mark Lebwohl, MD, Professor of Dermatology at the Mount Sinai School of Medicine, discusses the relationship between psoriasis and obesity. Dr. Lebwohl addresses comorbidities associated with obesity and offers suggestions on how to optimize treatment for psoriasis patients who are obese. The Impact of Biologic Agents on the Management of moderate to severe Psoriasis Expert Practice Alan Menter, MD Dr. Menter, Chief of the Division of Dermatology at Baylor University Medical Center and Clinical Professor of Dermatology at the University of Texas Southwestern Medical School, discusses how the availability of biologic agents for the treatment of moderate to severe psoriasis has changed his dermatology practice. He also describes what he has learned about how to incorporate biologic agents into a clinical practice and speculates on how these therapies may continue to affect the practice of dermatology in the future. Integrating Biologic Therapy for Psoriasis Into Your Clinical Practice Expert Practice David M. Pariser, MD Dr. Pariser, Professor of Dermatology at Eastern Virginia Medical School, describes the benefits of being able to provide biologic therapy for psoriasis patients and how to overcome the challenges associated with introducing these agents into a clinical practice. Biologic Agents for the Treatment of moderate to severe Psoriasis: The Nursing Perspective Expert Practice Melodie Young, MSN, RN, A/GNP Ms. Young, a registered nurse/nurse practitioner and former director of the Baylor Psoriasis Center at the Baylor University Medical Center in Dallas, Texas, describes the role of nurses in the use of biologic therapy for psoriasis. Clinical Practice Forum: Biologic Therapy for moderate to severe Psoriasis Biologic Bulletin, February 2005 Editors: James E. Turner, MD, PhD; Chai Sue Lee, MD Included in this article is an overview of the key clinical trial findings for the three biologic agents that have been approved for the treatment of psoriasis (efalizumab, etanercept, and alefacept), followed by 12 interesting case studies, and an in-depth discussion of the key issues raised in the case study presentations. Combining Traditional Agents and Biologics for the Treatment of Psoriasis Seminars in Cutaneous Medicine and Surgery. March 2005, Volume 24 Jennifer Clay Cather, MD; Alan Menter, MD The treatment of psoriasis has moved from intermittent therapy with traditional agents to continuous therapy with biologics aimed at achieving long-term continuous disease control. This transition requires treatment algorithms that incorporate both traditional agents and biologic agents. This article includes a review of the literature relating to the use of biologics in combination regimens with traditional agents for the treatment of psoriasis and psoriatic arthritis, in addition to an update on the clinical experiences at the authors' Psoriasis Specialty Clinic (Texas Dermatology Associates) in Dallas, Texas. Understanding the New Clinical Landscape for Psoriasis: A Comparative Review of Biologics. Journal Cutaneous Medicine and Surgery. August 2004, Volume 8 Daniel N Sauder, MD; Adam J. Mamelak, MD The biologic agents represent an important addition to the therapies available to patients with psoriasis, and studies have demonstrated the safety and efficacy of long-term use of these agents. Using data from the dermatology literature listed in the MEDLINE database, as well as abstracts and posters presented at dermatology society meetings, this article reviews the safety and efficacy of alefacept, efalizumab, etanercept, and infliximab for the treatment of psoriasis. Potential Future Therapies for Psoriasis. Seminars in Cutaneous Medicine and Surgery. March 2005, Volume 24 Kim A. Papp, MD, PhD, FRCPC Work in the laboratory and clinic has provided profound insights into the immunologic and inflammatory pathways that lead to psoriasis, and this has, in turn, resulted in new and exciting targets for therapy. This article reviews the recent literature concerning new therapies with potential applications in the treatment of psoriasis, including those derived from large molecules (protein-based fusion proteins and monoclonal antibodies) and small molecules. Overview of Biologic Agents in Medicine and Dermatology [review]. Seminars in Cutaneous Medicine and Surgery. March 2005, Volume 24 Jeffrey M. Sobell, MD Three biologic agents, alefacept, efalizumab, and etanercept, are currently approved by the Food and Drug Administration for the treatment of chronic plaque psoriasis, with others currently under clinical evaluation. This article reviews the advancements in our understanding of psoriasis as an immune-mediated disorder as well as the progress in molecular biology techniques that enable the manufacture of proteins, which has led to the emergence of these biologic agents for the treatment of psoriasis.