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| Expert Practice |
About Expert Practice
Welcome to PsoriasisTx Expert Practice. These reports are contributed by experts in the treatment of psoriasis and offer insights into patient selection, dosing and administration, efficacy, side effects of biologic therapy, and overall disease management.
New Article
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Examining Comorbidities Associated With Psoriasis
CME-Certified Expert Practice Article
An interview with J. Mark Jackson, MD
Cardiovascular disease is responsible for a substantial number of deaths in the United States each year. Studies have shown that psoriasis patients have a higher occurrence of cardiovascular disease risk factors than do individuals without psoriasis. In this Expert Practice, J. Mark Jackson, MD, Associate Clinical Professor of Medicine and Dermatology at the University of Louisville School of Medicine, discusses what is currently known about the association of psoriasis and comorbidities related to cardiovascular disease. Topics covered include prevalence of risk factors for cardiovascular disease among psoriasis patients, evaluation of cardiovascular risk factors prior to psoriasis treatment, the impact of psoriasis treatment on cardiovascular risk factors, and similarities in the underlying pathophysiology of psoriasis and cardiovascular risk factors.
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Previous Articles
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New Biologic Agents in Development for Psoriasis
CME-Certified Expert Practice Article
An interview with Gerald G. Krueger MD
There is considerable excitement surrounding several new biologic agents with novel mechanisms of action and their potential as treatments for psoriasis. We recently interviewed Gerald G. Krueger, MD, Professor of Dermatology at the University of Utah in Salt Lake City, to gain his insights on the emerging data for these agents. In this Expert Practice, Dr. Krueger discusses the mechanisms of action of these agents in development, as well as the clinical data reported to date.
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Update on the Long-Term Safety of Biologic Agents for Psoriasis
CME-Certified Expert Practice Article
An interview with Bruce Strober, MD, PhD
The use of biologics to treat psoriasis is increasing with each passing year. Although the efficacy of biologics has been established, investigation of the long-term safety of these agents is only starting. In this Expert Practice, Dr. Bruce Strober of the Dermatopharmacology Unit at the New York University School of Medicine discusses current data on the long-term safety of the biologics used to treat psoriasis.
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Addressing Quality-of-Life Issues in Psoriasis: Impact of Biologic Agents
CME-Certified Expert Practice Article
An interview with Melodie S. Young, MSN, RN, A/NP-C
In patients with psoriasis, quality of life (QOL) issues are a significant concern. Melodie S. Young, a nurse practitoner who practices at Modern Dermatology, a Baylor-Health Texas Affiliate in Dallas, was recently interviewed on the topic of QOL among psoriasis patients. In this Expert Practice, Ms. Young discusses the measurement tools used to assess QOL, how psoriasis negatively affects the lives of patients, and how successful treatment can improve QOL.
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A Dermatologist’s Guide to Psoriatic Arthritis
CME-Certified Expert Practice Article
An interview with Erin Boh, MD, PhD
Early recognition and treatment of psoriatic arthritis are the keys to improving care in patients with this disease. Recently, we interviewed Erin Boh, MD, PhD, Professor of Dermatology at Tulane University Medical School, who offered insights for dermatologists on how to best identify patients with psoriatic arthritis. In this Expert Practice, Dr. Boh discusses the incidence, signs, and symptoms of psoriatic arthritis, as well as the diagnostic tests and options available to manage patients with this condition.
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Strategies for the Management of Nail, Hand, and Foot Psoriasis
CME-Certified Expert Practice Article
An interview with Lubomira Scherschun, MD
On April 10, 2007 Curatio CME Institute interviewed Lubomira Scherschun, MD, a dermatologist at the Henry Ford Hospital in Detroit, Michigan, for her insights on the management of nail, hand, and foot psoriasis. In the resulting Expert Practice article Dr. Scherschun discusses the epidemiology and varying presentation of hand, foot, and nail psoriasis. Treatment strategies for patients with this recalcitrant type of psoriasis will also be reviewed.
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Managing Psoriasis in Overweight and Obese Patients
CME-Certified Expert Practice Article
An interview with 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.
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Biologics in 2006: The Year in Review
By Alan Menter, MD
Dr. Alan Menter, Chief of the Division of Dermatology at Baylor University Medical Center, Director of Baylor Psoriasis Research Center, and Clinical Professor of Dermatology at the University of Texas Southwestern Medical School, reviews the progress made in 2006 regarding the use of biologics in the treatment of psoriasis.
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Use of Biologic Agents in Monotherapy
By Craig Leonardi, MD
Craig Leonardi, MD, a St. Louis-based practicing dermatologist featured in a previous Expert Practice article, returns to discuss his views on biologics as monotherapy and in combination therapy to treat psoriasis. Dr. Leonardi shares his thoughts on how to pick a biologic to initiate psoriasis treatment and identifies factors that indicate a need to modify the original treatment plan.
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Practical Experience With Biologic Agents: Focus on Safety
By Steven Shapiro, MD
Steven Shapiro, MD, has been using biologic agents to treat psoriasis for more than 3 years. He is currently using etanercept, efalizumab, and adalimumab, with 23 patients having been on continuous efalizumab for 3 years and 15 patients on continuous etanercept for about 2 years. Overall, he has at least 170 patients on biologic therapy for psoriasis.
In this interview, Dr. Shapiro discusses the safety issues he considers when using biologic agents for psoriasis treatment—including the patient prescreening he conducts before placing any patient on a biologic agent.
Dr. Shapiro stresses the importance of tapering and overlapping therapy when switching from one therapy to another. He also affirms that biologic agents are generally safe for psoriasis treatment, and that they are as a rule safer than nonbiologic systemic agents.
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Long-Term Therapy Using Biologics and the Treatment of Psoriasis
By Jeffrey M. Weinberg, MD
In this new Expert Practice interview, Jeffrey M. Weinberg, MD, talks about his experience with long-term use of biologics. Dr. Weinberg has been an investigator in clinical trials involving all of the biologic agents approved for psoriasis, as well as some of the investigational agents. He has used biologic agents in some patients continuously for over 3 years.
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Highlights from DNA 2006
By Melodie Young, MSN, RN, A/NP-C
At the DNA annual convention in San Francisco, a few general themes kept recurring. The topics of particular interest were:
- New self-injection syringes and ease of use
- Managing patient expectations
- Psoriatic arthritis and the role of dermatology healthcare providers
- TB testing accuracy
- Differentiating between T-cell agents and anti-TNF agents
- Difficult-to-treat areas such as the scalp and psoriasis involving the hands and feet
- Juvenile psoriasis
- Disease return issues when stepping down with anti-TNF agents
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Safety of Biologic Agents
By David M. Pariser, MD, FACP
David M. Pariser, MD, FACP, evaluates the safety data available for biologic agents and the risks associated with their use. This article is based on the information shared at a recent multidisciplinary roundtable discussion involving the author (a dermatologist), as well as a cardiologist, gastroenterologist, infectious disease physician, neurologist, and oncologist.
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Which Patient, Which Agent, and Why?
By Craig Leonardi, MD
Craig Leonardi, MD, a dermatologist at Central Dermatology in St Louis, Missouri, shares his experiences with selecting the appropriate biologic agent for each patient (including those in difficult-to-treat populations), in addition to his strategies for treatment success.
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New Treatment Options for Hand and Foot Psoriasis
By Jeffrey J. Crowley, MD
Jeffrey J. Crowley, MD, a dermatologist at the Bakersfield Dermatology and Skin Cancer Medical Group in Bakersfield, California, shares his experiences treating patients with biologic agents for hand and foot psoriasis and reviews his strategies for treatment success.
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Personal Experience With Biologic Agents in the Management of moderate to severe Psoriasis: A Look at Safety
By Mark G. Lebwohl, MD
Dr. Mark G. Lebwohl, Professor of Dermatology and Chairman, Department of Dermatology, at Mount Sinai School of Medicine, discusses how he has incorporated biologic agents into his clinical practice, as well as his personal perspective on the safety data currently available for the various biologic therapies.
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Setting Your Patients Up for Success With Long-Term Biologic Therapy for Psoriasis
By Kathy Byrd, RN, BSN
Kathy Byrd, a registered nurse at the Dawes/Fretzin Dermatology Group in Indianapolis, Indiana, shares her personal experiences with starting patients on biologic therapy and describes the strategies she uses for maximizing long-term treatment success.
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Practical Aspects of Biologic Therapy for the Community Dermatologist
James E. Turner, MD
In this new article, Dr. James E. Turner of Mid-South Dermatology & Skin Cancer Center, and Clinical Professor of Dermatology at the University of Tennessee School of Medicine in Memphis, discusses the day-to-day utilization of biologic therapy in his community-based practice and describes his experiences—both good and bad—with efalizumab, etanercept, and alefacept in patients with moderate to severe psoriasis.
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The Impact of Biologic Agents on the Management of Moderate to Severe Psoriasis
Alan Menter, MD
Dr. Alan 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.
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Long-Term Therapy for Psoriasis—What Does the Future Hold?
By Dr. Tiffani Hamilton
Dr. Tiffani Hamilton, a practicing dermatologist and clinical researcher at Atlanta Dermatology, Vein and Research Center, LLC, discusses her clinical experience with the long-term use of biologic agents in the treatment of psoriasis. She also describes how she selects the most appropriate treatment strategy for different psoriasis patients and how she manages patients during long-term biologic therapy.
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A Practical Evaluation of the Safety of New Biologic Agents for Psoriasis
By Elaine Siegfried, MD
Dr Elaine Siegfried, a physician in private practice and Associate Clinical Professor at Saint Louis University, describes how the safety profiles of biologic agents compare with those of conventional systemic therapies and phototherapies for psoriasis. She also reviews the safety concerns that physicians should be most aware of when using biologic agents, and discusses strategies for preventing and managing serious adverse events during biologic therapy.
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How Patient-Reported Outcomes Have Enhanced the Treatment of Psoriasis
By 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.
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Integrating Biologic Therapy for Psoriasis Into Your Clinical Practice
By David M. Pariser, MD
David M. Pariser, MD, Professor in the Department 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.
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Biologic Agents for the Treatment of moderate to severe Psoriasis: The Nursing Perspective
By Melodie Young, MSN, RN, A/GNP
Melodie 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.
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Defining the Role of Biologic Agents in the Treatment of moderate to severe Psoriasis
By Alice B. Gottlieb, MD
Dr Gottlieb, a hospital-based psoriasis specialist and rheumatologist, describes how she has incorporated biologic agents into her clinical practice.
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Highlighted Article
Using Biologic Agents in Combination With Other Systemic Therapies in Psoriasis Patients
CME-Certified
Expert Practice Article
An interview with
Jennifer C. Cather, MD
The overwhelming majority of clinical trial data on the efficacy and safety of biologics in psoriasis treatment focuses on monotherapy. Consequently, many dermatologists assume that biologics cannot be combined with other systemic psoriasis treatments. In this Expert Practice, Jennifer C. Cather, MD, a dermatologist in practice at Modern Dermatology in Dallas, Texas, discusses the suitability of combining biologics with other types of psoriasis treatments, such as methotrexate, cyclosporine, or ultraviolet light. This article focuses on the ways that combination therapy with biologic and systemic agents can offer new strategies for improved management of psoriasis.
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