Mark G. Lebwohl, MD, the dean for Clinical Therapeutics at the Icahn School of Medicine at Mount Sinai,

Patient Preferences and Shared Decision-Making in Psoriasis Care

In this episode, ‘Patient Preferences and Shared Decision-Making in Psoriasis Care,’ the expert dermatologists explore the nuanced process of transition from topical to systemic therapy. Dr. Mark Lebwohl explains that while a 10% body surface area (BSA) often serves as a traditional threshold, systemic treatment is frequently necessary for patients with lower BSA if the psoriasis affects high-impact areas like the palms, soles, genitals, or hairline. He emphasizes that the National Psoriasis Foundation provides crucial support for clinicians to advocate for systemic options when a patient’s quality of life is significantly impaired, regardless of objective coverage scores.

Dr. Tina Bhutani-Jacques and Dr. Lebwohl discuss how they navigate the "shared decision-making" conversation by presenting patients with the full spectrum of modern options, including ultraviolet light, oral pills, and biologics. Dr. Lebwohl notes that specific patient needs—such as the requirement for rapid clearance before a wedding or a job interview—often push the choice toward faster-acting biologics. Conversely, comorbidities play a decisive role; for instance, IL-17 blockers are preferred for patients with multiple sclerosis, while they are avoided in those with Crohn's disease. The experts also touch on the "moderate" patient population, noting that while some oral therapies have broader labels for less severe disease, recent head-to-head trials show that many patients find the convenience of an injection every three months to be superior to a daily pill. The discussion concludes by reaffirming that because every patient defines convenience and success differently, a personalized, conversational approach is the only way to optimize long-term adherence and outcomes.

The next episode in this series, ‘Emerging Updates in Psoriasis from 2026 AAD Annual Meeting,’ features the panelists discussing late-breaking data regarding next-generation oral therapies and the dramatic synergy between weight-loss medications and psoriasis treatments. Dr. Bhutani-Jacques and Dr. Lebwohl explore how these combined approaches significantly improve skin clearance and systemic health.

Videos

Explore how cutting inflammation in psoriasis may lower heart risks, and why new oral TYK2 inhibitors could broaden treatment beyond injections.

Starting Treatment: Educating Patients and Initiating PERT for EPI

Once a diagnosis—or high clinical suspicion—is established, the panel turns to what comes next: patient education, treatment initiation, and supportive care coordination. Jennifer Geremia leads with the importance of educating patients that EPI is a long-term condition requiring long-term therapy. Without this foundational understanding, patients often stop therapy or take it inconsistently—since timing relative to meals is critical, any deviation compromises efficacy.

Sarah Enslin emphasizes setting realistic expectations from the start: patients should know what to anticipate in terms of timeframe for improvement and understand that dose adjustments are routine and do not indicate disease progression. She introduces the weight-based dosing framework and advises that providers build in a check-in at one to two weeks to assess and adjust. Capsules must always be taken with meals—not opened and sprinkled directly—though mixing with applesauce is acceptable as long as consumption is immediate.

The panel discusses ancillary support services with enthusiasm. Smoking and alcohol cessation are flagged as mandatory conversations, now embedded in their electronic health record workflows. Nutrition consults are described as transformative—a dietitian's ability to help patients maintain a pancreas-friendly diet within the constraints of their cultural preferences, financial resources, and lifestyle is something no provider can fully replicate. The shortage of dietitians in gastroenterology practice is explicitly called out as an unmet need.

Checking fat-soluble vitamin levels (A, D, E, K) at diagnosis and supplementing as needed is highlighted as an early, high-priority step. The panel also advocates for psychological support—particularly cognitive behavioral therapy—for patients who develop food fear or social anxiety. Palliative care is increasingly being invoked earlier in the care pathway, particularly for severely debilitated patients with chronic pancreatitis, to address pain and nutritional rehabilitation and break the cycle of repeated emergency department visits.

Optimizing PERT: Dosing, Adjustments, and Managing Non-Responders in EPI

," the panel provides practical guidance on fine-tuning PERT therapy—covering weight-based dosing, the role of PPIs, uric acid considerations, and strategies for patients who fail to respond to initial treatment.

Learn what happens after suspected EPI: patient education, enzyme therapy tips, nutrition and vitamin checks, plus smoking and alcohol support.

Clinical

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Video Series

Therapeutic Strategies in Wilson Disease

In this episode, 'Therapeutic Strategies in Wilson Disease,' the panelists explore the clinical decision-making process for managing copper toxicity. Dr. Rima Fawaz provides a foundational overview of current therapies, distinguishing between chelating agents—which bind to free, non-ceruloplasmin copper and promote renal excretion—and zinc therapy, which blocks intestinal copper absorption by inducing metallothionein. The experts also note recent findings suggesting that trientine may share some of zinc's absorption-blocking properties, adding a layer of mechanistic complexity to treatment selection.

A significant portion of the discussion focuses on the "low and slow" approach to starting chelation, particularly in patients with neurological symptoms. Dr. Peter Hedera explains the risk of paradoxical worsening, a phenomenon where the mobilization of copper can cause potentially irreversible neurological deterioration. Due to a lower perceived risk of this complication and a more favorable side-effect profile, trientine is often preferred over penicillamine for initial therapy. Conversely, zinc is identified as an ideal first-line option for asymptomatic patients or those diagnosed early through sibling screening, though its slow onset of action makes it unsuitable for acute de-coppering.

The panel emphasizes that Wilson disease requires lifelong maintenance, regardless of the initial therapy used. Whether staying on a reduced dose of a chelator or transitioning to zinc, the goal remains a stable, negative copper balance. Dr. Fawaz and Dr. Hedera conclude by highlighting the practical challenges of these regimens, such as the need to separate medications from food and each other, and the ongoing importance of monitoring 24-hour urine copper levels to guide long-term clinical success.

The next episode in this series, 'Evaluating Trientine Tetrahydrochloride in Wilson Disease from the CHELATE Trial,' features the panelists advancing their conversation on Wilson disease and focusing on the clinical advantages of newer chelation formulations. The experts discuss the transition from trientine dihydrochloride to the FDA-approved tetrahydrochloride salt, emphasizing improvements in storage, dosing frequency, and patient adherence.

Learn how chelators and zinc manage copper in Wilson disease, why trientine is favored, and when maintenance therapy becomes lifelong.

Impact of Early Diagnosis on Disease Progression and Quality of Life in Wilson Disease

This episode, titled 'Impact of Early Diagnosis on Disease Progression and Quality of Life in Wilson Disease,' features experts discussing the high stakes of clinical recognition and the evolving landscape of early detection. Dr. Rima Fawaz emphasizes that while no single test is perfectly diagnostic on its own, the emergence of newborn screening—such as the dried blood spot pilot in Washington state—is a monumental step toward identifying the condition before copper overload occurs. The panel notes that while genotype-phenotype correlations remain elusive, the ability to detect the ATP7B mutation at birth could change the trajectory of the disease for the 1 in 30,000 individuals affected.

The conversation shifts to the devastating consequences of untreated Wilson disease and the burden it places on patient quality of life. Dr. Peter Hedera outlines the severe neurological complications that can arise, including secondary dystonia, which may leave young patients mute, wheelchair-dependent, or requiring feeding tubes. He explains that unlike idiopathic Parkinson's disease, Wilson disease-related parkinsonism often fails to respond to standard symptomatic therapies, making early copper-clearing intervention the only effective path.

However, the panel also shares a message of hope. Both Dr. Fawaz and Dr. Hedera highlight that when caught early, even severe neurological symptoms like dysarthria and mobility issues can see near-complete reversal. This reinforces the "time is the enemy" mantra, as copper accumulates from the moment of conception. The episode concludes with a call for clinicians to be extremely aggressive with their index of suspicion, as the rewards of early treatment—returning a patient to a normal, functional life—are immense.

In the next episode, 'Therapeutic Strategies in Wilson Disease,' panelists will continue their discussion on Wilson disease and highlight the distinct mechanisms of copper chelators and zinc therapy. The experts compare first-line induction treatments for symptomatic patients with maintenance protocols and discuss the importance of lifelong management.

Newborn screening spots Wilson’s disease sooner, helping stop copper buildup and irreversible neurologic damage—improving outcomes and daily life.

Potential Therapeutic Opportunities of TYK2 Therapy Beyond Psoriasis and Identifying the Ideal Patient 

This episode, titled ‘Potential Therapeutic Opportunities of TYK2 Therapy Beyond Psoriasis and Identifying the Ideal Patient,’ features panelists Dr. Tina Bhutani-Jacques and Dr. Mark Lebwohl as they examine the systemic impact of psoriasis treatments on patient longevity and comorbidities. Dr. Lebwohl highlights compelling registry data showing that older TNF blockers significantly reduced heart attacks and extended life expectancy by lowering systemic inflammation. He expresses optimism that TYK2 inhibitors will eventually demonstrate similar protective benefits for the heart and joints as more long-term data becomes available. The discussion also touches on the potential for TYK2 inhibitors to be approved for other inflammatory conditions, noting promising off-label results and ongoing studies in lupus, alopecia areata, lichen planus, and psoriatic arthritis.

The experts then pivot to defining the "perfect patient" for this drug class, emphasizing the importance of patient lifestyle and preferences. Dr. Lebwohl identifies pediatric populations and adults with trypanophobia, or a fear of needles, as primary candidates for oral therapy. He shares a clinical anecdote about an Army Ranger candidate to illustrate how the lack of refrigeration requirements makes TYK2 inhibitors superior for patients in austere environments or those who travel frequently. Dr. Bhutani-Jacques adds that many of her patients in the Bay Area prefer the convenience of a pill to avoid the logistical hurdles of traveling with injectable biologics and cooling equipment. The conversation concludes by noting that the reduced stigma of oral medication often makes it a more approachable first-line systemic choice for younger patients who view daily pills as a more routine part of their wellness than injections.

In the next episode, ‘Patient Preferences and Shared Decision-Making in Psoriasis Care’, panelists will walk through the clinical consultation process for initiating systemic therapy. The experts discuss how high-impact areas, patient perception of severity, and specific comorbidities like multiple sclerosis or Crohn's disease dictate the selection of oral versus injectable treatments.

Derm experts compare TYK2 pills with biologics for psoriasis—safety, speed, infections, and when combination therapy helps stubborn skin and joints.

Clinicians weigh PEI questionnaires, symptom scores, and AGA updates to track exocrine pancreatic insufficiency and tailor patient-centered care.

Putting PROs to Work: The PEIQ and Symptom Scores in EPI Management

Podcasts

In this April episode, the discussion highlights how intentional choices and practice ownership can help physicians align professional with personal success.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

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podcasts page features a feed of medical news and interview podcast series, including DocTalk, Lungcast, Derm Discussions, and Heart Trials.

The Medical Sisterhood, with Mona Shahriari, MD

The Medical Sisterhood, hosted by Mona Shahriari, MD, is a podcast dedicated to empowering female physicians by providing a platform for shared experiences, mentorship, and support. 

Each episode delves into the unique challenges women in medicine face, including work-life balance, leadership roles, and overcoming gender biases. Shahriari aims to inspire women to lead fulfilling professional and personal lives on their own terms through candid discussions and expert interviews. 

e as we foster a community where women can uplift and support each other in achieving their goals!

The Medical Sisterhood: Exposure is Power-Women in Medicine Creating Opportunity, With Elizabeth Kiracofe MD

Vinod E. Nambudiri, MD, MBA, MPH, is affiliated with Brigham and Women's Hospital and specializes in Dermatology and Internal Medicine.

Articles

This Q&A interview with Nambudiri covers the AAD Clinical Image Collection, launched in January 2025 to address diversity in dermatology education.



Conference

 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

Plaque Psoriasis

The HCPLive plaque psoriasis page is a resource for medical news and expert insights on psoriasis. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for psoriatic disease, and more.

Q&A: How Dermatologists Can Utilize the AAD Clinical Image Collection, With Vinod Nambudiri, MD, MBA, MPH

Tatyana Kushner, MD, is an associate professor of medicine in the division of gastroenterology and hepatology at Weill Cornell Medicine.

Brelovitug achieved the FDA-specified primary endpoint for HDV RNA reduction and normalization of ALT in a phase 2b trial.

Hepatology

Hepatitis C

Hepatitis C page, resources on the topics of medical news and expert insight into HCV can be found. Content includes articles, interviews, videos, podcasts, and breaking news on hepatitis C virus research, treatment, and drug development.

AZURE-1: Brelovitug Meets Key Endpoints in Hepatitis D, With Tatyana Kushner, MD

Julie Silverstein, MD, is the medical director of the pituitary center and of the clinical trials unit and professor of medicine and neurological surgery at WashU Medicine.

Silverstein addresses a secondary analysis of the GRACE trial, highlighting relacorilant’s efficacy in reducing cortisol in patients taking GLP-1 RAs.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Relacorilant Reduces HbA1c in Cushing’s Despite GLP-1 Treatment, With Julie Silverstein, MD

Low-dose radiation therapy is gaining attention in the US for osteoarthritis and inflammatory pain, with clinicians citing anti-inflammatory effects.

Internal Medicine

Internal Medicine condition center page, resources on the topics of medical news and expert insight into internal medicine can be found. Content includes articles, interviews, videos, podcasts, and breaking news on internal medicine research, treatment, and drug development.

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Strategic Alliance Partnership

Low-Dose Radiation Therapy Gains Traction in US, With Hirsch Sudhir Matani, MD

Baba Inusa, MBBS, is a Consultant Paediatrician in the School of Life Course & Population Sciences at King's College London.

Inusa discusses how clinicians can close gaps in sickle cell disease care and global disparities. 

Hematology

Sickle Cell

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Using SWAY’s Global Sickle Cell Data to Close Access, Treatment Gaps 

Shashank Joshi, MD, is a consultant endocrinologist at Liavati Hospital and Joshi Clinic in Mumbai.

Joshi explains the narrow window of optimal iodine levels, highlighting the risk posed by supplements and iodized salt in tipping the scales toward health risks.

Thyroid Disorders

Navigating Iodine Deficiencies and Excesses in Thyroid Health, With Shashank Joshi, MD

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

The International Eczema Council set out to create a set of consensus-based definitions of remission, LDA, and vLDA in atopic dermatitis.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

International Eczema Council Releases Definitions of Remission, Low Disease Activity

Linda Stein Gold, MD, is a dermatologist at Henry Ford Health. 

Expert panel weighs IL‑17 vs IL‑23 biologics for psoriasis, highlighting fast onset, durability, and why switching within class may work.

Latest News

Patient Preferences and Shared Decision-Making in Psoriasis Care

Starting Treatment: Educating Patients and Initiating PERT for EPI

Therapeutic Strategies in Wilson Disease

Impact of Early Diagnosis on Disease Progression and Quality of Life in Wilson Disease

Potential Therapeutic Opportunities of TYK2 Therapy Beyond Psoriasis and Identifying the Ideal Patient