New Insight with Dr. Veeral Sheth

Diabetes Dialogue

Don’t Miss a Beat

Crisis Point

TJ Chao and Kristine Kucera, PA’s discuss the changing treatment algorithms of plaque psoriasis with the arrival of novel agents such as the TYK2 inhibitors. 

Impact of the expanding treatment landscape on the treatment algorithm of plaque psoriasis 

In this series, dermatologists TJ Chao and Kristine Kucera delve into recent developments in plaque psoriasis treatment, including the emergence of TYK2 inhibitors. They highlight the evolving role of physician assistants in managing plaque psoriasis and discuss its recognition as a systemic disease. The conversation covers lab and monitoring requirements for TYK2 inhibitors like deucravacitinib, alongside a review of short- and long-term clinical trial data. Chao and Kucera offer insights into patient selection and the patient experience with oral systemic agents, providing guidance for selecting appropriate therapies in the expanding treatment landscape.

This summary was AI-generated and edited for clarity.

Videos

Ophthalmology

Ophthalmology page, resources on the topics of medical news and expert insight into ophthalmic disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on eye disease research, treatment, and drug development.

Impact of the Expanding Treatment Landscape on the Treatment Algorithm of Plaque Psoriasis

Providers in rheumatology, dermatology and gastrointestinal disease how they are selecting between the various adalimumab biosimilars available patients.

Selecting Between Adalimumab Biosimilars for Your Patients

This is a video synopsis/summary of a panel discussion involving Jamie T. Brogan, MSN, APRN, FNP-BC; Kostas Botsoglou, MD; Jordan Axelrad, MD, MPH; Sophia Humphreys, PharmD, MHA; and Peter Lio, MD.

The discussion revolves around how to choose the appropriate biosimilar for patients. In dermatology, options are limited, especially for conditions like psoriasis where newer treatments may outperform existing biosimilars. However, for conditions like hidradenitis, where choices are scarce, biosimilars offer a straightforward solution. The growth of biosimilars is anticipated to provide more options for clinicians, allowing them to select treatments based on efficacy and patient insurance coverage.

Clinicians often consider insurance formularies to anticipate the most easily approved biosimilar for each patient. In conditions like inflammatory bowel disease (IBD), certain biologics like Adalimumab play a significant role in treatment, leading to the proliferation of biosimilars. While payer preferences often influence prescribing decisions, clinicians prioritize factors like citrate-free formulations, small volume, high concentration, and robust patient support programs when choosing biosimilars, aiming for broader uptake and patient adherence.

Video synopsis is AI-generated and reviewed by HCPLive editorial staff.

Providers in rheumatology, dermatology and gastrointestinal disease talk about how they are selecting between the various adalimumab biosimilars available for their patients.

Biosimilars

Peer Exchange

HCPLive® Peer Exchange panel discussions feature authoritative insights, opinions, and perspectives on important issues facing today's care professionals.

Abigail Brooks is an assistant editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

Despite being one of the most common conditions diagnosed by gastroenterologists and affecting 10-15% of people in the US, 

 continues to be a largely marginalized condition, leaving many patients to suffer in silence.

Like many with IBS, Jeffrey Roberts struggled to find adequate care as he moved from doctor to doctor to find somebody who did not think his health issues were “all in his head.” From the time he was initially diagnosed with IBS as a teenager to when he received an additional 

 diagnosis in his 40s, Roberts described difficulty finding someone who understood the quality of life issues he was suffering.

“When I was first diagnosed, there was so little information that was available that I actually went and started to research treatment options and physicians who were doing research that I could leverage,” Roberts explained in an interview with 

. “That's how I started attending medical conferences in order to really bring information back to patients. The idea was okay, I'm treating myself, but I want to be able to be knowledgeable to provide different treatment options for different types of patients, or even to help them have a conversation with their physician in the language that the physician would understand.”

In recognition of World IBS Day, we spoke with Jeffrey Roberts about what led him to found the holiday and the marginalization of the condition.

Putting Patients First: Breaking Stigma, Dispelling Misconceptions to Improve IBS Care

Roberts’ work as a patient advocate began in 1995 when he founded the first IBS patient community website. He later launched the IBS Patient Support Group community in 2016 as a public education advocacy community, co-founded Tuesday Night IBS, and eventually went on to create World IBS Day in 2019.

Although April has previously been coined IBS Awareness Month, Roberts explained how no one was “directing the traffic” and he thought it would be more beneficial to choose a single day to focus all attention to raise awareness and encourage patients to seek care for any symptoms they may be experiencing. Although he acknowledged IBS care has come a long way since he was first diagnosed, he also pointed to a number of lingering issues that he hopes to help address with his patient advocacy work.

“Years ago, because our understanding of the brain-gut axis was only in its early stages, some providers did tell patients that all of their symptoms were ‘in their head’ because routine testing at that time could not identify the cause of their symptoms,” Brian Lacy, MD, PhD, a gastroenterologist at Mayo Clinic in Jacksonville, explained in an interview with 

, noting this understanding has evolved in recent years. “We now know that psychological distress can affect the brain, which can then affect the gut. Thus, some patients with IBS may have a flare of their symptoms due to ongoing psychological distress, but it is important to point out that anxiety by itself, or depression, does not directly cause IBS.”

Despite recent advancements in the understanding of the true mechanisms behind IBS, important misconceptions remain among health care providers and continue to negatively impact the care patients receive.

, Hannibal Person, MD, assistant professor and medical director of the Center for Diversity and Health Equity at the University of Washington, explained how a lot of providers continue to see and treat IBS as a purely psychological condition despite evidence against this notion, saying “they tell their patients to sleep better, drink water, and manage their stress, even though there are all these other treatment opportunities, some of which are highly evidence-based, and there are guidelines.”

Even among those who acknowledge IBS as more than just a psychological condition, its previous reputation as a “diagnosis of exclusion” has lingered and continues to influence many clinicians’ approaches toward evaluating, managing, and treating IBS.

“It was taught in the distant past that IBS was a diagnosis of exclusion and that patients had to undergo a battery of tests in order to make that diagnosis,” Lacy said, explaining how some providers continue to rush into labeling patients as having IBS if they have gastrointestinal symptoms not readily diagnosed as something like inflammatory bowel disease or gastroesophageal reflux.

Anthony Lembo, MD, vice chair of research at Cleveland Clinic Digestive Disease Institute, described a similar diagnostic process, saying “20 years ago, they would do every test and then say it's IBS, or they would lump everybody with any symptom or GI issue that they couldn't explain into the same IBS group.”

In 2021, the American College of Gastroenterology released the first clinical guideline for the management of IBS with the goal of identifying and answering key diagnostic and clinical questions. Key recommendations included:

Use of a positive diagnostic strategy as compared to a diagnostic strategy of exclusion to improve time to initiating appropriate therapy.

Perform serologic testing to rule out celiac disease in patients with IBS and diarrhea symptoms, and check fecal calprotectin in patients with suspected IBS and diarrhea symptoms to rule out inflammatory bowel disease.

Limited trial of a low FODMAP diet in patients with IBS to improve global symptoms.

Use chloride channel activators and guanylate cyclase activators to treat global IBS with constipation symptoms.

Use rifaximin to treat global IBS with diarrhea symptoms, and use gut-directed psychotherapy to treat global IBS symptoms.

Investigators asserted these recommendations, in addition to other statements and information from the guideline regarding diagnostic strategies, specific drugs, doses, and duration of therapy, would influence new guidelines, assist in pharmaceutical and diet development, direct changes in study design, and inform regulatory agencies.

However, even with these guidelines providing a clear outline of the management of IBS, many clinicians continue to dismiss these patients, something Lembo attributed to the combination of gastrointestinal and psychosocial of IBS that frustrate clinicians and cause them to push patients away.

Lacy offered a similar explanation, saying “Some health care providers are still not quite as knowledgeable about the brain-gut axis and disorders of gut-brain interaction, so they may tell their patients that ‘there is nothing more to do to treat their condition’ when in fact there are multiple treatment options available.”

Although Mark Pimentel, MD, executive director of the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai, sympathized with primary care and the need to keep up with the latest news in so many disease spaces, he also acknowledged “There is education out there, and IBS is not a rare condition. You should be versed in it.”

He continued by pointing out fundamental issues with the name irritable bowel syndrome, saying it means “You're irritable, you have a bowel problem, and it's a syndrome, which means we don't know what's going on,” and further emphasizing the importance of uncovering the root causes of IBS to ascertain its organic basis and eventually dispel widespread misconceptions about it, even down to its name.

However, this will not be an easy feat, something Pimentel attributed largely to a lack of funding. Specifically, he referenced how Crohn’s disease affects a fraction of the people IBS does but gets far more funding, highlighting the need for biological, plausible causes of IBS to get more funding and help patients achieve better outcomes.

Roberts expressed hope that advocacy efforts like World IBS Day will help make this hope a reality, concluding “I’m really excited that it has caught on. Every disease seems to have a day, and so IBS now has its day, April the 19th.”

American College of Gastroenterology. Irritable Bowel Syndrome (IBS). Accessed April 19, 2024. 

https://gi.org/topics/irritable-bowel-syndrome/

IBS Patient Support Group. Who We Are. August 12, 2023. Accessed April 19, 2024. 

Tuesday Night IBS. Who We Are. Accessed April 19, 2024. 

https://www.tuesdaynightibs.com/who-we-are

Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. The American Journal of Gastroenterology. doi:10.14309/ajg.0000000000001036

Articles

In recognition of World IBS Day, we spoke with Jeffrey Roberts about what led him to found the holiday in 2019 and took a closer look at the continued marginalization of the condition.

News

news page, resources on the topics of disease- and specialty-specific medical news and expert insight can be found. Content includes articles, interviews, videos, podcasts, and breaking news on health care research, treatment, and drug development.

Clinical

clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

Gastroenterology

Gastroenterology condition center page is a comprehensive resource for clinical news and insights on digestive and GI conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for 

, IBS and IBD, Crohn's disease, and more.

Irritable Bowel Syndrome

On the HCPLive irritable bowel syndrome page, resources on the topics of medical news and expert insight into IBS can be found. Content includes articles, interviews, videos, podcasts, and breaking news on IBS, IBD, and more.

in rheumatology, dermatology, and gastrointestinal disease share strategies in how to increase the uptake of adalimumab biosimilar among providers.

Strategies to Increase Adalimumab Biosimilar Uptake in Clinical Practice

The conversation explores strategies to enhance the uptake of biosimilars, focusing on easing administrative burdens and improving patient access and affordability. Locally, initiatives have been implemented to streamline processes, such as eliminating prior authorizations for renewals of certain medications like adalimumab and reducing copayments for patients. These measures have positively impacted biosimilar uptake in the area.

Strategies for improving uptake include ensuring cost savings for patients, expanding formulary coverage to include more interchangeable products, and enhancing patient education. Patient support programs, including co-pay assistance cards and reimbursement specialists, play a crucial role in promoting biosimilar adoption, especially among Medicare and Medicaid patients. Access to these programs influences treatment decisions alongside considerations of safety and efficacy.

The conversation underscores the importance of balancing cost-saving measures with patient affordability and accessibility. It highlights the complexities clinicians face when navigating the healthcare landscape, where expensive branded medications may be accessible due to support programs, while cheaper alternatives like biosimilars remain out of reach for some patients. Ultimately, addressing these challenges requires a multifaceted approach that considers both systemic cost-saving measures and individual patient affordability.

A clinical pharmacist and specialists in rheumatology, dermatology, and gastrointestinal disease share strategies in how to increase the uptake of adalimumab biosimilar among providers.

Advances practice providers in dermatology discuss the safety data on the novel TYK2 inhibitor deucravacitnib. 

Safety Data on Deucravacitinib

Dermatologists Drs Tina Bhutani and Scott Boswell and patient Kanya Oul discuss unpredictable nature of generalized pustular psoriasis (GPP) and management of flares and GPP between flares.

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.

Unpredictable Nature of Generalized Pustular Psoriasis (GPP) and Treatment

Dermatologists Drs Tina Bhutani and Scott Boswell discuss use of spesolimab to treat generalized pustular psoriasis (GPP) flares.

Spesolimab for Treatment of Generalized Pustular Psoriasis (GPP) Flares

Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

During this Q&A interview, Crandall discussed the takeaways from her portion of an ACP conference presentation on current clinical guidelines in type 2 diabetes.


Type 2 Diabetes

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.

Conference

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

Carolyn J. Crandall, MD: Key Guideline Updates for Type 2 Diabetes

In this interview at the ACP conference, Inouye discussed some of the major reasons for her presentation titled ‘Delirium During Hospitalization.’

Discussing Delirium During Hospitalization with Sharon K. Inouye, MD, MPH

Lana Pine is the editor of HCPLive Rheumatology. She is an experienced editor and technical writer with a demonstrated history of working in the banking and publishing industries. In her free time, she enjoys cooking, yoga, listening to podcasts, and drawing. She can be reached via email at LPine@mjhlifesciences.com.

Most (94%) anti-nucleocapsid positivity was linked to a self-reported COVID-19 infection within the prior 3 months. 

Rheumatoid Arthritis

The HCPLive rheumatoid arthritis page is a comprehensive resource for clinical news and insights on arthritis. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for RA, and more.

COVID-19

COVID-19 page, resources on the topics of medical news and expert insight into coronavirus can be found. Content includes articles, interviews, videos, podcasts, and breaking news on COVID-19 research, treatment, and drug development.

Study Investigates Optimal COVID-19 Vaccination Timing in Inflammatory Disease

Connor Iapoce is an associate editor for 

 and joined the MJH Life Sciences team in April 2021. He graduated from The College of New Jersey with a degree in Journalism and Professional Writing. He enjoys listening to records, going to concerts, and playing with his cat Squish. You can reach him at 

Elna Saah, MD joins HCPLive to discuss the current landscape in sickle cell disease and recent advancements benefiting clinical care.

Hematology

Sickle Cell

Sickle Cell condition center page, resources on the topics of medical news and expert insight into sickle cell disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on sickle cell research, treatment, and drug development.

Elna Saah, MD: Unraveling the Current Landscape in Sickle Cell Disease

Modern large language models perform strongly on ophthalmic knowledge assessments and approach or exceed the scores of fully qualified and trainee ophthalmologists.

GPT-4 Nears "Expert-Level" Performance in Ophthalmology Examination

Patrick Campbell is the managing editor of HCPLive. Formerly the editorial lead of Endocrinology Network, Practical Cardiology, and Rheumatology Network, Patrick has spent years spearheading coverage surrounding cardiometabolic health and rheumatic disease for MJH Life Sciences. He now helps to lead coverage in each of these respective areas for HCPLive. Before joining MJH Life Sciences in 2019, he spent time as a beat reporter with the Pocono Record in Stroudsburg, PA, and Star News Group in Manasquan, NJ. He also touts experience in multimedia, having spent time as a multimedia specialist with NJ Advance Media and multimedia coordinator at the Pocono Record. Follow him on Twitter @RealPatCampbell or reach him via email at PCampbell@mjhlifesciences.com.

A new analysis of the REDUCE-IT trial reveals the benefits of icosapent ethyl in reducing cardiovascular outcomes regardless of LDL-C levels.

Dyslipidemia

REDUCE-IT Analysis Outlines Benefit of Icosapent Ethyl Across Range of LDL-C Levels

New phase 3 findings show daily oral budesonide reduces eGFR decline while maintaining patient quality of life over 2 years.

IgA Nephropathy

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

Nephrology

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

Budesonide Maintains IgA Nephropathy Kidney Failure Reduction, Quality of Life at 2 Years

A propensity score-matched, new-user analysis suggests SGLT2 inhibitors may reduce gout risk in type 2 diabetes patients relative to other second-line therapies.

Gout

On the HCPLive gout page, resources on the topics of medical news and expert insight into gouty arthritis can be found. Content includes articles, interviews, videos, podcasts, and breaking news on gout, and more.

Latest News

Impact of the Expanding Treatment Landscape on the Treatment Algorithm of Plaque Psoriasis

Selecting Between Adalimumab Biosimilars for Your Patients

Putting Patients First: Breaking Stigma, Dispelling Misconceptions to Improve IBS Care

Strategies to Increase Adalimumab Biosimilar Uptake in Clinical Practice

Safety Data on Deucravacitinib