Tina Bhutani-Jacques, MD, MAS, FAAD

Closing Thoughts on TYK2 Inhibition in Psoriasis

In the final episode, ‘Closing Thoughts on TYK2 Inhibition in Psoriasis,’ the panelists explore the culmination of their discussion on modern psoriasis care and offer closing pearls for clinical practice. Dr. Mark Lebwohl emphasizes that while every patient presents a unique constellation of desires, symptoms, and comorbidities, dermatologists are currently in a better position than ever to achieve high levels of clearance. He advises clinicians to run through a quick mental algorithm for every patient that accounts for factors such as smoking status, high blood pressure, and preferences regarding oral versus injectable administration. Dr. Lebwohl stresses that clinicians should never settle for just okay results, as tighter disease control directly reduces the risk of long-term complications like psoriatic arthritis and cardiovascular events.

Dr. Tina Bhutani-Jacques reinforces this message by encouraging providers to shed any lingering hesitation regarding the use of systemic therapies. She points out that the current and emerging classes of medications, particularly selective TYK2 inhibitors, are remarkably safe when paired with appropriate patient monitoring. The experts conclude by reminding clinicians that they are in a unique position to improve not just the skin, but the overall life expectancy and health of their patients. By focusing on shared decision making and the prevention of systemic inflammation, providers can ensure that even patients who are initially hesitant or satisfied with partial clearance understand the vital health benefits of more effective, modern interventions.

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Learn how to personalize systemic psoriasis care, weigh comorbidities, and aim for rapid clearance to reduce heart and joint risks.

Closing Thoughts on TYK2 Inhibition in Psoriasis 

Emerging Updates in Psoriasis from 2026 AAD Annual Meeting 

In ‘Emerging Updates in Psoriasis from 2026 AAD Annual Meeting,’ our panel explores the most impactful findings from the latest clinical gatherings, focusing on how new data is reshaping real-world practice. Dr. Mark Lebwohl highlights the clinical debut of several new TYK2 inhibitors and the recent FDA approval of icotrokinra, the first oral anti-IL-23 receptor peptide. A major focal point of the discussion is the revolutionary data regarding the combination of GLP-1 agonists with standard psoriasis biologics. Dr. Lebwohl notes that in patients with a BMI near 40, adding anti-obesity medication led to a 40% increase in PASI 100 achievement and a 64% improvement in psoriatic arthritis measures.

Dr. Tina Bhutani-Jacques and Dr. Lebwohl examine the biological mechanisms behind these results, suggesting that weight-loss drugs may possess independent anti-inflammatory properties that benefit the heart and joints even in the absence of significant weight reduction. Dr. Lebwohl emphasizes that addressing obesity is now a mandatory component of psoriasis care, as certain types of fat secrete the very cytokines that drive disease progression. He shares his clinical approach to these sensitive conversations, focusing on longevity and health rather than aesthetics. The experts conclude that by integrating anti-obesity treatments with highly selective TYK2 inhibitors or biologics, clinicians can move beyond treating skin surface area to fundamentally altering the patient's systemic inflammatory profile and long-term survival.

Our final episode, ‘Closing Thoughts on TYK2 Inhibition in Psoriasis,’ features the panelists offering practical advice for clinicians navigating the modern treatment landscape. Dr. Bhutani-Jacques and Dr. Lebwohl encourage providers to prioritize total skin clearance and proactive comorbidity management as the standard of care for all patients.

Learn how dermatologists tailor psoriasis treatment—topicals, phototherapy, pills or biologics—using shared decisions, severity and comorbidities.

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.

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

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.

Tina Bhutani-Jacques, MD, MAS, FAAD

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