Paradigm Shifts in the Management of Plaque Psoriasis: Advanced Practice Provider Perspectives - Episode 14
Matthew Brunner, MHS, PA-C, DFAAPA, highlights the most anticipated developments in the field of treating patients with plaque psoriasis.
Lakshi Aldredge, MSN, ANP-BC, DCNP: We’ve covered a lot. We talked about topical treatments, we touched on phototherapy, we talked about the oral treatments, and then the different class of biologic agents, including the TNF [tumor necrosis factor]–alpha inhibitors, IL-17s and the IL-23s. That’s what’s exciting: there’s even more research that’s happening in the field of psoriasis, and there are new agents coming into the field. Can you talk a little about what’s coming down the pipeline?
Matthew Brunner, MHS, PA-C, DFAAPA: I’m really excited. First, we have just seen such an explosion of immunology, knowledge, education, and therapeutics in the last 20 years. And that knowledge and advancement’s continuing. There are new classes of immunologic agents called tyrosine kinase inhibitors [TKIs], and they’re hopefully going to be entering the fray very soon. They’re going to offer another modality and an oral agent that patients will be able to take, hopefully with more convenient dosing options and good safety. We’ll see all that come to fruition.
Then there’s this topical therapeutic aryl hydrocarbon receptor modulating agents that are being studied in both psoriasis and atopic dermatitis. And we may see those in both topical and systemic iterations down the road. The future has never been brighter to be a psoriasis patient. I tell my patients all the time, it’s never great to have psoriasis, but you’ve never lived at a better time to have psoriasis. Every time I see them back in a future visit, the same holds true because new agents are coming—new targets, to help them manage their condition—are being brought to market. It’s really exciting. What do you think about the future?
Lakshi Aldredge, MSN, ANP-BC, DCNP: You said it very well. It’s such a great time to be in the field of psoriasis management because there continues to be such activity and research. We have very passionate researchers who are really looking to find a cure. In the meantime, finding all these targets that help improve the skin, help improve the joints. There new agents coming out, but it’s also important to understand that, for example, with the IL-23s, there are new indications being studied. Right now, many of the IL-23s are indicated for moderate to severe psoriasis in adult patients. We’re going to see clinical trials that are being completed currently in adolescents and in pediatrics. That’s something that we can look forward to. Also, we can look forward to data that are going to be coming shortly about psoriatic arthritis and the use of IL-23 inhibitors in psoriatic arthritis disease. That’s going to be very promising as well.
You said it perfectly: the future has never looked brighter for our patients with psoriasis. As we move toward the goal of clear or near-clear skin and also looking at them holistically, helping prevent the development or worsening of those other comorbidities—such as metabolic syndrome, psychosocial disease, and cardiovascular risk—all these treatment modalities can help us help our patients with psoriasis to live long and healthy, happy, successful lives. That’s our role as NPs [nurse practitioners] and PAs [physician assistants] in dermatology. It’s a very exciting time.
Matthew Brunner, MHS, PA-C, DFAAPA: Thank you for joining me today. This has been really a fun conversation. Hopefully it’s been educational for those of you watching. Thank you for watching HCPLive® Peers & Perspectives®. If you enjoyed the content, please subscribe to our e-newsletters to receive upcoming Peers & Perspectives® and other great content right in your in-box.
Transcript edited for clarity.