Advances & Unmet Needs in the Management of Plaque Psoriasis – Expert Advanced Practice Provider Perspectives - Episode 15
Douglas DiRuggiero, DMSc, PA-C, reviews how deucravacitinib impacts the quality of life for patients with plaque psoriasis.
Alexa Hetzel, MS, PA-C: We’re jumping into this last section here, talking about future directions and some of the unmet needs we have for our patients. Douglas, how do you anticipate the impact novel and emerging treatments for plaque psoriasis will have on patient quality of life and disease outcomes?
Douglas DiRuggiero, DMSc, PA-C: Well, everything Darren just said is an indirect answer to this. We have a new novel medication that’s in our hands right now. With this novel medication, we have the opportunity to offer patients something oral. Any time something new comes out, I want to know a couple questions answered in my brain. When I sit in a product theater, or I’m at a conference, when I listen to a virtual presentation, I want to know, is it safe, and does it works? Underneath the category of "does it work", does it work well? Does it keep working? And does it work better than what we already have?
It’s been tough I think for deucravacitinib. It’s got a lot of answers that it has to provide for questions. When we get these new novel emerging therapies, we want to have those questions answered. In the trials, it compared itself with apremilast, both looking at safety and efficacy data. We’ve been writing apremilast since 2014 when it came out. We all have experience with apremilast, but we know it can cause some nausea, vomiting, changes in stools, and there are some questions you want to ask about this depression. So deucravacitinib needed to make sure the audiences know that it didn’t see any nausea, vomiting, or diarrhea problems, and it never saw any signs of depression or suicide. So that satisfies those direct issues you have with the current medication.
Then they have to talk about whether they’re like the other JAKs [Janus kinase inhibitors]. And as one of my colleagues already said: Do we have to have all the same concerns of the 5 black box warnings? Good for us, the FDA has taken that pressure off of us. But that doesn’t mean that, with these novel therapies that are here to stay, we don’t have to do our due diligence with asking the right questions and selecting the right patients. We’ve got a lot more patients that are going to be right on this medication.
To answer your question more directly, isn’t it exciting that we have these novel topical things that are coming out—and we haven’t gotten into that—but we have novel topicals, new compounds, and new molecules. We now have these new classes of intercellular interrupters of gene transcription with these JAKs and now in TYK [tyrosine kinase inhibitors], which is a type of JAK. And we still have our monoclonal antibodies and our other orals. We have so many arrows in our quiver that we can shoot at this disease, and the reason for this is to improve patients’ lives. That’s our No. 1 concern. That’s why I got into doing medicine. It’s why I still love doing what I do, because I see patients’ lives change.
Transcript edited for clarity