Novel Topical Treatments in the Management of Plaque Psoriasis - Episode 10
Mona Shahriari, MD, and Linda Stein Gold, MD, review the long-term safety and efficacy data of tapinarof as well as its use in clinical practice for the management of plaque psoriasis.
Brad Glick, DO, MPH: Mona, what has your experience been? Give me your perspective, not only the long-term extension PSOARING 3 but also what you’ve seen in clinical practice. Comment as well on the very few adverse effects in the tapinarof trials, particularly highlighting folliculitis and contact dermatitis.
Mona Shahriari, MD, FAAD: Linda did an incredible job summarizing the PSOARING 3 open-label extension. It was a unique trial design. During that 40 week-period, we had patients coming on and off drug the entire time. But when you looked at their response, we saw this durable disease control. This pointed to the drug working over time, but we also didn’t see tachyphylaxis, which is something that we’ve historically been concerned about with our topical corticosteroids. When it comes to using this drug in the real world and the safety signals, I’ve written quite a few prescriptions since this drug has launched. The safety profile has been consistent with what we saw in the clinical trial. I’ve seen folliculitis, contact dermatitis, and nasopharyngitis, but nothing was different from what we had seen in the clinical trials. When it comes to the folliculitis piece, for the majority of my patients, we treat through it because they’re happy with the results and it goes away on its own. That’s very powerful as well. That might be 1 of the reasons we didn’t see high treatment discontinuation rates within the clinical trial.
Brad Glick, DO, MPH: Linda, postapproval, is that your experience as well?
Linda Stein Gold, MD: It’s very similar. What I love about being a medical dermatologist who sees a lot of patients but also does clinical trials is that we get a unique perspective. We get to see a drug as it’s being born and raised, FDA approved, and then when it’s launched. Sometimes, clinical trial results don’t mirror what we see in actual practice, and we find that very frustrating. But I’ve had an experience similar to Mona’s in that it’s worked the same way in my practice—with patients who have comorbidities and might be using other medications—as what we saw in clinical trials.
Brad Glick, DO, MPH: In my experience, 1 year postapproval, is that I’ve seen folliculitis, but I’m not seeing it at the same rate that we saw in the trials. Linda, to your point that it’s not always the same, 1 good thing is that we’re not seeing any new safety signals that I’ve seen at least in the trenches.
Transcript edited for clarity