Emerging Treatment Options for the Management of Moderate to Severe Psoriasis - Episode 7

The Future of Plaque Psoriasis Management

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Dr Jerry Bagel looks to the future of moderate-to-severe plaque psoriasis management.

Jerry Bagel, MD, MS: I think we’re in a pretty good place. We have drugs that are FDA approved, [taken] 4 times a year, and 65% of people are clear, 80% of them are 90% better, and they don’t have many adverse events to talk about. I think we need to learn how to compound other topicals with them [approved drugs] to get rid of the rest of the psoriasis. I know the National Psoriasis Foundation, where I’m on the board of directors, is involved with $4 million of funding research a year, where we’re trying to look at what is really causing psoriasis to begin with. I still think all of that is about 10 years away. But when people asked me about this question 15 years ago, I never thought I could think about a cure back then. I can start thinking about that now. I think there might be a little lag in the development of more drugs also because biosimilars are going to come into play. I think we’re going to be forced to use some biosimilars along the way, and that will interfere in the economics of pharma [the pharmaceutical industry]. I think we’re in a pretty good place right now for moderate to severe psoriasis.

I also teach in Italy, and they have centers of excellence, like 100 of them, and if a patient gets into one of them and needs a biologic, they get it. So I think access, patients’ access, somehow needs to be improved so that more people can get it. Most people don’t realize that if they come to your office, they’re not going to have to pay thousands and thousands of dollars for their drugs. There’s going to be some sort of assistance program for most people who need it. I wish they knew that because then they would come in and get treatment instead of suffering.

If you talk to any of the major representatives, they’re going to know, there’s an ambassador program from AbbVie Inc [Chicago, Illinois], there’s another program from Janssen Pharmaceuticals, [Beerse, Belgium], there’s a different program for Eli Lilly & Co [Indianapolis, Indiana]. They all have programs that can help their patients. I think that would be something if people knew about, they would [be more willing] to make an appointment and see people who are willing to treat them.

With psoriatic arthritis, it is one thing to help someone who has psoriasis, you want to make them look better and feel better. But if you have joint discomfort, you really want to get on top of that because if you don’t, it’s going to continue, and you’re going to be disabled. So it would be really good if you have any joint discomfort with psoriasis, to get people to jump on that because it would be a shame. There are decent drugs right now. There could be better [drugs] for psoriatic arthritis, but there are decent drugs that are also safe, that could help save your joints from destruction.

Transcript edited for clarity.