Psoriasis 2015: Pearls from Bruce Strober, MD, PhD

  • Apremilast achieves PASI 75 in approximately 30% of patients after 16 weeks of therapy.
  • Apremilast has FDA-approval for the treatment of both psoriasis and psoriatic arthritis.
  • Apremilast is associated with a >5% weight loss in between 10-20% of treated patients.
  • Secukinumab is the FDA-approved biologic medication with currently the highest level of clinical efficacy of all the self-injectable medications.
  • A side effect of secukinumab is oral candidiasis, which is usually mild and occurs in up to 5% of patients.
  • Secukinimab therapy should be used with caution in patients with inflammatory bowel disease.
  • IL-23 inhibition is a future mechanism of action for psoriasis therapy that shows very high efficacy in early clinical trials.
  • Ixekizumab is an IL-17 inhibitor that promises the highest level of efficacy of its class.
  • Tofacitinib inhibits JAK kinases and likely will be an oral drug approved for psoriasis. The only question is which dose, 5 or 10 mg, will be approved.
  • Secukinumab, ustekinumab and apremilast, like TNF inhibitors, are able to treat psoriatic arthritis to varying levels of efficacy. The TNF inhibitors remain the gold-standard therapies for psoriatic arthritis, though.