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Fostering Patient Wellness: Prioritizing Safety and Education in PDE4 Utilization

Opinion
Video

Experts in dermatology highlight the crucial role of setting treatment response expectations and stress the need for discussions on managing mild plaque psoriasis, highlighting the utilization of systemic therapies in this context.

This is a video synopsis/summary of a panel discussion involving Lisa Swanson, MD, FAAD, and Robert J. Casquejo, PA-C.

In this conversation, dermatologists discuss the favorable side effect profile of phosphodiesterase-4 (PDE-4) inhibitors, particularly apremilast. They highlight common side effects such as gastrointestinal issues, weight loss, headache, and the significant concern of diarrhea, which some patients struggle with, potentially leading to discontinuation. The dermatologists share their experiences and strategies for managing this side effect.

They emphasize the importance of patient education and setting realistic expectations regarding the medication's speed of action. Acknowledging that apremilast may not work overnight, they advocate for open communication about the medication's safety and efficacy profile, guiding patients through potential side effects. The dermatologists suggest using topical medications concurrently to expedite results.

The discussion shifts to the uniqueness of apremilast as an oral medication with a narrow side effect profile, making it appealing, especially for systemic treatment-naive patients. They emphasize the need for patient education, counseling, and managing expectations to navigate through the initial challenges, such as diarrhea.

The dermatologists also address the broader topic of systemic therapy for mild psoriasis, pointing out that the National Psoriasis Foundation (NPF) guidelines advocate for achieving clear or almost clear skin, even in mild cases. They stress the importance of dermatologists actively discussing systemic therapy with patients experiencing mild psoriasis, aligning with the goal of the NPF and emphasizing the potential benefits of early intervention. The conversation underscores the need for a proactive approach to systemic therapy in mild cases, encouraging dermatologists to initiate these discussions and consider systemic options based on patient preferences and treatment goals.

Video synopsis is AI-generated and reviewed by DermatologyTimes editorial staff.

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