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Unmet Needs in the Treatment Spectrum of Plaque Psoriasis


Experts in dermatology review unmet needs in the plaque psoriasis treatment landscape, as well as ongoing studies coming down the pipeline.

Alexa Hetzel, MS, PA-C: So, Jennifer, with the rapid expansion of the treatment spectrum over the past decade, what unmet needs do our patients still have? What unmet needs do we have?

Jennifer Conner, MPAS, PA-C: I think what I would love to see—and we’ve done a little bit of research in my office—is a way to identify which of these systemic agents [and] biologics is going to work for a particular patient. That’s what I’m waiting for. That’s what really excites me. There is some testing that’s out there. [I’m] interested to see how that’s going to pan out and whether we’ll get some good data that will really drive the decision-making process. That’s where I think it would be the most helpful. Right now, I think we do a pretty good job based on clinical history and comorbidities. Do they have psoriatic arthritis? That’s how I make my decisions now, along with the patient’s preference. But I would love to have some of that information to help guide the decision, to know this patient’s going to respond better to an IL-23 inhibitor vs an IL-17 inhibitor from the get-go. Wouldn’t that be great?

Alexa Hetzel, MS, PA-C: Yes. It’s like knowing the secret code before we go in there. So then, Laura, what’s new? What’s ongoing? What are you excited about? What articles have you read? What do we have coming in the pipeline?

Laura Bush, DMSc, PA-C: We want to know that secret code. There is an oral IL-23 [inhibitor] that’s being worked on. That’s pretty exciting because I feel like the IL-23s are fairly safe, so that’s pretty neat to me.

Alexa Hetzel, MS, PA-C: We did the study in our office and it’s really incredible. It was a phase 2 [study] and only 16 weeks and I’m so sad when they’re over because they do so well. Now we have to wait another what year until phase 3 comes and then 5 years until FDA approves [it]. But it is so exciting. Terry, do you know of anything new coming down the pipeline?

Terry Faleye, MPAS, PA-C: I know that there’s been some anticipation with bimekizumab coming to market. I think that the excitement is definitely still there, especially looking at the data that are there as well. For a while people were [not excited about] another IL-17, but it is 17A and 17F as well. So I think there is definitely that, and it’s a great arsenal that’ll be able to be added to the pipeline.

Alexa Hetzel, MS, PA-C: Lakshi, anything you’re excited about?

Lakshi Aldredge, MSN, ANP-BC: Just in the space of dermatology in general, we’re so fortunate that we have so much researchgoing on. I’m really excited about the oral therapies that are coming out, the expansion of JAK [inhibitor] therapies, including deucravacitinib. I’m also really excited that companies are looking at and extrapolating data specifically for psoriasis in specific body regions: hard-to-treat areas, scalp, genitals…. We have an agent for the first time focusing on generalized pustular psoriasis. Again, a very small number of patients, but it’s incredibly debilitating. I think it’s really exciting that even some of the existing drugs are getting [more] information about how they can be utilized more effectively within the psoriasis [disease] state but also in other disease states.

Alexa Hetzel, MS, PA-C: Awesome.Jennifer, anything else exciting in the back house of the research side of your office?

Jennifer Conner, MPAS, PA-C: I’m trying to think what else we have going on right now. There’s a retinoic acid receptor inhibitor. That’s the one thing that comes to mind.

Alexa Hetzel, MS, PA-C: …It’s just so exciting that there are so many great things that are coming down the pike, and it just gives us more options. More options are good, and the more options we have, the more we understand psoriasis better, and the closer we’re getting to a cure.

Transcript edited for clarity.

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