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Psoriasis

Advances in the Treatment of Psoriasis and Other Autoimmune Disorders

Lisa B. Samalonis, Managing Editor

The Dermatologist spoke with Joel M. Gelfand, MD, MSCE, professor of dermatology and epidemiology, Perelman School of Medicine, University of Pennsylvania in Philadelphia, Pennsylvania, about his involvement with The 2018 Interdisciplinary Autoimmune Summit (IAS) meeting, the evolving landscape of psoriasis, and his outlook on the future of immune-mediated inflammatory diseases (IMIDs).

Advisors for the 5th annual meeting include Leonard H. Calabrese, DO; Joel M. Gelfand, MD, MSCE; and Stephen B. Hanauer, MD. New 2018 IAS co-chairs are Adam S. Cheifetz, MD; Joseph F. Merola, MD, MMSc, FAAD, FACR; and Mital Patel, MD.

Q. Why is it beneficial for dermatologists to attend the IAS?

A. IAS is a truly unique CME opportunity that brings together dermatologists, rheumatologists, gastroenterologists, and other physicians to exchange ideas and learn from each other’s experience with complex immune-mediated diseases. Complex cases will be discussed on psoriasis, psoriatic arthritis, rheumatoid arthritis, spondyloarthropathies, Crohn disease, and ulcerative colitis.

Q. Why are you involved with the IAS meeting?

A. The faculty are terrific, and the attendees are very engaged. The progress in immune-mediated diseases is staggering—IAS helps us all stay up-to-date with the latest breakthroughs.

Q. Are there any messages about IMIDs that you would like to share with the readers?

A. We can do more for patients with immune-mediated diseases than ever before.

Q. Where do you see the future of treatment of psoriatic disease?

A. Treatments will become increasingly patient centered and will offer a variety of mechanism of action’s necessary for long-term control of a complex chronic inflammatory disease. Increasingly patients will be able to achieve and maintain complete skin clearance.

Q. What are some of your recent research highlight in this area?

A. We have had a lot of advances in my lab. We have shown tha a simple measure of body surface area (BSA) affected by psoriasis is predictive of future diabetes and all-cause mortality. Patients with >10% BSA affected should be especially targeted for preventive health screening and intervention.1,2 We also showed in a randomized placebo-controlled trial that ustekinumab (Stelara) reduces aortic vascular inflammation by 19% compared with placebo. This finding suggests that ustekinumab can reduce aortic vascular inflammation in a manner that predicts a lowering of major cardiovascular events over time. The effects are similar to what is seen with statins. The study is ongoing, and we will look at the effects of continued treatment with ustekinumab for up to 52 weeks on aortic vascular inflammation. Results were presented at the Late Breaking Clinical Trials session at the 2018 American Academy of Dermatology Annual Meeting in San Diego, California.3

For more information about the meeting, please visit http://www.iasmeeting.com/.

References

1. Wan MT, Shin DB, Hubbard RA, Noe MH, Mehta NN, Gelfand JM. Psoriasis and the risk of diabetes: A prospective population-based cohort study. J Am Acad Dermatol. 2018;78(2):315-322.e1.

2. Noe MH, Shin DB, Wan MT, Gelfand JM. Objective measures of psoriasis severity predict mortality: A prospective population-based cohort study. J Invest Dermatol. 2018;138(1):228-230.

3. Gelfand JM, et al. A phase IV, randomized, double-blind, placebo-controlled crossover study of the effects of ustekinumab on vascular inflammation in psoriasis (The Vip-U Trial). Presented at: 2018 American Academy of Dermatology Annual Meeting; February 16-20, 2018; San Diego, CA.