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Treatment of Psoriasis:

Improvements Through Clinical Trials


Date: March 29, 2017 (60 minutes)

Featured Speakers:

  • Howard Welgus, Executive Medical Director, Dermatology, Premier Research
  • Ted Trafford, Managing Director, Probity Medical Research

The Heartbreak of Psoriasis is No Longer

Treatment of psoriasis, a skin condition afflicting about 2 percent of the U.S. population, has undergone a revolution over the past two decades. This webinar will examine the clinical and pathogenetic aspects of the disease and the characteristics of clinical trials that seek to address this genetic condition.

The pathophysiology of psoriasis involves the activation and proliferation of T helper cells, in particular Th-17 cells. Activated Th-17 cells produce the clinical hallmarks of psoriatic lesions: erythema, scaling, and induration. Several environmental triggers are known to exacerbate psoriasis, including emotional stress, injury, some types of infection, and reactions to certain drugs.

In the past 20 years, treatments for psoriasis have greatly improved life for the severely afflicted. The treatment revolution has come in the biologics arena in products that have provided essentially clear skin for more than half of patients. The first treatments were TNF inhibitors Enbrel and Humira, then the IL-12/23 inhibitor Stellara, and now the IL-17a inhibitors Cosentyx and Taltz. The IL-17a inhibitors are so effective that about 80 percent of patients experience 75 percent improvement after 12 weeks of treatment, and almost 60 percent see 90 percent improvement.

For those with mild to moderate impairment, the therapeutic mainstays have remained potent topical steroids, for their anti-inflammatory properties, and vitamin D derivatives, cell differentiators that help slow and correct the hyper-proliferative state of the disease.

The association of arthritis with psoriasis has been known for centuries, but until about a decade ago, psoriasis was otherwise thought to be a disease limited to the skin. Since then, psoriasis has been found to have a number of co-morbidities, and its systemic nature is now well-established. Metabolic syndrome is twice as common in psoriatics as in the general population. Patients with severe psoriasis are 58 percent more likely to have a major cardiac event and 43 percent more likely to have a stroke than otherwise normal individuals. What’s more, psoriatics are 30 percent more likely to develop diabetes, and 10 percent will develop inflammatory bowel disease.

Keywords: Psoriasis, Dermatology


    Howard Welgus, Executive Medical Director, Dermatology, Premier Research

    Dr. Howard Welgus is a board-certified dermatologist who received his medical and scientific training at Washington University School of Medicine in St. Louis. After completing a residency in Dermatology, he stayed on faculty at Washington University for 17 years, becoming a tenured full Professor and heading their Division of Dermatology at The Jewish Hospital of St. Louis for most of this time. Howard published over 120 manuscripts during his tenure at Washington University.

    Howard was recruited into the pharmaceuticals industry in 1999, spending 10 years at Pfizer in Ann Arbor. During this time, he was Vice President and Therapeutic Area Head of the Dermatology and Inflammation disciplines. These therapeutic areas placed over 20 compounds into Development during this time span. Howard was also involved in developing Lyrica® for fibromyalgia and Xeljanz® for rheumatoid arthritis and psoriasis. When Pfizer closed the Ann Arbor site in 2009, Howard joined Nycomed (Fougera/PharmaDerm) as their head of Research & Development and was also their Chief Medical Officer. At Nycomed, Howard directed the post-approval development of several important topical dermatologics and he also contributed to the launch of generic imiquimod which largely replaced Aldara®.

    Howard is a Fellow of the American Academy of Dermatology and is a member of several prestigious medical societies including the American Dermatologic Association, the American Society of Clinical Investigation, and the Association of American Professors. While at Washington University, he served on the National Institutes of Health GMA-1 study section for 4 years.

    Ted Trafford, Managing Director, Probity Medical Research

    Ted Trafford is currently the Managing Director of Probity Medical Research, a company providing administrative support to its consortium of clinical trial sites in the US, Canada, Australia and South America. Ted has been involved with Dermatology clinical trials for 21 years.

    Starting as a lab assistant and clinical research coordinator for a new dermatology clinical research site in 1995, Ted’s background in dermatology clinical research began with learning the fundamentals of clinical research with a focus on dermatology trials. Now, after having been involved with over 400 dermatology clinical trials, Ted has a unique operational perspective that comes from the clinical trial site and the patients they care for.

    Ted is responsible for leading the operations of Probity Medical Research in support of their 46 sites and consults on dermatology study design, subject recruitment and clinical trial site logistics.


    Senior professionals from pharmaceutical and biotechnology companies involved in dermatology related drug development or clinical trials


    Premier Research is a leading CRO serving highly innovative biotech, pharmaceutical and medical device companies. The company has a wealth of experience in rare disease and pediatric research having managed about 100 projects in each area in the last five years alone. Its services include clinical research and regulatory outsourcing in the areas of analgesia; neurology; infectious, cardiovascular, and respiratory disease; dermatology; oncology; and medical devices.

    Premier Research and operates in 84 countries. It employs 1,000+ clinical professionals dedicated first and foremost to fulfilling each customer's requirements in a timely, accurate, and cost-effective manner. This includes a strong international network of monitors and project management professionals combined with regulatory, data management, statistical, scientific, and medical experts, and staff at its well-established network of dedicated clinical sites.

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