Treatment of Psoriasis: Improvements Through Clinical Trials

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.

Speakers

Howard Welgus, Executive Medical Director, Dermatology, Premier Research

Message Presenter

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.

Message Presenter