Ep. 280 "On-Treatment Remission in Psoriasis"

What exactly is on-treatment remission in psoriasis? Listen as rheumatologist Dr. Jeffrey Stark discusses this question with dermatologist Dr. April Armstrong and patient advocate Elizabeth Park. On-treatment remission is a relatively new term being applied to the management of psoriasis. What does this mean for treatment goals and why is it important to address that last 10% of residual skin involvement? is it truly possible to attain skin clearance? Listen as rheumatologist Dr. Jeffrey Stark, head of medical immunology at UCB asks such questions and more with internationally recognized dermatologist and researcher Dr. April Armstrong, Chief of Dermatology at UCLA and patient advocate Elizabeth Park offering her perspective of living with plaque psoriasis since age 11. The intent of this episode is to identify what on-treatment remission is and why it is important to achieve in the management of psoriasis.  This episode is sponsored by UCB.  Timestamps: 0:00 Intro to Psoriasis Uncovered and guest welcome to dermatologist Dr. April Armstrong, Professor and Chief of Dermatology, University of California Los Angeles (UCLA) and patient advocate Elizabeth Park who shares her perspective on living with psoriasis.  1:05 The evolution of psoriasis management over the last 15 years from a better understanding of the disease and treatment to attain clear skin.    3:30 Elizabeth's early days of diagnosis and management of her psoriasis at a young age.  7:20 How talking to my doctor and advocating for myself changed my psoriasis management.  8:47 Why clearing even residual psoriasis plaques is important to reducing the inflammatory storm and subsequent risks associated with psoriasis. 11:43 Psoriasis is more than what's visible on the skin.                                                                                                                                                         12:08 How Elizabeth stays vigilant about changes and chooses to live her life.  13:00 The concept of on-treatment remission vs a cure, and how it relates to psoriasis and guidelines in use for other diseases. 16:14 The official definition of on-treatment remission in psoriasis. 19:35 The mental load of having psoriasis and what clearance or remission means to Elizabeth. 21:56 Nuances of on-treatment remission vs tight disease control. 23:56 As a chronic disease, ongoing treatment is necessary. 26:15 We are living in an exciting time where through use of advanced therapies, clearance is possible for many people. Key Takeaways: ·       Introduced in June 2025 through a consensus statement from the Medical Board of the National Psoriasis Foundation, on-treatment remission is a new view of managing psoriasis made possible through a greater understanding of the disease and the evolution of systemic treatments.    ·       Attaining complete clearance and remission of psoriasis is possible with current and ongoing treatment.  ·       Intervening early in psoriasis management to control the cytokine storm and attain remission may help prevent progression of related           comorbidities like cardiovascular disease or psoriatic arthritis. Guest Bios:   April Armstrong, M.D., M.P.H. is an internationally renowned dermatologist and clinical researcher who is a Professor and Chief of Dermatology at the University of California Los Angeles (UCLA) where she specializes in inflammatory skin diseases such as psoriasis, atopic dermatitis, and hidradenitis suppurativa (HS). Dr. Armstrong is also the Co-Director for Network Resources at the UCLA Clinical and Translational Research Institute. She has conducted over 150 clinical trials and published over 600 articles in scientific journals.                        Dr.  Armstrong holds multiple leadership positions including Past Chair of the National Psoriasis Foundation Medical Board, Co-President of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), councilor for the International Psoriasis Council, and board member for the International Dermatology Outcome Measures, and the American Academy of Dermatology. Elizabeth Park is a patient advocate and volunteer for the National Psoriasis Foundation. She developed plaque psoriasis in 2008 after being misdiagnosed with seborrheic dermatitis. For most of her adolescence she managed her scalp psoriasis with topicals and phototherapy. In college her psoriasis became worse and she sought other treatment options which included oral systemic treatments and biologics. She is vigilant about changes to her skin and does what she can to live a healthy life to stay on top of her disease management. Resources: "Redefining Remission: A new definition for patients, providers and payers" Advance Online. S. Schlosser. July 2025. April W. Armstrong, MD, MPH; Geroge C. Gondo, MA; Joseph F. Merola, MD, MMSc; et al "Defining On- Treatment Remission in Plaque Psoriasis" A Consensus Statement from the National Psoriasis Foundation Medical Board. JAMA Dermatology, June 2025.