Facing The Challenges of Systemic Therapy Selection for Psoriasis

In this episode of Derms and Conditions, host James Q. Del Rosso, DO, is joined by Brad Glick, DO, dermatologist and residency program director at Larkin Health Center in South Florida, to discuss the complexities of selecting systemic therapies for psoriasis. They share insights on navigating the abundance of treatment options, focusing on patient-centric considerations, with an emphasis on the TYK2 inhibitor deucravacitinib. They begin by highlighting how treatment selection often depends more on disease location and patient impact than on body surface area alone and discuss the importance of addressing comorbidities, such as metabolic syndrome or inflammatory bowel disease, when determining the best therapy for each patient. Dr Glick then shares anecdotal examples to illustrate the value of deucravacitinib, including its success in treating an elderly patient with longstanding psoriasis and a younger patient with psoriasis and psoriatic arthritis. Efficacy in difficult-to-treat sites such as the scalp is also important to note. They then address the importance of collaboration with primary care physicians to address underlying cardiovascular and metabolic risks while encouraging patients to adopt healthy lifestyle changes like smoking cessation and exercise. They conclude by highlighting the importance of long-term data, citing deucravacitinib’s 4-year efficacy and safety results, and anticipate the arrival of new oral therapies that will further expand treatment choices and improve patient outcomes. Tune in to the full episode for deeper insights into the challenges and opportunities in systemic therapy selection for psoriasis, including strategies for navigating the expanding treatment landscape, tips for addressing comorbidities, and pearls for integrating therapies like deucravacitinib into practice with a patient-centered approach.