USC Dermatology-Focused Clinical Investigator Discusses the Impact of Moderate to Severe Plaque Psoriasis

Feb 1, 2020 | Dermatology, Moderate-to-severe Psoriasis, Monoclonal Antibodies, USC Keck School of Medicine

USC Dermatology-Focused Clinical Investigator Discusses the Impact of Moderate to Severe Plaque Psoriasis

Dr. April W. Armstrong, Associate Dean of Clinical Research at Keck School of Medicine at University of Southern California (USC), reports that nearly 6.4 million people are suffering from plaque psoriasis, a chronic autoimmune disease that can cause significant discomfort and outbreaks in awkward places and can penetrate much deeper than the skin. This autoimmune condition can profoundly impact people’s lives. With no cure, nearly 50% of patients diagnosed don’t know what to do about treatment options and need help.

No Cure

There is no cure for moderate-to-severe psoriasis. Symptoms can become extremely uncomfortable to painful, from redness and thickness of the skin to flaking, and it can emerge in many awkward parts of the body. For example, people can experience the condition on the elbows, knees, or scalp. According to the Mayo Clinic for those severe cases where biologics are considered, there are a number of approved drugs including Enbrel (Amgen), Remicade (Janssen), Humira (AbbVie), Stelara (Janssen), Simponi (Janssen), Otezla (Celgene) Cosentyx (Novartis) and Taltz (Lilly). Mayo Clinic notes that these powerful drugs must be used with significant caution as they strongly impact the immune system and could permit life-endangering infections.

In a confusing market, lots of competitive advertising doesn’t help. Objective research is a patient’s friend. In Choosing First-Line Biologic Treatment for Moderate-to-Severe Psoriasis: What does the Evidence Say, physicians from the Dermatology Research and Education Foundation in Irvine, California, and peers discuss some key elements that influence which first-line biologic treatment for moderate-to-severe psoriasis to elect. Author Jashin Wu, et al. noted that elements can include body surface area (BSA) impacted, comorbidities including psoriatic arthritis (PsA), and other elements such as certain psoriasis that are extremely challenging to treat. In a MedPage piece quote, Wu noted: “Once I determine a patient has a BSA (affected) of 10% or more, and if they have PsA, then I use TNF inhibitors or I-17 inhibitors.” He continued, “If there is no PsA, then I prefer a biologic with long dosing intervals like Stelara or Tremfya.”

What about ILUMA?

In the Tucson Arizona article, Dr. Armstrong, also a faculty with the Dermatology Research and Education Foundation, is associated with an introduction to ILUMYA. ™ This particular report, originating from KGUN 9 in Tucson, Arizona, also prominently introduced the treatment known as ILUMYA.™ This biologic was approved in 2018 by the U.S. Food and Drug Administration for adults with moderate-to-severe plaque psoriasis and who are eligible for systemic therapy or phototherapy. The dug was originally developed by Schering Plough and became part of Merck after a merger. Sun Pharmaceuticals acquired the worldwide rights to the biologic for $80 million.

The approval was based on the results from two Phase III clinical trials evidencing significant improvements in patients who received the drug (100mg) compared with a placebo.

Updates on ILUMYA

In a recent academic research publication titled Update on Tildrakizumab for Psoriasis,” published in Current Dermatology Reports, Wake Forest researchers finds that this recently approved drug “is a useful therapy for treating moderate-to-severe psoriasis.” In another study involving Dr. Armstrong from USC, as well as other dermatology efforts, the investigators looked at effectivity and cost and reported that the highest priced drug was for Stelara (Janssen) and the lowest cost was Brodalumab (Valeant in the U.S.).

Lead Research/Investigator Profile

April W. Armstrong is Associate Dean of Clinical Research at Keck School of Medicine at USC and serves as Director of Clinical Research for the Southern California Clinical and Translational Research Institute (SC CTSI). In the Department of Dermatology at USC, she serves as Vice-Chair, Director of Clinical Trials and Outcomes Research, and Director of the Psoriasis Program. Dr. Armstrong obtained her medical degree from Harvard Medical School and completed a dermatology residency at the Harvard Dermatology Residency Program. She also obtained a Master of Public Health degree from Harvard School of Public Health. Dr. Armstrong has conducted studies examining how new therapies impact patients’ disease states, quality of life, and their access to medical care. She is also examining how technology-enabled healthcare delivery can be applied to manage patients with chronic dermatological diseases. Her work has been supported by the NIH, Patient-Centered Outcomes Research Institute (PCORI), the Agency for Healthcare Research and Quality (AHRQ), the Dermatology Foundation, and the National Psoriasis Foundation.


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