Strategies and Pathways Targeting Domains in the Treatment of Psoriatic Disease

TARGET AUDIENCE:
This activity has been designed to address the educational needs of rheumatology and dermatology clinicians. It may also be of benefit to other clinicians interested in the care of patients who have psoriatic disease
PROGRAM OVERVIEW:
Psoriatic disease is a complex disease in which musculoskeletal and cutaneous inflammation occurs alongside hyperproliferation of both bone and skin. Patients have heterogeneous presentations of disease activity across 6 domains: Psoriasis, peripheral arthritis, enthesitis, dactylitis, spondylitis, and nail disease. Associated inflammatory processes give rise to additional conditions such as uveitis and inflammatory bowel disease, and comorbid metabolic diseases can further complicate disease management. Psoriatic arthritis (PsA) is frequently accompanied by fatigue, pain, and disability that negatively impact quality of life for patients and further challenge effective management. Aggressive targeted treatment started early in the disease process has demonstrated the best patient outcomes. New guidelines are available that provide treatment recommendations but are not concrete algorithms, so clinicians are left to make treatment decisions based on their understanding of agents’ mechanisms of action and personal experience without sufficient data because head-to-head data to inform decisions are lacking. In this roundtable discussion, rheumatologist and dermatologist faculty discuss the pathologic pathways targeted by biologic therapy, and screening to identify PsA in patients with psoriasis early. Cases are used to illustrate the complexities of psoriatic disease management, and as a springboard to show clinical application of recent guideline recommendations for treatment.
LEARNING OBJECTIVES:
Learning Objectives
Upon completion of this activity, participants should be able to:
• Describe the mechanisms of action for targeted agents to treat psoriasis/PsA
• Develop treatment plans for patients with psoriasis/PsA based on clinical evidence, guideline recommendations, and individual disease manifestations and disease activity
• Make appropriate individualized treatment decisions based on assessment of patient phenotypes, disease activity, comorbidities, treatment experience, and preferences