Main description:

Biologic therapy is a treatment that strives to modulate a patient's immune system to fight a given disease. In psoriasis, a skin disorder that is partly caused by a dysregulated immune system resulting in well-demarcated red areas of the skin with white scales, biologic therapy has the potential to vastly improve upon patient outcomes by minimizing the symptoms of this disease while maximizing the safety profile of the therapy.

This book offers an up-to-date and comprehensive review on biologic therapy for the treatment of psoriasis. With over 10 FDA approved biologic agents for psoriasis (with more in the pipeline), confusion exists among providers regarding which agent is best for a particular patient. Chapters cover all FDA approved psoriasis biologic agents (including pipeline agents) for use in pediatric, adult, and geriatric patients. This book is unique in that it will not only cover cutting edge treatment principles based on the latest research, it will also be one of the most comprehensive reviews of psoriasis biologics in the COVID-19 era.

Biologic Therapy for Psoriasis is a must-have resource for board certified dermatologists and rheumatologists, dermatology and rheumatology residents and fellows, dermatology physician assistants, nurse practitioners and medical students. The ultimate goal of this book is to improve patient care by making the busy practicing dermatology provider more adept with these particular therapies.

Contents:

Table of Contents

Chapter 1: Introduction to Biologic Therapy for Psoriasis

Review epidemiology, morphology and types of psoriasis

Review immune-mediated pathophysiology of psoriasis

Introduce and review psoriasis outcome measures

Briefly mention and discuss older systemic agents (methotrexate, cyclosporine and acitretin) and the advantages/disadvantages versus biologic agents

Chapter 2: Laboratory Monitoring: TB, Hepatitis and HIV

Discuss risk of TB activation, role of TB testing and treatment of latent TB infections

Discuss risk of Hep B/C reactivation, role of testing and treatment regimen for Hep B/C infections and management of positive Hep B Core Ab

Discuss role of HIV screening in biologic therapy for psoriasis

Chapter 3: TNF-alpha class of Biologic Agents in Psoriatic Disease

Review up do date safety and efficacy data from phase III clinical trials for certolizumab, adalimumab, etanercept in psoriasis

Review up do date safety and efficacy data from phase III clinical trials for certolizumab, adalimumab, golimumab, etanercept in psoriasis in psoriatic arthritis

Discuss the unique merits and demerits for each agent

Chapter 4: IL-17 class of Biologic Agents in Psoriatic Disease

Review up do date safety and efficacy data from phase III clinical trials for secukinumab, brodalumab and ixekizumab in psoriasis

Review up do date safety and efficacy data from phase III clinical trials for secukinumab, and ixekizumab in psoriasis in psoriatic arthritis

Discuss the unique merits and demerits for each agent

Include phase II data for pipeline agents

Chapter 5: IL-12/23 and IL-23 class of Biologic Agents in Psoriatic Disease

Review up do date safety and efficacy data from phase III clinical trials for ustekinumab, guselkumab, risankizumab and tildrakizumab in psoriasis

Review up do date safety and efficacy data from phase III clinical trials for ustekinumab and guselkumab in psoriatic arthritis

Discuss the unique merits and demerits for each agent

Include phase II date for pipeline agents

Chapter 6: Combination Therapy with Biologic Agents

Review available safety and efficacy data with biologic agents and systemic agents (methotrexate, cyclosporine, acitretin, and other biologics (dual biologics))

Review available safety and efficacy data with biologic agents and phototherapy

Review available safety and efficacy data with biologic agents apremilast

Chapter 7: Biologic Agents in the Treatment of Pediatric Psoriasis

Review effective counseling methods for parents

Review data on compliance with biologic use in the pediatric population along with different types of delivery methods (ex. auto-injector vs. syringe)

Discuss unique challenges and solutions when using a biologic agents in the pediatric population

Review phase III safety and efficacy data for ustekinumab, etanercept and ixekizumab for use in the pediatric population

Discuss the role of biologic agents in the treatment of recalcitrant cases of pediatric psoriasis

Chapter 8: Special Site Psoriasis

* Review safety and efficacy data for biologic treatment of nail psoriasis

* Review safety and efficacy data for biologic treatment of scalp psoriasis

* Review safety and efficacy data for biologic treatment of palmoplantar psoriasis

* Review safety and efficacy data for biologic treatment of genital and inverse psoriasis

Chapter 9: Comparing Biologic Agents in the Treatment of Psoriasis

Introduce concept of network meta-analysis

Review key network meta-analysis studies for psoriasis biologics including

Short term and long term efficacy of biologic agents

Cumulative clinical improvement and speed of improvement with biologic agents

Efficacy and safety of biologic agents

Tolerability

Discuss data on cost-effectiveness of different biologic treatments for psoriasis (economic model of analysis)

Discuss data and review studies on drug survivability

Chapter 10: Long Term Registry Data for Psoriasis Biologics

Discuss importance of registry studies and how they are conducted

Discuss benefits and disadvantages or registry studies

Review key findings from psoriasis registry studies concerning biologic agents (examples PSOLAR, BADBIR, Psonet initiative)

Discuss real world efficacy studies for psoriasis biologics

Chapter 11: Psoriasis Biologic Agents in Special Populations

* Discuss biologic use in pregnant and breastfeeding patients

* Discuss biologic use in patients who are HIV positive

* Discuss biologic use in patients with history of malignancy

* Discuss biologic use in geriatric patients

* Discuss management recommendation for biologic use in patients undergoing surgery

* Discuss the role of biomarkers/precision medicine with psoriasis biologics

Chapter 12: Psoriasis Biologics and the COVID-19 Pandemic: Lessons Learned

Discuss data on COVID-19 infection risk and psoriasis biologics

Discuss data on COVID-19 morbidity and psoriasis biologics

Discuss role of psoriasis biologics in treating cytokine storm

Discuss data on covid-19 vaccination responses in patients receiving biologics

Discuss lessons learned and implications for future novel viral outbreaks