Faculty Opinions recommendation of Are patients with psoriasis undertreated? Results of National Psoriasis Foundation survey.

The biologic agents vary considerably in terms of their long-term duration of effect. Using the definitions provided by the National Psoriasis Foundation Medical Board, the objective of this review was to compare all biologic agents with respect to time to relapse and potential for rebound. Overall, alefacept had the longest off-treatment benefit (29.9 weeks in Psoriasis Area and Severity Index [PASI] 75 responders), followed by ustekinumab (22 weeks), infliximab (19.5 weeks), adalimumab (18 weeks), etanercept (12.1 weeks in PASI 50 responders), and lastly efalizumab (9.6 weeks). Rebound was reported commonly for efalizumab (14%) and extremely rarely for etanercept (0.002%).

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Results of a Survey of the National Psoriasis Foundation Medical Board on the Management of Ear Psoriasis

Journal of Psoriasis and Psoriatic Arthritis ◽

10.1177/2475530319891954 ◽

2019 ◽

Vol 5 (1) ◽

pp. 28-31

Author(s):

Amy Blake ◽

Clinton Enos ◽

April W. Armstrong ◽

Amit Garg ◽

Alice Gottlieb ◽

...

Keyword(s):

Side Effects ◽

Sample Size ◽

Treatment Response ◽

Biologic Therapies ◽

Adverse Side Effects ◽

Medical Board ◽

Choice Of Treatment ◽

Complete Inspection ◽

Routine Inspection ◽

National Psoriasis Foundation

Background: There is limited literature on the occurrence and management of psoriasis involving the ear. Objective: To better understand psoriasis of the ear and current approaches for management. Methods: The Medical Board of the National Psoriasis Foundation was surveyed on the frequency and presentation of psoriasis of the ear, the types of examinations performed, and the rationale for choice of treatment. Results: In this survey, the observed frequency of ear psoriasis was wide (10%-70%). The scalp was the most common concurrent site of extra-auricular psoriasis. Inspection of the ear was commonly reported; however, 75% of respondents report not inspecting the canal. Topical corticosteroids were the most commonly used treatment. Systemic and biologic therapies are infrequently used. Limitations: This study is limited by the sample size of respondents. Not every question of the survey was answered by all those surveyed. Conclusions: Results from our survey suggest that the evaluation of psoriasis of the ear is often not complete. Inspection of the ear, including the canal, is recommended, especially if the scalp is involved. Routine inspection of the ear is recommended both to evaluate treatment response and for potential adverse side effects. In the setting of persistent ear disease, collaboration between dermatologists and otolaryngologists is encouraged.

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A systematic review of herpes zoster incidence and consensus recommendations on vaccination in adult patients on systemic therapy for psoriasis or psoriatic arthritis: From the Medical Board of the National Psoriasis Foundation

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2019.03.017 ◽

2019 ◽

Vol 81 (1) ◽

pp. 102-110 ◽

Cited By ~ 12

Author(s):

Emily Baumrin ◽

Abby Van Voorhees ◽

Amit Garg ◽

Steven R. Feldman ◽

Joseph F. Merola

Keyword(s):

Systematic Review ◽

Herpes Zoster ◽

Psoriatic Arthritis ◽

Systemic Therapy ◽

Adult Patients ◽

Medical Board ◽

Consensus Recommendations ◽

National Psoriasis Foundation ◽

Herpes Zoster Incidence

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2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

Journal of Psoriasis and Psoriatic Arthritis ◽

10.1177/2475530318812244 ◽

2018 ◽

Vol 4 (1) ◽

pp. 31-58 ◽

Cited By ~ 2

Author(s):

Jasvinder A. Singh ◽

Gordon Guyatt ◽

Alexis Ogdie ◽

Dafna D. Gladman ◽

Chad Deal ◽

...

Keyword(s):

Health Care ◽

Psoriatic Arthritis ◽

Literature Review ◽

Evaluation Methodology ◽

Interleukin 12 ◽

Care Providers ◽

American College Of Rheumatology ◽

Clinical Scenarios ◽

Review Team ◽

National Psoriasis Foundation

Objective: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). Methods: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. Results: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. Conclusion: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

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2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis

Arthritis & Rheumatology ◽

10.1002/art.40726 ◽

2018 ◽

Vol 71 (1) ◽

pp. 5-32 ◽

Cited By ~ 86

Author(s):

Jasvinder A. Singh ◽

Gordon Guyatt ◽

Alexis Ogdie ◽

Dafna D. Gladman ◽

Chad Deal ◽

...

Keyword(s):

Psoriatic Arthritis ◽

American College Of Rheumatology ◽

National Psoriasis Foundation

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Prevalence of Utilization Management Policies Among the Psoriatic Disease Community: Results From the 2019 National Psoriasis Foundation Advocacy Survey

Journal of Psoriasis and Psoriatic Arthritis ◽

10.1177/2475530320956602 ◽

2020 ◽

Vol 5 (4) ◽

pp. 178-183

Author(s):

George Gondo ◽

Julia Boles ◽

Patrick Stone ◽

Leah Howard ◽

Stacie J. Bell

Keyword(s):

Online Survey ◽

Patient Characteristics ◽

Insurance Company ◽

Utilization Management ◽

Psoriatic Disease ◽

Management Policies ◽

National Psoriasis Foundation ◽

Step Therapy ◽

To Receive ◽

Disease Community

Introduction: Utilization management (UM) policies are becoming more common among commercial insurance policies. However, little research has been conducted to understand the prevalence of experiencing UM restrictions among patients with psoriatic disease. Objectives: To understand the prevalence of UM policies within the psoriatic patient community and examine their relationship with patient characteristics. Methods: An online survey of 1205 individuals with a psoriatic disease from the National Psoriasis Foundation’s constituent database was conducted. Data were collected from July 7 to July 31, 2019. The main outcomes of interest for the present study were frequency of experiencing UM policies (eg, prior authorization [PA] or step therapy [ST]) from their insurance company, number, and type of UM policies experienced and relationship between patient characteristics and experiencing these policies. Results: Survey respondents reported high rates of experiencing some form of UM restriction (80.5%). Nearly half (45.1%) of the survey respondents indicated their insurer required them to try a therapy other than the therapy originally prescribed by their physician, a practice known as ST or “fail first” and 73% of respondents reported having to receive PA from their insurer before initiating treatment. Conclusions: Individuals with psoriatic disease commonly encounter UM policies from their insurer when attempting to manage their disease. Statistical analyses suggest that UM policies are related to the type of treatment used by patients and the type of psoriatic disease.

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