Peer Exchange

Jason Hawkes, MD, MS; Saakshi Khattri, MD; James Song, MD; and Fabrizio Galimberti, MD, PhD, discuss how comprehensive psoriasis management requires integrating multiple severity assessment tools; considering disease impact beyond body surface area; addressing undertreatment especially in patients with high-impact locations and diverse skin types; recognizing the value of biologics as demonstrated in studies like SPECTREM; and embracing future directions that prioritize personalized approaches, earlier intervention, and quality-of-life outcomes.

Experts discuss the impact of hypercortisolism, its clinical presentation, the relationship with comorbidities like hypertension and type 2 diabetes, and the 3 screening tests used in clinical practice to diagnose the condition.

Experts discuss the mechanism of action of oral Janus kinase (JAK) inhibitors, the impact of selectivity on efficacy and safety, the long-term safety and efficacy of JAK inhibitors in atopic dermatitis (AD) treatment compared with other disease states, and the latest data for the 2 oral JAK inhibitors approved for AD and their implications for treatment.

Panelists discuss novel approaches to diagnosing and treating generalized pustular psoriasis, highlighting emerging therapies, advances in early detection, and personalized treatment strategies to improve patient outcomes.

Brad P. Glick, DO, MPH, FAAD; Zed Zha, MD, FAAFP; Charles Vega, MD, FAAFP; Mona Shahriari, MD, FAAD, and Michael R. Nazareth, MD, PhD, FAAD, discuss reviewing strategies for diagnosing atopic dermatitis and determining disease severity in adult patients, exploring the latest data for the use of systemic therapies for adults with atopic dermatitis, and using practical approaches and strategies for comanagement of adult patients with atopic dermatitis between primary care practitioners and dermatologists.

Giselle Mosnaim, MD, MS; Shyam Joshi, MD; Mark Lebwohl, MD; and Jason Hawkes, MD, MS, discuss how chronic spontaneous urticaria, driven by both IgE and IgG pathways, may soon be treated with selective Bruton tyrosine kinase inhibitors that show promising efficacy and safety in targeting both mechanisms, potentially filling an important gap between antihistamines and biologics in the treatment landscape.

M. Bradley Drummond, MD, MHS; MeiLan K. Han, MD, MS; Emily Wan, MD, MPH; and Ravi Kalhan, MD, MS, discuss updates and additions in the recently released 2025 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Report. We will review the clinical and economic burden of chronic obstructive lung disease (COPD) and unmet needs in its treatment. We will summarize key changes in the recent GOLD Report and highlight the clinical evidence for 2 new agents, dupilumab and ensifentrine, in treating stable COPD. Finally, we will discuss current GOLD recommendations for using these agents and their expected role in clinical practice.

Panelists discuss multidisciplinary approaches to the management of pediatric atopic dermatitis (AD), including the pathophysiology of AD, the role of type 2 inflammation, and the importance of early diagnosis and referral. They explore the atopic march and its potential links to other allergic diseases, review current treatment options and recent guidelines, and highlight advances in systemic therapies for moderate to severe AD, while addressing challenges related to treatment resistance and evolving strategies to manage pediatric patients.

Panelists discuss how IL-13 targeting biologics, including dupilumab, tralokinumab, and lebrikizumab, are advancing the treatment of atopic dermatitis, improving efficacy, safety, and patient outcomes, while addressing key challenges in diagnosis and treatment selection.

Manesh R. Patel, MD; Payal Kohli, MD, FACC; John M. Flack, MD, MPH, FAHA, FASH, MACP, CHS, and C. Michael Gibson, MS, MD, explore the challenges and evolving management strategies for resistant hypertension, including medication adherence, comorbidities like CKD, traditional and novel drug mechanisms like aprocitentan, and the importance of accurate blood pressure measurement, while emphasizing the critical role of the endothelin pathway and comprehensive treatment approaches.

Panelists discuss how a multidisciplinary approach, early diagnosis, and emerging therapies are essential in managing Familial Chylomicronemia Syndrome (FCS)to prevent acute pancreatitis and mitigate long-term cardiovascular risks.

Panelists discuss how comprehensive cardiovascular disease management requires integrating screening protocols, risk assessment, and targeted interventions across the lifespan, from pediatric lipid testing through adult treatment strategies, while addressing barriers to care and leveraging both established and emerging therapeutic options.

Panelists discuss how addressing the gaps in screening, diagnosis, and treatment can significantly improve outcomes for patients with chronic kidney disease (CKD) in the context of type 2 diabetes.

This discussion provides an in-depth overview of Primary Biliary Cholangitis (PBC), covering pathophysiology, clinical presentation, diagnostic approaches, disease progression, management strategies—including first- and second-line therapies—and recent advances in PPAR agonist treatments to guide optimal care for patients.

Panelists discuss how to effectively diagnose and manage chronic spontaneous urticaria, highlighting the importance of personalized treatment approaches and the exploration of emerging therapies to improve patient outcomes.

Panelists discuss how advancements in understanding IgA nephropathy (IgAN) and emerging therapies aim to address unmet treatment needs while improving patient outcomes through targeted approaches to disease management.

Panelists discuss how evolving treatment strategies and improved diagnostic approaches can enhance the management of Cchronic Sspontaneous Uurticaria (CSU), ultimately aiming to improve patient outcomes and quality of life.

Panelists discuss how early diagnosis and the utilization of systemic Janus kinase inhibitors are crucial in the effective management of alopecia areata, highlighting the impact of disease severity and patient experiences on treatment strategies.

Raj Chovatiya, MD, PhD, MSCI; George Han, MD; Elizabeth (Lisa) Swanson, MD; and Peter Lio, MD, explore the latest advances in oral systemic treatments for atopic dermatitis, including the use and long-term safety of oral JAK inhibitors, strategies for switching therapies, and navigating treatment breaks.

Medical experts discuss hypercortisolism in the diabetes landscape.

A panel of experts on atopic dermatitis review clinical trial data and discuss how treatment advances are improving patient-reported outcomes and elevating the standard of care.

A panel of experts on iron deficiency anemia has a comprehensive discussion on the clinical utilization of intravenous iron, highlighting available products and clinical practices on administration and monitoring.

Led by Gordon K. Lam, MD, FACR, a panel of medical experts will provide insights surrounding treatment and management for patients diagnosed with rheumatoid arthritis.

Pamela Kushner, MD, FAAFP; Nancy Reau, MD; Arun B. Jesudian, MD, and Kimberly Brown, MD, discuss diagnosing hepatic encephalopathy (HE), strategies for preventing the progression of cirrhosis, the current standard of care for HE management, and provide guidance to support primary care clinicians in effectively treating patients with HE in the outpatient setting.

Experts on chronic obstructive pulmonary disease (COPD) have a comprehensive discussion on treatment practices, with a focus on emerging pathways and the role of type 2 inflammation in patients with the disease.

A panel of experts discuss simplified treatment approaches for HIV, highlighting the role of the primary care and advanced practice provider, the importance of early treatment initiation, and ways to manage drug resistance.

Nicole Chase, MD, leads a panel of medical professionals highlighting critical aspects of asthma exacerbation and treatment management.

Medical experts provide a comprehensive approach to proactively treathigh levels of LDL, highlighting lesser-known therapies and trials that could benefit the field and mitigatehyperchlolesteromia.

Hanford Yau, MD, Ralph DeFronzo, MD, Pam Kushner, MD, Honey East, MD, and Christopher Lucci, MD, discuss the challenges of managing patients with resistant diabetes, emphasizing key strategies for identifying and treatingunderlying hypercortisolismthat leads to resistant diabetes.

Experts extensively review the array of psoriasis treatments, from topicals to biologics, exploring the landscape of IL therapies and their enhanced safety and efficacy compared to previous agents. The physicians also highlight how common comorbidities may impact on treatment decisions.