Boni Elewski, MD: Biologics for Pediatric Psoriasis Patients

In part 1 and part 2 of her interview with HCPLive, Boni Elewski, MD, Professor and Chair, Director of Clinical Research at the University of Alabama, Birmingham, spoke of biologics that could be used for the management of psoriasis and psoriatic arthritis.

In addition to therapies used on adults with psoriasis, several biologics for pediatric patients had already been approved by the Food and Drug Administration, including etanercept, ustekinumab, ixekizumab and secukinumab.

While the latter 2 drugs do require laboratory monitoring in the form of a tuberculosis test at baseline, the efficacy of these drugs are on par with atanercept. Each therapy included routine dosing, though some are as infrequent as 3 to 4 injections a year.

“So, there's a choice, and actually both IL-17 (drugs) can be used for psoriatic arthritis,” Elewski said. “There's a lot of options for children, and apremilast is undergoing a pediatric study looking at its efficacy in children, which would give an option for children whose parents are needle-phobic.”

In addition to her patients, Elewski’s own family has been affected psoriasis, with both her father and sister living with the condition. When asked about her role in the future of psoriasis care, Elewski was dedicated to ending the burden of psoriasis completely.

“I tell my residents that I'm going to keep moving on seeing patients until my residents ask me ‘Dr. Elewski, what did psoriasis used to look like? Because we don't see it anymore.’”, Elewski said.

Elewski asserted that biologics will soon be able to completely rid patients of their condition, but in order to reach such a goal, more clinicians would have to embrace the idea of prescribing them to affected patients.

“It would be great to have that biologic that you give and you're totally clear, but we're so close to that because we have drugs that really get you clear,” Elewski said. “We just have to get them more embraced by more clinicians to be writing them because it's sad to see patients out there suffering with psoriasis, not realizing that there's a great option for them that is safe, effective and targeted for them”