Individualizing Oral Therapy Selection for Patients With PsO

In ‘Individualizing Oral Therapy Selection for Patients With PsO,’ our panel explores how clinicians identify patients who may benefit from oral systemic therapy and how they distinguish among available options. The experts note that oral treatment may be particularly attractive to patients who are systemic-therapy naïve, prefer pills to injections, travel frequently, or value the flexibility associated with shorter drug exposure.

The discussion then examines how different oral therapies may fit different clinical scenarios. Faculty review the role of apremilast in patients with milder overall disease or involvement of high-impact sites such as the scalp, nails, palms, and soles. They discuss deucravacitinib as a more efficacious oral option for moderate-to-severe disease and note additional considerations related to psoriatic arthritis. The panel also considers icotrokinra for moderate-to-severe psoriasis, including younger eligible patients and those with high-impact-site involvement.

Head-to-head evidence is highlighted as an increasingly valuable tool for differentiating oral therapies. The faculty discuss the progression in efficacy seen across generations of oral treatment and how patient selection may also depend on speed of response, psoriatic arthritis, and willingness to use injectable therapy.

The experts conclude by reviewing high-level efficacy trends and emphasizing that patients with localized high-impact disease may experience substantial burden despite low body surface area.

Our next episode, ‘High-Impact Site Clearance and Durability With Oral IL-23 Inhibition in PsO,’ focuses on extended icotrokinra data in high-impact-site disease and explores the biology that may contribute to sustained response.