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Saakshi Khattri,MD: Evolving Therapies for Psoriatic Disease

Though Dr. Khattri felt the diagnosis of psoriatic arthritis had been “stagnant”, the inclusion of biologic therapies and more has been a welcomed change.

Though the dermatology field is growing at an almost alarming rate, some areas of study such as psoriasis have evolved at a different pace.

In part 2 of her interview with HCPLive, Saakshi Khattri, MD, Director of Center for Connective Tissue Diseases, Icahn School of Medicine at Mount Sinai, New York, touched on how this particular field of study has and has not changed, and how dermatologists could aid psoriasis patients including those with psoriatic arthritis.

“Dermatology and rheumatology do overlap considerably, and certainly when it comes to psoriatic diseases…psoriasis and psoriatic arthritis can be seen in the same patient,” Khattri said. “Psoriasis is generally the first manifestation of psoriatic disease in the sense that invariably, most PSA patients initially had skin psoriasis. So that's really the earliest marker of disease in some ways.”

At times, dermatologists act as the first and only point of contact for patients with psoriasis. By the time a patient is referred to a rheumatologist for a potential diagnosis of the condition, they are typically symptomatic.

From there, diagnostic tools such as ultrasounds, MRIs, and occasionally x-rays are utilized to properly diagnose the conditions.

Despite this, Khattri noted that, in some ways, the diagnosis of psoriatic arthritis had been “stagnant” in the previous decade.

This may be in part to the availability of certain tools such as ultrasounds and MRIs, which Khattri said are not offered to every patient for insurance reasons.

“But other than that, I think the diagnosis of PSA has pretty much dependent on clinical exam and a history taking, which has been unchanged for the last 10 years,” Khattri said.

Though a trend in early intervention was noted, the real change has come in the form of biologic therapies, as well as IL-17 blockers and JAK inhibitors that had been approved for psoriatic disease in recent years.

Khattri added that clinicians still have “a long way to go” regarding the treatment of psoriatic disease, yet the promise that these developing treatments such as JAK inhibitors hold has been a welcomed and fruitful change.

“It's good to have oral options because not all patients want an injection, so for those patients, it's good to have an oral option,” Khattri said. “Certainly if patients have failed other modalities, to have multiple options to choose from so that we can skip to something else is important. So, the more the better.”

To hear more details on these treatments and therapies from Dr. Khattri, watch the video above.