In another segment of his interview, Mark Lebwohl, MD, discussed the various ways to address different psoriasis patients depending on their backgrounds with obesity, cancer, and psoriatic arthritis.
During his latest interview with HCPLive, Mark G. Lebwohl, MD, went in depth on his 2023 Winter Clinical Miami presentation on finding the right treatment for patients with psoriasis.
He is known for his work as a dermatologist, for his contributions to psoriasis research, and for his position as Dean of Clinical Therapeutics at the Icahn School of Medicine at Mount Sinai.
Lebwohl described the different ways he believes clinicians should address patients with psoriasis seeking treatment, depending on the patient’s health history.
“So there are a couple of things that you see as soon as the patient walks in the room, you don't need a scale to see if the patient is obese,” he explained. “And if they're obese, then there are some drugs that work less well that TNF blockers for example, are a bit less effective, with the exception of infliximab, which is given milligrams per kilogram just given according to the patient's weight.”
He referenced other drugs such as ustekinumab, where a dose adjustment is also needed.
“But then, there are drugs which are fixed in dose,” Lebwohl said. “And some of them are so effective, that it doesn't matter that the patient is more overweight. Classic examples: the 17 and 23 blockers are working incredibly well, regardless of how much you weigh.”
Additionally, Lebwohl mentioned that clinicians should also ask about patients’ joint pain issues and find out whether or not they have psoriatic arthritis.
“And there, it's very clear which drugs work better,” he explained. “The TNF blockers, for long periods of time, were the gold standard for psoriatic arthritis. We now have the IL17 blockers, which are equally effective to the TNF blockers. The JAK inhibitors are even more effective. And some of the JAK inhibitors. Specifically, upadacitinib is approved for psoriatic arthritis and has been shown to have greater efficacy than adalimumab.”
Lebwohl further discussed drugs that might be used in the case of patients having psoriasis and a history of cancer, such as the IL17 blocker secukinumab.
To find out more about Lebwohl’s Winter Clinical presentation on psoriasis treatment, view the HCPLive interview above.