This symposium took place on 15th September 2017 as a part of the the 26th European Academy of Dermatology and Venereology (EADV) congress in Geneva, Switzerland
Chairperson: Kristian Reich1
Speakers: Caitriona Ryan,2 Hervé Bachelez3
1. SkinflammationTM, Dermatologikum Hamburg, Germany
2. St. Vincent’s Hospital, Dublin, Ireland
3. Saint-Louis Hospital, Paris, France
Disclosure: Prof Reich is a shareholder of Ocean Pharma and has served as a consultant and/or paid speaker for, and/or participated in clinical trials sponsored by Abbvie, Amgen, Biogen, Boehringer Ingelheim, Celgene, Covagen, Forward Pharma, GlaxoSmithKline, Janssen-Cilag, LEO Pharma, Lilly, Medac, Merck Sharp & Dohme Corp., Novartis, Ocean Pharma, Pfizer, Regeneron, Sanofi, Takeda, UCB Pharma, and Xenoport. Prof Ryan is a speaker for, and an advisor and/or a recipient of honoraria from, AbbVie, Boehringer Ingelheim, Dermira, Dr. Reddy’s Laboratories, Lilly, Janssen, LEO Pharma, Medimetriks, Novartis, Sanofi, and UCB Pharma. Prof Bachelez is a recipient of grant support provided by Pfizer, and is a speaker for and/or an advisor of and/or a consultant for Abbvie, Actelion, Amgen, AnaptysBio, Bayer, Boehringer Ingelheim, Celgene, Lilly, Janssen, LEO Pharma, Menarini, MSD, Novartis, Pfizer, Pierre Fabre, and Takeda.
Acknowledgements: Writing assistance was provided by Dr Stéphanie Heyraud, of Integrated Medhealth Communication North America Inc., Ontario, Canada.
Support: The meeting and publication of this article was funded by LEO Pharma. The views and opinions expressed are those of the authors and not necessarily of LEO Pharma.
Citation: EMJ Dermatol. 2017;5:44-52.
Dermatologists today have more tools than ever at their disposal for managing psoriasis, including newer-generation biologics, which target molecular drivers of psoriatic inflammation that were scarcely known a decade ago. With a deeper understanding of epidermal immunology, we now recognise key pathogenic roles for multiple cytokines and cytokine receptors. Among current treatment targets, we now include not only the tumour necrosis factor pathway, but also interleukins (IL) of the IL-17 family (which are produced by T helper 17 [Th17] cells, among other skin cells) and IL-23 (which polarises the immune response toward Th17 production), as well as the corresponding receptors and intracellular signalling molecules. Rapid and complete skin clearance has become increasingly feasible, as suggested by studies of the newer biologics, including ustekinumab (targeting Th1 and Th17 cell development), secukinumab and ixekizumab (targeting the IL-17A cytokine), and brodalumab (targeting the IL-17 receptor subunit A). Paralleling the improved skin-related outcomes, we see a lightening of the burden of disease that patients experience with this chronic condition.
The bar is being raised when it comes to treatment goals investigated as endpoints in Phase III trials, and we see a shift from control to partial, or even complete, clearance. A similar evolution toward ambitious and personally tailored treatment goals is needed in the clinic. The speakers in this symposium addressed the promise of the new approaches, and the continuing challenge of choosing the optimal therapeutic approach, to ensure that each patient gets the best results from their therapies, whether old or new.
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