Promising new directions in psoriasis research

In 2017, NPF awarded a Discovery Grant to the University of Utah’s Aaron Secrest, M.D., Ph.D., to study the symptoms most responsible for psoriatic disease burden. As a result, Secrest’s graduate student, LaVar Edwards, received an invite to NPF’s second annual Research Trainee Symposium.
Edwards found the Trainee Symposium to be a career-altering experience. The guidance from experts in the field, the sense of community with fellow trainees, and, most significantly, hearing from patients about their experiences with psoriatic disease, opened his eyes to the need and to the opportunity for more research in support of NPF’s mission.
“As someone new to the research community, I found the entire symposium helpful and informative,” Edwards says. “However, listening to the experiences of people who are living with psoriasis caused me consider how I could do more.”
Over Presidents’ Day weekend, Edwards rode this wave of research energy to the 76th annual meeting of the American Academy Dermatology (AAD) in San Diego. He presented two posters that demonstrated the power of a data analysis technique he developed to help understand certain types of skin cancer. The technique is likely to have value analyzing data from psoriasis patients as well – maybe even the data generated by NPF’s global research platform, Citizen Pscientist.
Joining Edwards at AAD were thousands of dermatologists and stakeholders in the community that fight against diseases affecting the skin. A vast mosaic of information was presented. What follows is a brief roundup of just three of the important psoriasis-specific themes.

Treat to Target

A year and a half after NPF’s seminal publication of treatment targets for psoriasis in the United States, data from the Corrona Psoriasis Registry was used to shed light on the frequency of patients achieving treatment targets and related benefits. 
NPF Medical Board member Joe Merola, M.D., and his colleagues showed that one year after enrolling in Corrona, 69 percent of patients had achieved a body surface area (BSA) of 3 percent or less and 46 percent had achieved BSA of 1 percent or less. Patients achieving these targets reported better quality of life, less itch and improved productivity at work. 
Another study, presented by NPF Medical Board member Alice Gottlieb, M.D., Ph.D., described a new disease severity measure (Investigators Global Assessment x BSA) as a promising and convenient way to assess whether patients are reaching their treatment goals.  

Patient compliance in the real world

While clinical trials tell us how a well-defined population is likely to respond to a drug, they don’t always tell us about common real-life events such as pausing, stopping and switching biologics. Yet events like FDA’s 2016 Patient Focused Drug Development meeting on psoriasis remind us that this knowledge is critical. Encouragingly, many studies at AAD focused on filling this knowledge gap. 
  • Steven R. Feldman, M.D., Ph.D., and his colleagues demonstrated increased health care utilization costs for patients switching or stopping the use of certain biologics in a large insurance claims database. 
  • Other studies, like the one presented by Jeffrey Crowley, M.D., and his colleagues looking at the effect of an anti-IL-23 biologic on non or partial responders to an anti-TNF, demonstrated the potential of newer biologics in patients who failed to respond to anti-TNFs. 
  • Another study, presented by Kristian Reich, M.D., demonstrated an encouraging 87 percent of patients being able to recapture a PASI90 response after stopping and restarting treatment with the anti-IL-23 biologic. 

Cardiovascular comorbidities

Thanks to research supported by NPF and others, we know that psoriatic disease is linked to a long list of comorbid conditions affecting organs throughout the body. NPF-funded researcher and current Medical Board member Nehal Mehta, M.D., has demonstrated an increase in vascular inflammation that correlates with the severity of psoriasis skin symptoms. 
The missing puzzle piece is whether successful treatment of psoriasis skin symptoms results in an associated improvement in vascular health. NPF Scientific Advisory Committee member Joel Gelfand, M.D., is working in collaboration with Mehta to answer this question. 
At AAD, Gelfand presented results from their on-going Vascular Inflammation in Psoriasis trial, which is exploring an array of psoriasis treatments on vascular inflammation as measured by an imaging technique called fluorodeoxyglucose positron emission tomography-computed tomography, or FDG-PET/CT. He reported an 18 percent improvement in vascular inflammation in psoriasis patients treated with an IL-12/23 biologic as compared to untreated controls.  
Each of these studies demonstrate an exciting frontier of clinical psoriatic disease research. In each case, what we learn from the work being done helps inform treatment decisions and increases the odds for improved long-term health of patients. And in each case, a long list of new questions for researchers to tackle at the basic, translational and clinical level has been unearthed. We expect LaVar Edwards will find plenty of interesting work to occupy his desire to do more research for patients with psoriatic disease. 
Visit our grants page to learn more about and to apply for NPF research grants.

Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

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