New Treatments Enhance Care for Diverse Range of Patients With Psoriasis

Chronic plaque psoriasis in a patient with skin of color | Image credit: DermNet

Recent developments in psoriasis treatment, particularly the market availability of apremilast (Otezla; Amgen) for pediatric patients,¹ have added to the growing body of research and therapies.

Simultaneously, there is a growing recognition of the unique challenges faced by patients with skin of color. Historically, research and clinical practice often have overlooked the distinct manifestations and treatment needs of these patients.² AbbVie’s 2024 Science of Skin event in August, and advocacy efforts by organizations such as the National Psoriasis Foundation (NPF), have highlighted these disparities and emphasized the need for more inclusive and representative research.

Pediatric patients and those with skin of color represent special populations in psoriasis treatment, each requiring tailored considerations.

New Treatment for Pediatric Psoriasis

Amgen recently announced that apremilast is now available in the US for pediatric patients 6 years and older with moderate to severe plaque psoriasis.¹ It was approved by the FDA in April 2024.³ Apremilast is the first and only oral medication approved in the US for young patients with severe plaque psoriasis. Pediatric patients must weigh at least 20 kg (44 lb) and be candidates for phototherapy or systemic therapy to be considered for this treatment.

Significance of the Approval

Leah Howard, JD, president and CEO of the NPF, underscored the importance of this development. “We celebrate every time a new treatment option becomes available for the psoriatic disease community,” she said in an interview with Dermatology Times. Howard emphasized that pediatric-specific research is crucial because children’s physiological differences mean treatments approved for adults must be thoroughly tested for safety and efficacy in younger populations.

The Personal Impact of Psoriasis

The availability of new treatments such as apremilast has significant implications on the lives of patients and their families.

Trisha, the mother of a 10-year-old girl named Joee, recently reflected on the challenges they have faced during Joee’s plaque psoriasis journey in an interview with Dermatology Times. Joee’s diagnosis and the search for effective therapy were fraught with difficulties, both emotional and practical. Trisha noted, “Just dealing with the day-to-day stress of the actual itchiness and trying to help her through all of that...was the most stressful part.”

The introduction of oral medications is particularly significant for families. Trisha highlighted the practical benefits: “An oral medication is a lot easier than having to try to say, ‘Here, let’s stick you every single week or every month.’”

Addressing Disparities in Care

The fourth annual Science of Skin event emphasized the importance of addressing disparities in psoriasis care, particularly for patients with skin of color. Board-certified dermatologist Chesahna Kindred, MD, MBA, FAAD, founder of Kindred Hair & Skin Center in Marriottsville, Maryland, discussed the unique challenges faced by these patients, including misdiagnosis and differing disease manifestations, with Dermatology Times.

Kindred highlighted that psoriasis in patients with skin of color often presents differently and that there is a greater impact on quality of life regardless of disease severity.

“Another layer of the impact is just a misdiagnosis, and we know in dermatology that different diseases can look alike: Mimickers and the same disease can look differently,” Kindred said. “Add the extra layer that if it’s a patient with melanin-rich skin, it also can look different, on top of all the differential diagnoses we typically come up with.”

She stressed the importance of including diverse populations in clinical trials to ensure that new treatments are effective for all skin types.

Advocacy and Policy Efforts

Patient advocacy organizations such as the NPF play a crucial role in bridging the gap between research advancements and patient care.

Howard noted the importance of advocacy in not only promoting research but also ensuring that new treatments are accessible and effective for all patients, including underserved populations such as children.

“We have the unique ability to really put a spotlight on the challenges of the psoriatic disease community overall, and then individual subpopulations of that community,” Howard noted.

Recommendations for Clinicians

Both Howard and Kindred offered valuable advice for clinicians. Howard encouraged clinicians to stay engaged with patient advocacy organizations and utilize available resources to better understand the complexities of living with psoriasis. Kindred advised dermatologists to approach the diagnosis and treatment of patients with skin of color with cultural competence and humility, acknowledging that misdiagnoses and gaps in knowledge can occur.

References

1. Otezla (apremilast) now available in the US for moderate to severe pediatric plaque psoriasis. News release. Amgen. August 20, 2024. Accessed September 11, 2024. https://www.prnewswire.com/news-releases/otezla-apremilast-now-available-in-the-us-for-moderate-to-severe-pediatric-plaque-psoriasis-302225697.html#:~:text=Earlier%20this%20year%2C%20the%20U.S.,for%20phototherapy%20or%20systemic%20therapy

2. Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol. 2014;7(11):16-24.

3. FDA approves Otezla (apremilast) for the treatment of pediatric patients 6 years of age and older with moderate to severe plaque psoriasis. News release. Drugs.com. April 25, 2024. Accessed September 11, 2024. https://www.drugs.com/newdrugs/fda-approves-otezla-apremilast-pediatric-patients-6-years-age-older-moderate-severe-plaque-psoriasis-6289.html#:~:text=Optum%20RX%3A%20April%2025%2C%202024,for%20phototherapy%20or%20systemic%20therapy