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How do you approach treatment change in patients with psoriasis who have been stable on an IL-17 or IL-23 agent but then begin to have breakthrough skin disease?
Do you first try adding topicals or UV? At what point do you decide to switch biologics and at that point do you try to class switch to a different MOA drug, or try another drug within the same class? Do you consider switching from IL-17A to IL-17A/F a class switch?
Answer from: at Community Practice
It really depends on where the patient is in their treatment journey. Patients who have tried and failed other biologics I try to optimize response by:
increasing the biologic dosing frequency if insurance will allow,
adding topicals, particularly newer ones like tapinarof or roflumilast,
addin...
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Answer from: at Academic Institution
I would also add that is important to investigate for or address possible triggers that might resulting in the breakthrough disease such as new medications or infection (e.g. Strep).
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at Georgia Dermatology Partners
Couldn’t agree more. Check a blood glucose a...
Couldn’t agree more. Check a blood glucose a...