Jerry Bagel, MD, MS: Advancements in Psoriasis Therapies

In an interview with HCPLive, Jerry Bagel, MD, MS, Director of the Psoriasis Treatment Center of Central New Jersey, spoke of advancements in the field of psoriasis research that included safer and more diverse treatment options, as well as how these recent changes in psoriasis therapies could inform the next 10 years.

To provide context on how psoriasis therapies had evolved in the previous decade, Bagel referenced older psoriasis commercials, and how 1 therapy would typically be followed by an extensive list of side effects and comorbidities that included lymphoma and even death.

“That was 10 plus years ago, (and) now you get these 3 commercials, but you don't have those box warnings anymore,” Bagel said. “You don't have death, you don't have lymphoma, you don't have malignancy, you don't have major adverse cardiac events, you don't have them. So, I think that the adverse event profile of the biologics that we have today are so much safer than what we had before. That's what's really changed.”

Some of these changes could be attributed to newer topical therapies such as tapinarof and roflumilast, the latter of which is a once-daily phosphodiesterase type 4 (PDE4) inhibitor that targets enzymes associated with overactive immune responses in patients with psoriasis.

“Since they're non-steroidal, you don't have to worry about writing a different prescription for the face and one for under the breast and one for the legs, you can use just 1 cream,” Bagel said. “Tapinarof in fact has a remission associated with it after clearance of up to 3 or 4 months. So, there's some fascinating facts to still be learned about tapinarof’s mechanism of action and how it can be used in the treatment of psoriasis.”

Though there have been countless strides in psoriasis management, Bagel believed more could be done in regards to determining the triggers of psoriasis in addition to atopic dermatitis (which he considered to be the new research world of psoriasis), as well as providing patients with greater access to care.

“I think we have a lot of good medications, (and) we could do more, but people need more access to more dermatologists,” Bagel said. “There's too long a waiting list, people waiting too long to be seen, (and) I think that's partially because dermatologists are doing a lot of cosmetics and they don't have as much time for medical dermatology. But I think we need patients to know where to go, they need to know who a medical oriented dermatologist is, (and) who a cosmetic oriented dermatologist is so they can make that decision.”