Mark G. Lebwohl, MD: Present and Future Therapies for Individuals with Psoriasis

During this segment of his HCPLive interview, Mark G. Lebwohl, MD, discussed other elements he had gone into in his talk from the Clinical Dermatology 2023 Conference for PAs & NPs.

Lebwohl’s work as dermatologist and his contributions to psoriasis research are well known, as is his position as Dean of Clinical Therapeutics at the Icahn School of Medicine at Mount Sinai.

HCPLive: At the Derm Fall Clinical Conference, you described emerging therapies for psoriasis in your presentation. What are some of the major emerging treatment approaches or therapies that are being researched currently that may change the landscape of selection?

Lebwohl: In terms of systemic therapies, there are actually several in development, but they are probably years away. In terms of topical therapies, we have 2 new topical agents. One is called tapinarof, and the other one is called roflumilast. And you know they've changed the landscape of topical therapy quite a bit. They're not steroids. So they don't have any of the steroid side effects. And those have been real breakthroughs in the treatment of psoriasis.

HCPLive: Is there any new clinical trial data that you highlight in the presentation that you think it may be important to discuss for this topic?

Lebwohl: Yes, deucravacitinib has excellent data, and we're actually only beginning to get data on its usefulness in psoriatic arthritis. But its approval data was quite impressive, published in The Lancet, it was compared to placebo and to apremilast. It was clearly superior to both the other things and it has very good maintenance of response, which is the new data that I show. Even when you follow those patients for 2 years, they continue to respond just as well so they don't lose that benefit.

For bimekizumab, all the data is fairly new to us. Finally we will actually have the drug. The comparison of bimekizumab to adalimumab in a clinical trial I touch on as well.

Bimekizumab is very effective for psoriatic arthritis. Adalimumab has been the gold standard. If you look at the overview of the trial, it looks like bimekizumab is comparable to adalimumab but when you really get into the details, and you just look at monotherapy for bimekizumab versus adalimumab, it was actually superior. So I do think we're going to have a drug that will help a lot of our psoriatic arthritis patients. Where we still need a lot of development and need a lot of improvement is psoriatic arthritis.

HCPLive: Zooming out, what would you say are some of the takeaways that you would hope clinicians leave your presentation with?

Lebwohl: There's a story that I have told as a lecturer. I had to give this story to a group of 107 psoriasis patients for the National Psoriasis Foundation…I actually read to this group of 107 patients, a list of conditions and I had them all stand up.

I said, after I finish this list, if I mentioned the condition that you have, please sit down. I mentioned HIV, TB, hepatitis, hepatitis B, hepatitis C, positive AMA, Crohn's disease, ulcerative colitis, history of cardiovascular disease, either personal or family history of cancer, overweight, joint pains. I went through this long list and many other comorbidities, and then I said, “Okay, if I said a condition that you have, please sit down.” Out of 107 people, there was 1 person left standing. And the point is that there is no one best drug. It is all dependent on what the patient's comorbidities are.

To learn more about the latest conference coverage and interviews, view the page here.

The quotes contained in this interview description were edited for clarity.