2016 AAD Updates

I recently returned from the 2016 American Academy of Dermatology Conference in Washington D.C., where I had an opportunity to share some of my research and get updates on all the latest in the field of dermatology. It was a wonderful meeting with over 18,000 in attendance! 

Once again there was much discussion of psoriasis and the new biologics available for treatment, as well as the importance of screening for other medical conditions such as high blood pressure and heart disease in these patients. Counseling psoriasis patients to stop smoking, minimize alcohol consumption and maintain a healthy weight was emphasized.

Another interesting topic was a review of treatment of pre-cancerous lesions such as actinic keratoses with topical chemotherapy creams. This can be combined with therapies such as liquid nitrogen for improved outcomes. Photodynamic therapy is another way to treat these lesions for both a medical and cosmetic improvement. As the population ages and there is an accumulation of sun damage, treatment strategies for both pre-cancerous lesions and skin cancers will become even more important.

On the cosmetic side there was a focus on combination therapy for rejuvenation of the aging skin and discussion on complications from treatments. I had the opportunity to present on facial vascular anatomy and strategies to prevent and treat vascular complications including blindness from filler.  I also was invited to teach in a hands-on workshop where I educated other dermatologists how to inject filler in various areas of the face to get the best cosmetic result. Participants were able to practice injecting directly into a training model to practice their skills.

Overall it was a great meeting with lots of pearls shared. I'm looking forward to next year's meeting in Orlando.  

New Psoriasis Treatments

I recently returned from the American Academy of Dermatology (AAD) Annual Meeting in San Francisco, where I had an opportunity to collaborate with and learn from many leaders in the field of dermatology. One of the areas I was interested to hear more about was the latest in treatment for psoriasis. This was a popular topic due in part to Novartis recently receiving approval from the FDA for its new treatment called Cosentyx (secukinumab). Secukinumab is the first in a new line of psoriasis drugs called interleukin inhibitors, which block interaction with the IL-17A receptor that triggers the inflammatory response in psoriasis.

Older treatments such as Enbrel, Remicade and Humira block a protein called TNF that signals the body to create inflammation. Stelara (ustekinumab) targets proteins known as IL-12 and IL-23, while secukinumab goes after IL-17A, which only recently has been linked to psoriasis. Similar IL-17 drugs are in development at Eli Lilly & Co. (ixekizumab) and in a partnership between Amgen and AstraZeneca (brodalumab). These IL-17 therapies are expected to be more effective for patients with moderate to severe psoriasis.

Dr. Mark Lebwohl presented summary data on all three IL-17 targeted therapies – secukinumab, ixekizumab, and brodalumab. Studies show a high response rate and improvement in plaque, scalp and nail psoriasis for all of these new class of drugs.

Data on secukinumab showed superior results to ustekinumab in delivering clear skin to subjects with moderate to severe plaque psoriasis over 16 weeks. Secukinumab has previously shown greater efficacy to placebo and to Etanercept. The study is ongoing and 52-week data will be reported at a later date. It will be interesting to see if the results hold but the early results are certainly encouraging.

Dr. Andrew Blauvelt presented additional data on the long-term benefits of secukinumab, showing sustained efficacy to two years with a favorable safety profile.  

With approximately 9 million psoriasis sufferers in the US and Canada, it is exciting to see these new treatments coming to market. Like any systemic medication there are potential side effects, but if you are suffering from psoriasis and are interested in further treatment, consult your dermatologist.