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9th Annual Fall Conference Session Rewind: Plaque Psoriasis and ENBREL Product Theater

 
We’d like to present a Session Rewind from Dr. Paul Wallace’s product theater on Thursday, November 10th at the 9th Annual Fall SDPA Conference.  
 
PRISTINE: “In Adult Chronic Moderate to Severe Plaque Psoriasis: A Trial Evaluating the Efficacy and Safety of Enbrel” Sponsored by: Amgen Pfizer.
 
Dr. Paul Wallace specializes in psoriasis and practices in Beverly Hills, California.  During his session he presented on the emotional, physical, and psychological impact of psoriasis, reminding us that the patient’s grief is often much greater than normally communicated.  For the psoriasis patient, the normal things of life often feels like an uphill battle.  
 
He told the story of a patient in Los Angeles with plaque psoriasis who had once been forbidden from entering their gym because of the visible impact of their disease.  While the patient fought the ruling in court and won, Dr. Wallace warns that such public embarrassment and the social pressure to “hide” is fairly common for those suffering from psoriasis.  
 
Dr. Wallace reminds us that as dermatologists and derm PAs, perhaps we owe our psoriasis patients a bit more attention and care.
 
“There will be no telethons for psoriasis,” he said.
 
Dr. Wallace noted that psoriasis affects more than just the patient, but the patient’s closest relationships, as well.  It is those closest to the patient who is often tasked with providing their primary emotional and medical support.  Likewise, it is those closest to the patient who helps them navigate the difficult social stigmas that psoriasis often invites.
 
The study’s objective was primarily to assess the efficacy and safety of ENBREL for adult chronic moderate to severe cases of severe plaque psoriasis.  Clinical trial results show improvement with ENBREL in terms of there being an improvement from baseline to week 24.  This is especially true for the scalp.  Part of the study’s design was that 20% of patients taking ENBREL 50mg were also using concomitant topical steroid prep at week 24. 
 
Dr. Wallace notes that those with psoriasis often must deal with the burden of finding clothes to hide their condition.  However, since the scalp itself cannot be easily hidden, this is often a huge burden to the patient, for women especially.
 
Psoriasis patients often deal with depression, they sleep a lot, and are forced to withdraw from social events.  Yet the trial demonstrates that after week 12 of ENBREL treatment, the patient often experiences rapid improvement of emotional and psychological health.  This shows the patient how efficacious the treatment can be with ENBREL.
 
At weeks 12 and 24 of the trial, approximately 90% of patients reported satisfaction with ENBREL.  62-78% patients achieved PASI 75 at weeks 12 and 24, respectively.  Mean PASI scores improved by 75% and 82%, respectively.      
 
Dr. Wallace reminds us that we must do due diligence in sharing with our patients all safety information relevant to medications, ENBREL included.  He urges that we need to do the homework that primary care doctors simply often fail to do.  Overall, the most common AEs for ENBREL were flu-like symptoms and a mild headache.  Important safety information on Enbrel includes risks in the following realms:  Neurologic, Congestive Heart Failure, Hemotological Events, risk of Melanoma, and Hep-B Virus Reactiviation.
  
ENBREL is intended for those 18 years or older with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.  It is administered by injection.