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Archive

Summer 2013, Vol. 21 No. 2

Hong Kong J. Dermatol. Venereol. (2013) 21, 85


Reports on Scientific Meetings

Scientific Dinner Symposium

Reported by SM Wong 黃思敏

Date: 8 April 2013

Venue: Sheraton Hong Kong Hotel & Towers, Hong Kong

Organiser: The Hong Kong Society of Dermatology and Venereology


The updated role of biologics for psoriasis and its comorbidity

Speaker: Prof. Wolf Henning Boehnche
Chairman, Dermatology Unit, Geneva University Hospital, Geneva, Switzerland

The concept of managing psoriasis has extended, not just on the skin or joint problem but also its comorbidities such as metabolic syndrome, depression and lymphoma. In the past, dermatologists targeted on step-wise approach in controlling the rash based on the belief that psoriasis was a disorder of keratinocytes/T-cells. Besides topical and phototherapy, we used rotational therapy (methotrexate, retinoid, PUVA) or intermittent therapy approach (cyclosporine). Recent clinical trials on biologics, in particular, ustekinumab, which is an IL12/23 inhibitor, have proven its efficacy to achieve PASI 75. Thus, patients' expectations are met. In terms of maintenance and long-term efficacy, it was generally well-tolerated with sustained efficacy for up to three years. In terms of safety, it was well-tolerated and there was no increased cumulative toxicity in long-term use for up to five years regarding serious infections, non-melanocytic skin cancers, other malignancies or major adverse cardiovascular events. About 25% of psoriasis patients suffered from psoriatic arthropathy (PsA) with 50% developed structural deformity. Prognosis was better in patients who received treatment within two years after the onset of PsA than those more than two years. Dermatologists should screen patients for PsA in this 'window of opportunity'. The concept of 'Psoriasis March' - interplay of inflammatory process secondary to psoriasis and obesity may lead to insulin resistance, endothelial dysfunction and subsequent cardiovascular risk - was on hot debate. Monitoring cardiovascular risk in psoriatic patients including blood pressure, body mass index, fasting lipid and sugar would be advisable.

Learning points:
In the future, individualised and comprehensive treatment approach to psoriasis would be desirable.