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Plaque Psoriasis Flashcards

1
Q

Guidelines for psoriasis

A

2019 Joint American Academy of Dermatology Association and National Psoriasis Foundation (AAD-NPF)

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2
Q

Current recommended classes for psoriasis

A
  1. TNFa inhibitors
  2. IL12/IL23 Inhibitors
  3. IL17 inhibitors
  4. IL23 inhibitors
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3
Q

TNFa inhbitors (4) recommended for psoriasis

A
  1. Enbrel (etanercept)
  2. Remicade (infliximab)
  3. Humira (adalimumab)
  4. Cimzia (certolizumab)
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4
Q

IL12/23 inhibitor (1) recommended for psoriasis

A
  1. Stelara (ustekinumab)
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5
Q

IL 17 inhibitors recommended for psoriasis (3)

A
  1. Cosentyx (secukinumab)
  2. Taltz (ixekizumab)
  3. Siliq (brodalumab)
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6
Q

IL 23 inhibitors recommended for psoriasis (3)

A
  1. Tremfya (guselkumab)
  2. Ilumya, Ilumetri (tildrakizumab)
  3. Skyrizi (risankizumab)
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7
Q

Generic and class: Skyrizi

A

Skyrizi (risankizumab), IL23

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8
Q

Generic and class: Enbrel

A

Etanercept, TNFai

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9
Q

Generic and class: Cosentyx

A

Secukinumab, IL17i

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10
Q

Generic and class: Tremfya

A

Guselkumab, IL23

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11
Q

Generic and class: Remicade

A

infliximab, TNFa

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12
Q

Generic and class: Humira

A

adalimumab, TNFa

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13
Q

Generic and class: Ilumya, Ilumetri

A

tildrakizumab

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14
Q

Generic and class: Taltz

A

Ixekizumab, IL17

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15
Q

Generic and class: Siliq

A

Brodalumab, IL17

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16
Q

Generic and class: Stelara

A

Ustekinumab, IL12/23

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17
Q

Recommendation for TNFa inhibitors and IL-12/23

A

may be used in combination with Otezla (apremilast)

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18
Q

Combination therapy for psoriasis options

A
  1. TNFa + Otezla (apremilast)
  2. IL12/23 + Otezla (apremilast)
  3. Acetretin
  4. cyclosporine
  5. methotrexate
  6. UV phototherapy
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19
Q

First and only topical PDE4i for plaque psoriasis

A

Zoryve (roflumilast)

20
Q

Pricing for Zoryve 60 g tube

21
Q

When was Zoryve approved for topical treatment of plaque psoriasis including intertriginous areas

22
Q

age for patients to take Zoryve

A

12 andolder

23
Q

Oral PDE4i approved in 2014 for the treatment of psoriatic arthritis and plaque psoriasis in patients wo are candidates for phototherapy or systemic therapy

A

Otezla (apremilast)

24
Q

Otezla (apremilast) pricing

A

$5k-$8k for 60, 30 mg tablets

25
Q

Topical PDE4i approved in 2016 for the treatment of mild to moderate atopic dermatitis in adult and pediatric patients 3 months and older

A

Eucrisa (crisabarole)

26
Q

Eucrisa (crisabarole) pricing

A

$800-$900 for 60 g tube

27
Q

Roflumilast was approved in 2011 for what indication and under what brand name?

A

Daliresp, for COPD

28
Q

Roflumilast is water/lipid INsoluble?

A

water-insoluble

29
Q

Which PDE enzymes does roflumilast affect?

30
Q

Where is PDE4 expressed? (4)

A
  1. Keratinocytes
  2. Neutrophils
  3. Langerhans cells
  4. T cells
31
Q

In which cells do the expressoin of PDE4 lead to plaque formation?

32
Q

By breaking down cAMP, PDE4 modulates (5)

A
  1. pro/anti-inflammatory cytokine synthesis
  2. T cell activation
  3. neutrophil degranulation
  4. Ag-presentation
  5. immune cell proliferation
33
Q

Roflumilast MoA

A

inhibits the PDE4 isoenzyme and prevents cAMP hydrolysis, increasing INTRACELLULAR cAMP

34
Q

Increased intracellular cAMP leads to: (4)

A
  1. inhibition of O2 formulation in epithelial cells, neutrophils, and smooth muscle cells
  2. inhibition of smooth muscle and inflammatory cell proliferation
  3. inhibition of fibroblasts
  4. inhibition of mucus production
35
Q

Increasing intracellular cAMP in patients with COPD specifically results in

A
  1. decreased cytokine release
  2. decreased inflammatory mediators
  3. decreased expression of cell surface markers
  4. decreased apoptosis
36
Q

What role does roflumilast have in COPD?

A

increases lung function, decreases frequency of exacerbations in patients with severe COPD associated with chronic bronchitis

37
Q

PSORRO trial

A

Efficacy and Safety of Oral Roflumilast for Moderate-to-Severe Psoriasis; multi-center, company-independent, randomized, double-blind, placebo controlled trial

38
Q

PSORRO trial methods

A

1:1 randomized, PO roflumilast 500 μg or placebo, and at week 12 patients were switched to open-label roflumilast through week 24

39
Q

primary endpoint for PSORRO

A

≥75% greater reduction in baseline PASI75 at week 12

40
Q

PASI75

A

a 75% or greater reduction in PASI scores from baseline and is indicative of excellent disease improvement.

41
Q

PSORRO trial week 12 results

A

35% (8 patients) achieved PASI75 vs 0 in placebo

42
Q

PSORRO trial week 24 results

A

PASI50: 65%
PASI75: 44%
PASI90: 22%
PASI100: 9%

43
Q

PSORRO n=

44
Q

Zoryve cream/foam is formulated with HYDROARQ technology?

45
Q

HYDROARQ Technology

A

suspends API in pH-balanced suspension, free from excipients, irritants, fragrances, and gluten

46
Q

Zoryve cream is the first drug formulated with ____, a novel emulsifier with non-ceramide stripping properties

A

Crodafos CES

Arctic (12 decks)

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