Top

Published in:

01-02-2021 | Plaque Psoriasis | Original Research

Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations

Authors: Paolo Gisondi, Marina Talamonti, Andrea Chiricozzi, Stefano Piaserico, Paolo Amerio, Anna Balato, Federico Bardazzi, Piergiacomo Calzavara Pinton, Anna Campanati, Angelo Cattaneo, Paolo Dapavo, Clara De Simone, Valentina Dini, Maria C. Fargnoli, Maria L. Flori, Marco Galluzzo, Claudio Guarneri, Claudia Lasagni, Francesco Loconsole, Ada Lo Schiavo, Piergiorgio Malagoli, Giovanna Malara, Santo R. Mercuri, Maria L. Musumeci, Luigi Naldi, Manuela Papini, Aurora Parodi, Concetta Potenza, Francesca Prignano, Franco Rongioletti, Luca Stingeni, Rossana Tiberio, Marina Venturini, Luca Bianchi, Antonio Costanzo, Francesco Cusano, Giampiero Girolomoni, Anna M. Offidani, Ketty Peris

Published in: Dermatology and Therapy | Issue 1/2021

Abstract

Introduction

Treat-to-target strategies are used in several chronic diseases to improve outcomes. Treatment goals have also been suggested for psoriasis, but there is currently no consensus on targets, and guidance is needed to implement this strategy in clinical practice. The project ‘Treat to Target Italia’ was launched by a scientific board (SB) of 10 psoriasis experts to generate expert consensus recommendations.

Methods

On the basis of the published literature, their clinical experience, and the results of a survey among Italian dermatologists, the SB identified four relevant topics: (1) clinical remission; (2) quality of life; (3) abrogation of systemic inflammation; (4) safety. They drafted 20 statements addressing these four topics and submitted them to a panel of 28 dermatologists, in a Delphi process, to achieve consensus (greater than 80% agreement).

Results

Consensus was reached on all statements. Treatment goals defining clinical remission should include a 90% improvement from baseline in the Psoriasis Area and Severity Index (PASI90 response) or an absolute PASI score of less than or equal to 3. Patient’s quality of life and satisfaction are important targets. If PASI targets are achieved, there should be no or very low impact of psoriasis on quality of life [Dermatology Life Quality Index (DLQI) score less than or equal to 3]. If PASI or DLQI goals are not achieved within 3–4 months, treatment should be changed. Abrogation of systemic inflammation may be crucial for preventing or delaying inflammatory comorbidities. Safety is an equally important target as efficacy.

Conclusion

These 20 consensus statements define the parameters of a treat-to-target strategy for psoriasis in Italy. It is hoped that use of these in the management of patients with psoriasis will improve treatment outcomes and patient health-related quality of life.

Gelfand JM, Weinstein R, Porter SB, Neimann AL, Berlin JA, Margolis DJ. Prevalence and treatment of psoriasis in the United Kingdom: a population-based study. Arch Dermatol. 2005;141(12):1537–41. https://doi.org/10.1001/archderm.141.12.1537.CrossRefPubMed

Parisi R, Symmons DP, Griffiths CE, Ashcroft DM, Identification and Management of Psoriasis and Associated Comorbidity (IMPACT) project team. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013;133(2):377–85. https://doi.org/10.1038/jid.2012.339.CrossRefPubMed

Stern RS, Nijsten T, Feldman SR, Margolis DJ, Rolstad T. Psoriasis is common, carries a substantial burden even when not extensive, and is associated with widespread treatment dissatisfaction. J Investig Dermatol Symp Proc. 2004;9(2):136–9. https://doi.org/10.1046/j.1087-0024.2003.09102.x.CrossRefPubMed

Reich K. The concept of psoriasis as a systemic inflammation: implications for disease management. J Eur Acad Dermatol Venereol. 2012;26(Suppl 2):3–11. https://doi.org/10.1111/j.1468-3083.2011.04410.x.CrossRefPubMed

Villasenor-Park J, Wheeler D, Grandinetti L. Psoriasis: evolving treatment for a complex disease. Cleve Clin J Med. 2012;79(6):413–23. https://doi.org/10.3949/ccjm.79a.11133.CrossRefPubMed

Mease PJ, Armstrong AW. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs. 2014;74(4):423–41. https://doi.org/10.1007/s40265-014-0191-y.CrossRefPubMedPubMedCentral

Gisondi P, Girolomoni G. Psoriasis and atherothrombotic diseases: disease-specific and non-disease-specific risk factors. Semin Thromb Hemost. 2009;35(3):313–24. https://doi.org/10.1055/s-0029-1222610.CrossRefPubMed

Cohen AD, Gilutz H, Henkin Y, et al. Psoriasis and the metabolic syndrome. Acta Derm Venereol. 2007;87(6):506–9. https://doi.org/10.2340/00015555-0297.CrossRefPubMed

Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14):1735–41. https://doi.org/10.1001/jama.296.14.1735.CrossRefPubMed

10.

Gelfand JM, Dommasch ED, Shin DB, et al. The risk of stroke in patients with psoriasis. J Invest Dermatol. 2009;129(10):2411–8. https://doi.org/10.1038/jid.2009.112.CrossRefPubMedPubMedCentral

11.

Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient-membership survey. Arch Dermatol. 2001;137(3):280–4.PubMed

12.

Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64(Suppl 2):ii18–23. https://doi.org/10.1136/ard.2004.033217 (discussion ii4-5).CrossRefPubMedPubMedCentral

13.

Russo PA, Ilchef R, Cooper AJ. Psychiatric morbidity in psoriasis: a review. Australas J Dermatol. 2004;45(3):155–9. https://doi.org/10.1111/j.1440-0960.2004.00078.x (quiz 60-1).CrossRefPubMed

14.

Nast A, Gisondi P, Ormerod AD, et al. European S3-guidelines on the systemic treatment of psoriasis vulgaris–update 2015–Short version–EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015;29(12):2277–94. https://doi.org/10.1111/jdv.13354.CrossRefPubMed

15.

Blauvelt A, Papp KA, Griffiths CE, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol. 2017;76(3):405–17. https://doi.org/10.1016/j.jaad.2016.11.041.CrossRefPubMed

16.

Blauvelt A, Reich K, Tsai TF, et al. Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate-to-severe plaque psoriasis up to 1 year: results from the CLEAR study. J Am Acad Dermatol. 2017;76(1):60–9e9. https://doi.org/10.1016/j.jaad.2016.08.008.

17.

Langley RG, Elewski BE, Lebwohl M, et al. Secukinumab in plaque psoriasis–results of two phase 3 trials. N Engl J Med. 2014;371(4):326–38. https://doi.org/10.1056/NEJMoa1314258.CrossRefPubMed

18.

Lebwohl M, Strober B, Menter A, et al. Phase 3 studies comparing brodalumab with ustekinumab in psoriasis. N Engl J Med. 2015;373(14):1318–28. https://doi.org/10.1056/NEJMoa1503824.CrossRefPubMed

19.

Leonardi C, Matheson R, Zachariae C, et al. Anti-interleukin-17 monoclonal antibody ixekizumab in chronic plaque psoriasis. N Engl J Med. 2012;366(13):1190–9. https://doi.org/10.1056/NEJMoa1109997.CrossRefPubMed

20.

Leonardi CL, Kimball AB, Papp KA, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1). Lancet. 2008;371(9625):1665–74. https://doi.org/10.1016/S0140-6736(08)60725-4.CrossRefPubMed

21.

Papp KA, Langley RG, Lebwohl M, et al. Efficacy and safety of ustekinumab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2). Lancet. 2008;371(9625):1675–84. https://doi.org/10.1016/S0140-6736(08)60726-6.CrossRefPubMed

22.

Papp KA, Leonardi C, Menter A, et al. Brodalumab, an anti-interleukin-17-receptor antibody for psoriasis. N Engl J Med. 2012;366(13):1181–9. https://doi.org/10.1056/NEJMoa1109017.CrossRefPubMed

23.

Thaci D, Blauvelt A, Reich K, et al. Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe plaque psoriasis: CLEAR, a randomized controlled trial. J Am Acad Dermatol. 2015;73(3):400–9. https://doi.org/10.1016/j.jaad.2015.05.013.CrossRefPubMed

24.

Thaci D, Humeniuk J, Frambach Y, et al. Secukinumab in psoriasis: randomized, controlled phase 3 trial results assessing the potential to improve treatment response in partial responders (STATURE). Br J Dermatol. 2015;173(3):777–87. https://doi.org/10.1111/bjd.13814.CrossRefPubMed

25.

Carretero G, Puig L, Carrascosa JM, et al. Redefining the therapeutic objective in psoriatic patients candidates for biological therapy. J Dermatolog Treat. 2018;29(4):334–46. https://doi.org/10.1080/09546634.2017.1395794.CrossRefPubMed

26.

Gisondi P, Altomare G, Ayala F, et al. Italian guidelines on the systemic treatments of moderate-to-severe plaque psoriasis. J Eur Acad Dermatol Venereol. 2017;31(5):774–90. https://doi.org/10.1111/jdv.14114.CrossRefPubMed

27.

Gulliver W, Lynde C, Dutz JP, et al. Think beyond the skin: 2014 Canadian expert opinion paper on treating to target in plaque psoriasis. J Cutan Med Surg. 2015;19(1):22–7. https://doi.org/10.2310/7750.2014.13151.CrossRefPubMed

28.

Mahil SK, Wilson N, Dand N, et al. Psoriasis treat to target: defining outcomes in psoriasis using data from a real-world, population-based cohort study (the British Association of Dermatologists Biologics and Immunomodulators Register, BADBIR). Br J Dermatol. 2019. https://doi.org/10.1111/bjd.18333.CrossRefPubMedPubMedCentral

29.

Puig L. PASI90 response: the new standard in therapeutic efficacy for psoriasis. J Eur Acad Dermatol Venereol. 2015;29(4):645–8. https://doi.org/10.1111/jdv.12817.CrossRefPubMed

30.

Armstrong AW, Siegel MP, Bagel J, et al. From the Medical Board of the National Psoriasis Foundation: treatment targets for plaque psoriasis. J Am Acad Dermatol. 2017;76(2):290–8. https://doi.org/10.1016/j.jaad.2016.10.017.CrossRefPubMed

31.

Baker C, Mack A, Cooper A, et al. Treatment goals for moderate to severe psoriasis: an Australian consensus. Australas J Dermatol. 2013;54(2):148–54. https://doi.org/10.1111/ajd.12014.CrossRefPubMed

32.

Gladman DD, Poulin Y, Adams K, et al. Treating psoriasis and psoriatic arthritis: position paper on applying the treat-to-target concept to Canadian daily practice. J Rheumatol. 2017;44(4):519–34. https://doi.org/10.3899/jrheum.161473.CrossRefPubMed

33.

Mrowietz U, Kragballe K, Reich K, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011;303(1):1–10. https://doi.org/10.1007/s00403-010-1080-1.CrossRefPubMed

34.

Amatore F, Villani AP, Tauber M, Viguier M, Guillot B, Psoriasis Research Group of the French Society of Dermatology. French guidelines on the use of systemic treatments for moderate-to-severe psoriasis in adults. J Eur Acad Dermatol Venereol. 2019;33(3):464–83. https://doi.org/10.1111/jdv.15340.

35.

Armstrong A, Jarvis S, Boehncke WH, et al. Patient perceptions of clear/almost clear skin in moderate-to-severe plaque psoriasis: results of the clear about psoriasis worldwide survey. J Eur Acad Dermatol Venereol. 2018;32(12):2200–7. https://doi.org/10.1111/jdv.15065.CrossRefPubMed

36.

Armstrong AW, Koning JW, Rowse S, Tan H, Mamolo C, Kaur M. Under-treatment of patients with moderate to severe psoriasis in the United States: analysis of medication usage with health plan data. Dermatol Ther (Heidelb). 2017;7(1):97–109. https://doi.org/10.1007/s13555-016-0153-2.CrossRef

37.

Lebwohl MG, Kavanaugh A, Armstrong AW, Van Voorhees AS. US perspectives in the management of psoriasis and psoriatic arthritis: patient and physician results from the population-based multinational assessment of psoriasis and psoriatic arthritis (MAPP) survey. Am J Clin Dermatol. 2016;17(1):87–97. https://doi.org/10.1007/s40257-015-0169-x.CrossRefPubMed

38.

Lynde CW, Beecker J, Dutz J, et al. Treating to target(s) with interleukin-17 inhibitors. J Cutan Med Surg. 2019;23(2_suppl):3S-34S. https://doi.org/10.1177/1203475418824565.

39.

Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008–15.PubMed

40.

Jones J, Hunter D. Consensus methods for medical and health services research. BMJ. 1995;311(7001):376–80. https://doi.org/10.1136/bmj.311.7001.376.CrossRefPubMedPubMedCentral

41.

Lakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezinska-Wcislo L, Slomian A. Associations between site of skin lesions and depression, social anxiety, body-related emotions and feelings of stigmatization in psoriasis patients. Postepy Dermatol Alergol. 2018;35(1):60–6. https://doi.org/10.5114/pdia.2016.62287.CrossRefPubMedPubMedCentral

42.

Bardazzi F, Starace M, Bruni F, Magnano M, Piraccini BM, Alessandrini A. Nail psoriasis: an updated review and expert opinion on available treatments, including biologics. Acta Derm Venereol. 2019;99(6):516–23. https://doi.org/10.2340/00015555-3098.CrossRefPubMed

43.

Dopytalska K, Sobolewski P, Blaszczak A, Szymanska E, Walecka I. Psoriasis in special localizations. Reumatologia. 2018;56(6):392–8. https://doi.org/10.5114/reum.2018.80718.CrossRefPubMedPubMedCentral

44.

Strober B, Papp KA, Lebwohl M, et al. Clinical meaningfulness of complete skin clearance in psoriasis. J Am Acad Dermatol. 2016;75(1):77–82e7. https://doi.org/10.1016/j.jaad.2016.03.026.

45.

Bai F, Li GG, Liu Q, Niu X, Li R, Ma H. Short-term efficacy and safety of IL-17, IL-12/23, and IL-23 inhibitors brodalumab, secukinumab, ixekizumab, ustekinumab, guselkumab, tildrakizumab, and risankizumab for the treatment of moderate to severe plaque psoriasis: a systematic review and network meta-analysis of randomized controlled trials. J Immunol Res. 2019;2019:2546161. https://doi.org/10.1155/2019/2546161.CrossRefPubMedPubMedCentral

46.

Gordon KB, Reich K, Crowley JJ, et al. Disease activity and treatment efficacy using patient-level Psoriasis Area and Severity Index scores from tildrakizumab phase 3 clinical trials. J Dermatolog Treat. 2020:1–10. https://doi.org/10.1080/09546634.2020.1747590.

47.

Hongbo Y, Thomas CL, Harrison MA, Salek MS, Finlay AY. Translating the science of quality of life into practice: what do dermatology life quality index scores mean? J Invest Dermatol. 2005;125(4):659–64. https://doi.org/10.1111/j.0022-202X.2005.23621.x.CrossRefPubMed

48.

Korman NJ, Zhao Y, Pike J, Roberts J. Relationship between psoriasis severity, clinical symptoms, quality of life and work productivity among patients in the USA. Clin Exp Dermatol. 2016;41(5):514–21. https://doi.org/10.1111/ced.12841.CrossRefPubMed

49.

Leman J, Walton S, Layton AM, et al. The real world impact of adalimumab on quality of life and the physical and psychological effects of moderate-to-severe psoriasis: a UK prospective, multicenter, observational study. J Dermatolog Treat. 2019:1–9. https://doi.org/10.1080/09546634.2019.1592096.

50.

Puig L, Augustin M, Blauvelt A, et al. Effect of secukinumab on quality of life and psoriasis-related symptoms: a comparative analysis versus ustekinumab from the CLEAR 52-week study. J Am Acad Dermatol. 2018;78(4):741–8. https://doi.org/10.1016/j.jaad.2017.10.025.CrossRefPubMed

51.

Hjuler KF, Gormsen LC, Vendelbo MH, Egeberg A, Nielsen J, Iversen L. Increased global arterial and subcutaneous adipose tissue inflammation in patients with moderate-to-severe psoriasis. Br J Dermatol. 2017;176(3):732–40. https://doi.org/10.1111/bjd.15149.CrossRefPubMed

52.

Kerdel F, Don F. The importance of early treatment in psoriasis and management of disease progression. J Drugs Dermatol. 2018;17(7):737–42.PubMed

53.

Pietrzak D, Pietrzak A, Grywalska E, et al. Serum concentrations of interleukin 18 and 25-hydroxyvitamin D3 correlate with depression severity in men with psoriasis. PLoS One. 2018;13(8):e0201589. https://doi.org/10.1371/journal.pone.0201589.CrossRefPubMedPubMedCentral

54.

Mease PJ, Gladman DD, Papp KA, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69(5):729–35. https://doi.org/10.1016/j.jaad.2013.07.023.CrossRefPubMed

55.

Elnabawi YA, Dey AK, Goyal A, et al. Coronary artery plaque characteristics and treatment with biologic therapy in severe psoriasis: results from a prospective observational study. Cardiovasc Res. 2019;115(4):721–8. https://doi.org/10.1093/cvr/cvz009.CrossRefPubMedPubMedCentral

56.

von Stebut E, Reich K, Thaci D, et al. Impact of secukinumab on endothelial dysfunction and other cardiovascular disease parameters in psoriasis patients over 52 weeks. J Invest Dermatol. 2019;139(5):1054–62. https://doi.org/10.1016/j.jid.2018.10.042.CrossRef

57.

Deodhar A, Mease PJ, McInnes IB, et al. Long-term safety of secukinumab in patients with moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis: integrated pooled clinical trial and post-marketing surveillance data. Arthritis Res Ther. 2019;21(1):111. https://doi.org/10.1186/s13075-019-1882-2.CrossRefPubMedPubMedCentral

58.

Gisondi P, Tessari G, di Mercurio M, Del Giglio M, Girolomoni G. Retention rate of systemic drugs in patients with chronic plaque psoriasis. Clin Dermatol. 2013;1(1):8–14.

59.

Howell ST, Cardwell LA, Feldman SR. Treating moderate-to-severe plaque psoriasis with guselkumab: a review of phase II and phase III trials. Ann Pharmacother. 2018;52(4):380–7. https://doi.org/10.1177/1060028017743268.CrossRefPubMed

60.

Kimball AB, Rothman KJ, Kricorian G, et al. OBSERVE-5: observational postmarketing safety surveillance registry of etanercept for the treatment of psoriasis final 5-year results. J Am Acad Dermatol. 2015;72(1):115–22. https://doi.org/10.1016/j.jaad.2014.08.050.CrossRefPubMed

61.

Langley RG, Kimball AB, Nak H, et al. Long-term safety profile of ixekizumab in patients with moderate-to-severe plaque psoriasis: an integrated analysis from 11 clinical trials. J Eur Acad Dermatol Venereol. 2019;33(2):333–9. https://doi.org/10.1111/jdv.15242.CrossRefPubMed

62.

Strober B, Crowley J, Langley RG, et al. Systematic review of the real-world evidence of adalimumab safety in psoriasis registries. J Eur Acad Dermatol Venereol. 2018;32(12):2126–33. https://doi.org/10.1111/jdv.15203.CrossRefPubMed

63.

Gottlieb AB, Kalb RE, Langley RG, et al. Safety observations in 12095 patients with psoriasis enrolled in an international registry (PSOLAR): experience with infliximab and other systemic and biologic therapies. J Drugs Dermatol. 2014;13(12):1441–8.PubMed

64.

Papp K, Gottlieb AB, Naldi L, et al. Safety surveillance for ustekinumab and other psoriasis treatments from the Psoriasis Longitudinal Assessment and Registry (PSOLAR). J Drugs Dermatol. 2015;14(7):706–14.PubMed

65.

Warren RB, Smith CH, Yiu ZZN, et al. Differential drug survival of biologic therapies for the treatment of psoriasis: a prospective observational cohort study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). J Invest Dermatol. 2015;135(11):2632–40. https://doi.org/10.1038/jid.2015.208.CrossRefPubMed

66.

Menter A, Papp KA, Gooderham M, et al. Drug survival of biologic therapy in a large, disease-based registry of patients with psoriasis: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR). J Eur Acad Dermatol Venereol. 2016;30(7):1148–58. https://doi.org/10.1111/jdv.13611.CrossRefPubMedPubMedCentral

Title: Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations
Authors: Paolo Gisondi
Marina Talamonti
Andrea Chiricozzi
Stefano Piaserico
Paolo Amerio
Anna Balato
Federico Bardazzi
Piergiacomo Calzavara Pinton
Anna Campanati
Angelo Cattaneo
Paolo Dapavo
Clara De Simone
Valentina Dini
Maria C. Fargnoli
Maria L. Flori
Marco Galluzzo
Claudio Guarneri
Claudia Lasagni
Francesco Loconsole
Ada Lo Schiavo
Piergiorgio Malagoli
Giovanna Malara
Santo R. Mercuri
Maria L. Musumeci
Luigi Naldi
Manuela Papini
Aurora Parodi
Concetta Potenza
Francesca Prignano
Franco Rongioletti
Luca Stingeni
Rossana Tiberio
Marina Venturini
Luca Bianchi
Antonio Costanzo
Francesco Cusano
Giampiero Girolomoni
Anna M. Offidani
Ketty Peris
Publication date: 01-02-2021
Publisher: Springer Healthcare
Keywords: Plaque Psoriasis
Vulgar Psoriasis
Published in: Dermatology and Therapy / Issue 1/2021
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI: https://doi.org/10.1007/s13555-020-00475-8

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations

Abstract

Introduction

Methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

The Role of Actin in Muscle Spasms in a Case Series of Patients with Advanced Basal Cell Carcinoma Treated with a Hedgehog Pathway Inhibitor

Calcipotriol/Betamethasone Dipropionate Foam Inhibits Th17 Cytokine Secretion and Improves Epidermal Barrier Markers in a Human Th17 Skin Inflammation Model

Lessons Learned from the First Decade of Laser-Assisted Drug Delivery

Dermatologic Manifestations, Histologic Features and Disease Progression among Cutaneous Lupus Erythematosus Subtypes: A Prospective Observational Study in Asians

Treatment Response of Patients with Erythrodermic Psoriasis after Switching to Guselkumab

Increasing Access to Specialized Dermatology Care: A Retrospective Study Investigating Clinical Operation and Impact of a University-Affiliated Free Clinic

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page