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Insights on Oral Psoriasis Treatments by Dermatology Nurse Practitioner

Core Concepts
Oral psoriasis treatments are evolving, offering new options for patients with psoriasis.
The content discusses oral psoriasis treatments in a podcast format featuring Dr. Steve Feldman and guest Lakshi Aldridge, a dermatology nurse practitioner. The conversation covers the role of nurse practitioners in managing psoriasis, the eligibility criteria for oral treatments, and specific considerations for various oral agents. The discussion delves into traditional oral agents like methotrexate, cyclosporine, and acitretin, as well as newer options such as TYK2 and PDE4 inhibitors. Insights are shared on the efficacy, safety profiles, and considerations for each oral treatment. The conversation also touches on the evolving landscape of psoriasis management, emphasizing the importance of a team-based approach and the availability of oral treatments for patients who may be hesitant to try biologics. Highlights: Role of nurse practitioners in dermatology care Evolution of psoriasis treatment options Considerations for selecting oral agents Efficacy and safety profiles of different oral treatments Importance of patient-specific treatment approaches
"We have three dermatology nurse practitioner fellowship training programs that are 1-year long." "Most nurse practitioners gained their education and training in formal training programs." "TYK2 (tyrosine kinase 2) inhibitor that has come along and the PDE4 (phosphodiesterase-4) inhibitor."
"The most successful management of any dermatology patient — especially those with complex, chronic cutaneous disorders — is best managed by a derm team." "The patient sitting in front of you has specific needs." "Apremilast is a safe choice that's quite convenient."

Key Insights Distilled From

by Steven R. Fe... at 06-28-2023
S2 Episode 4: Oral Psoriasis Drugs: What Are NPs Prescribing?

Deeper Inquiries

How can the role of nurse practitioners in dermatology continue to evolve to enhance patient care?

The role of nurse practitioners in dermatology can continue to evolve by focusing on specialized training programs, such as dermatology nurse practitioner fellowships, to ensure that NPs have the necessary expertise to provide high-quality care to patients with skin conditions like psoriasis. Additionally, fostering collaboration within multidisciplinary dermatology teams can further enhance patient care by leveraging the unique skills and perspectives of different healthcare professionals. Nurse practitioners can also play a key role in patient education and empowerment, helping individuals better understand their condition and treatment options. Embracing technological advancements, such as telemedicine and digital health tools, can also expand the reach of dermatology NPs and improve access to care for patients in underserved areas.

What are the potential drawbacks of relying solely on oral treatments for psoriasis management?

While oral treatments for psoriasis can be effective in managing the condition, there are several potential drawbacks to relying solely on them. One major concern is the risk of adverse effects associated with oral medications, such as liver toxicity with methotrexate or teratogenicity with acitretin. Regular monitoring of patients on oral treatments is essential to mitigate these risks. Another drawback is the time it may take to see significant improvement with oral agents compared to biologics, which can lead to patient dissatisfaction or non-adherence. Cost considerations, including the expense of lab monitoring and potential out-of-pocket expenses for patients, can also be a limiting factor. Additionally, some patients may not achieve the desired level of disease control with oral treatments alone, necessitating a switch to more potent therapies like biologics.

How might advancements in oral psoriasis treatments impact the overall landscape of dermatological care?

Advancements in oral psoriasis treatments, such as the introduction of novel agents like TYK2 inhibitors and PDE4 inhibitors, are reshaping the landscape of dermatological care by expanding the therapeutic options available to healthcare providers and patients. These new oral treatments offer alternative pathways for managing psoriasis, especially for individuals who may be hesitant to pursue biologic therapies. The improved safety profiles and efficacy of these oral agents are changing the treatment paradigm, allowing for more personalized and targeted approaches to psoriasis management. As the arsenal of oral treatments grows, healthcare providers have a broader range of options to tailor treatment plans to individual patient needs, potentially leading to better outcomes and improved quality of life for individuals living with psoriasis. Additionally, advancements in oral psoriasis treatments may contribute to a shift in the traditional stepwise approach to psoriasis management, offering more flexibility in selecting the most appropriate therapy based on patient characteristics and preferences.