Early intervention in psoriasis and immune-mediated inflammatory diseases: A hypothesis paper

Abstract

Psoriasis is an immune-mediated inflammatory disease (IMID) which may have a major impact on a patient’s life, especially when the disease is moderate to severe. There is evidence that treatment of psoriasis during the first years is conservative and frequently based on topical agents which rarely clear lesions. Treatment with systemic agents including biologics is often undertaken only when topical agents have proved unsuitable, even in patients with moderate to severe disease. However, there is evidence that in other IMIDs (rheumatoid arthritis and Crohn’s disease), targeted systemic treatment given early in the treatment pathway may improve long-term patient outcomes. We hypothesize that a patient-centered therapeutic approach, undertaken early in the psoriasis treatment pathway (“early intervention”) with the goal of complete clearance, may improve control of cutaneous symptoms and may also modify disease course and burden. Critical points to address when designing an early intervention study would include: the definition of psoriasis disease activity; patient selection; intervention selection; and dosing strategies.

• Comorbidities
• early intervention
• management
• pathophysiology
• psoriasis

Acknowledgements

The authors thank S. McGrath and C. Incles of IntraMed Europe for writing support and editorial assistance.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. Funding sources: Development of this article was supported by Janssen Pharmaceutica NV.

Interest disclosures

G. G. has been a consultant, investigator, and/or speaker for Abbot, GSK, Janssen, Merck-Serono, MSD, Novartis; C. G. has been a consultant, investigator and/or speaker for Abbott, Janssen, Leo, MSD, Novartis, Pfizer; J. K. has been a consultant, investigator, and/or speaker for Centocor, Janssen, Lilly, Merck-Serono, Pfizer; F. N. has been a consultant, investigator and/or speaker for Celgene, Basilea, Janssen, Novartis, Pfizer; J. F. N. has been a consultant, investigator and/or speaker for Janssen; J. P. has been a consultant, investigator, and/or speaker for Abbott, Biogen-Idec, Centocor, Essex pharma, Galderma, Janssen, Merk-Serono, Novartis, Pfitzer, Wyeth; L. P. has been a consultant, investigator, and/or speaker for Abbott, Amgen, Celgene, Janssen, Leo, Merck-Serono, Pfizer; M. S. has been a consultant, investigator and/or speaker for Janssen, Pfizer; P. v. D. K. has been a consultant, investigator, and/or speaker for Abbott, Actelion, Almirall, Celgene, Centocor, Galderma, Janssen, Leo Pharma, Merck-Serono, Novartis, Philips Lighting, Pfizer, Schering Plough, Soffinova, UCB, Wyeth; M. A. has been a consultant, investigator, and/or speaker for Abbott, Janssen, MSD; P. E. has been a consultant, investigator, and/or speaker for Abbott, Janssen, Merck, Novartis, Pfizer; C. P. has been a consultant, investigator, and/or speaker for Abbott, Amgen, Astellas, Basilea, Celgene, Janssen, Novartis, Pierre Fabre.