Skin Disease States and Remissions

At the 9th Annual Interdisciplinary Autoimmune Summit, Joseph Merola, MD, MMSc, and Adam Cheifetz, MD, presented their discussion-based session, “Deep Dive: Can We Achieve Remission?”, sharing their insights on the topic.

Dr Merola started with a focus psoriasis, particularly how many patients with some of the newer therapies are starting to clear. However, despite of this patients are still showing a disconnect even between patient recorded outcomes around the following:

• Itch
• Skin pain
• Impact on quality of life
• Mood
• Fatigue

“Even when treating the objective where physicians can call a patient in remission, they still don’t feel they are in remission which is residual stuff we’re not addressing or fixing,” he added.

Comparing this with psoriatic arthritis, Dr Merola noted that measures haven’t gotten nearly as far with the utilization of measuring tools, such as minimal disease activity, as they are not deep remission but low disease activity measure.

He then turned the following questions over to participants: How do we think about remission in 2022 from a physician standpoint as opposed to a patient standpoint? How do we get patients where they want to be?

Continuing on he addressed a few disease states and how far systemic agents have come to achieve remission. He noted that there still a ways to go for hidradenitis suppurativa where the activity and damage shared parallels with inflammatory bowel disease. However, the new world of eczema and atopic dermatitis agents are increasingly getting more patients in the clear similar to psoriasis where physicians are seeing a wave of clarity and patient impact.

Despite this, there still remains a gap in patient symptoms like itch. He noted that while physicians may improve the skin, itch creates the disconnect between physician and patient. He added that, with regards to psoriatic arthritis, there’s a need to push the barrier and a whole lot of subjectivity around remission.

Reference
Merola J, Cheifetz A. Deep dive: can we achieve remission. Presented at: IAS 2022; April 21-24, 2022; virtual.