Plaque Psoriasis

Question 1

Guidelines for psoriasis

Answer 1

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

Question 2

Current recommended classes for psoriasis

Answer 2

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

Question 3

TNFa inhbitors (4) recommended for psoriasis

Answer 3

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

Question 4

IL12/23 inhibitor (1) recommended for psoriasis

Answer 4

1. Stelara (ustekinumab)

Question 5

IL 17 inhibitors recommended for psoriasis (3)

Answer 5

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

Question 6

IL 23 inhibitors recommended for psoriasis (3)

Answer 6

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

Question 7

Generic and class: Skyrizi

Answer 7

Skyrizi (risankizumab), IL23

Question 8

Generic and class: Enbrel

Answer 8

Etanercept, TNFai

Question 9

Generic and class: Cosentyx

Answer 9

Secukinumab, IL17i

Question 10

Generic and class: Tremfya

Answer 10

Guselkumab, IL23

Question 11

Generic and class: Remicade

Answer 11

infliximab, TNFa

Question 12

Generic and class: Humira

Answer 12

adalimumab, TNFa

Question 13

Generic and class: Ilumya, Ilumetri

Answer 13

tildrakizumab

Question 14

Generic and class: Taltz

Answer 14

Ixekizumab, IL17

Question 15

Generic and class: Siliq

Answer 15

Brodalumab, IL17

Question 16

Generic and class: Stelara

Answer 16

Ustekinumab, IL12/23

Question 17

Recommendation for TNFa inhibitors and IL-12/23

Answer 17

may be used in combination with Otezla (apremilast)

Question 18

Combination therapy for psoriasis options

Answer 18

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

Question 19

First and only topical PDE4i for plaque psoriasis

Answer 19

Zoryve (roflumilast)

Question 20

Pricing for Zoryve 60 g tube

Answer 20

$800-$1k

Question 21

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

Answer 21

2023

Question 22

age for patients to take Zoryve

Answer 22

12 andolder

Question 23

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

Answer 23

Otezla (apremilast)

Question 24

Otezla (apremilast) pricing

Answer 24

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

Question 25

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

Answer 25

Eucrisa (crisabarole)

Question 26

Eucrisa (crisabarole) pricing

Answer 26

$800-$900 for 60 g tube

Question 27

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

Answer 27

Daliresp, for COPD

Question 28

Roflumilast is water/lipid INsoluble?

Answer 28

water-insoluble

Question 29

Which PDE enzymes does roflumilast affect?

Answer 29

just PDE4

Question 30

Where is PDE4 expressed? (4)

Answer 30

1. Keratinocytes 2. Neutrophils 3. Langerhans cells 4. T cells

Question 31

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

Answer 31

T cells

Question 32

By breaking down cAMP, PDE4 modulates (5)

Answer 32

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

Question 33

Roflumilast MoA

Answer 33

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

Question 34

Increased intracellular cAMP leads to: (4)

Answer 34

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

Question 35

Increasing intracellular cAMP in patients with COPD specifically results in

Answer 35

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

Question 36

What role does roflumilast have in COPD?

Answer 36

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

Question 37

PSORRO trial

Answer 37

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

Question 38

PSORRO trial methods

Answer 38

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

Question 39

primary endpoint for PSORRO

Answer 39

≥75% greater reduction in baseline PASI75 at week 12

Question 40

PASI75

Answer 40

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

Question 41

PSORRO trial week 12 results

Answer 41

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

Question 42

PSORRO trial week 24 results

Answer 42

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

Question 43

PSORRO n=

Answer 43

46

Question 44

Zoryve cream/foam is formulated with HYDROARQ technology?

Answer 44

cream

Question 45

HYDROARQ Technology

Answer 45

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

Question 46

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

Answer 46

Crodafos CES