Anti-TNF-α Therapies in the Treatment of Dermatologic Diseases

A supplement to Skin & Allergy News.
Supported by an unrestricted educational grant from Amgen and Wyeth.
It features highlights of faculty presentations that took place at the Skin Disease Education Foundation's 29th Annual Hawaii Dermatology Seminar held March 18-24, 2005, in Maui, Hawaii.

•Contents
•Target Audience
•Educational Needs
•Learning Objectives
•CME Recognition

To view the supplement, click the image above. To take the CME test, download and print out the PDF file, and follow the test instructions on page 11.

Contents

TNF-α-Inhibiting Biologics and the Treatment of Psoriasis, Psoriatic Arthritis, and Other Dermatologic Diseases
Bruce E. Strober, MD, PhD, Chair
Associate Director, Dermatopharmacology Unit
Assistant Professor
Ronald O. Perelman Department of Dermatology
New York University School of Medicine
New York, N.Y.
Grant/Research: Abbott, Amgen-Wyeth, Biogen Idec, and Genentech. Consultant: Amgen-Wyeth, Biogen Indec and Genentech. Speaker's Bureau: Amgen, Biogen Idec, and Genentech. Dr. Strober discusses the investigational use of infliximab and adalimumab in the treatment of psoriasis and psoriatic arthritis. He also discusses the experimental use of infliximab, adalimumab, and etanercept in the treatment of other dermatologic diseases including Behçet's disease, aphthous stomatitis, sarcoidosis, pyoderma gangrenosum, hidradenitis suppurativa, and some bullous disorders.

Efficacy and Safety of Anti-TNF-α Agents in Psoriasis
Alice Bendix Gottlieb, MD, PhD
Professor of Medicine, Department of Medicine
Professor, Department of Molecular Genetics, Microbiology & Immunology
W.H. Conzen Chair in Clinical Pharmacology
Director, Clinical Research Center
UMDNJ-Robert Wood Johnson Medical Center
New Brunswick, N.J.
Received Funding for Clinical Grants: Abbott Laboratories, Amgen Inc., Beiersdorf AG, Biogen Idec, Inc., Bristol-Myers Squibb Company, Celgene Corporation, Centocor, Inc.,WH Conzen Chair in Clinical Pharmacology, Fujisawa Healthcare, Inc., Genentech, Inc., Ligand Pharmaceuticals, Inc., and Synta Pharmaceuticals Corp. Consultant: Abbott, Advanced ImmuniT Inc., Allergan Inc., Amgen, Beiersdorf, Biogen Idec, Bristol-Myers Squibb, Celgene, CellGate, Inc., Centocor, Eisai, Inc., Genentech, Kemia, Medarex, Inc., Novartis AG, Roche, Sankyo Pharma, Schering-Plough Corporation, Warner Chilcott PLC, and Wyeth. Speaker's Bureau: Amgen, Biogen Idec, and Wyeth. She discusses the investigational use of adalimumab and infliximab for the treatment of psoriasis and psoriatic arthritis.

Making the Transition From Cyclosporine and Methotrexate to Biologic Treatment
Paul S. Yamauchi, MD, PhD
Medical Director
Dermatology Institute of Southern California
David Geffen School of Medicine at University of California, Los Angeles
St. John's Hospital
Santa Monica, Calif.
Received grant/research support from, is a consultant to, and is on the Speaker's Bureau at Amgen. He discusses the investigational use of etanercept combined with methotrexate or cyclosporine, and the use of other biologic agents in making a therapeutic transition to etanercept.

Target Audience

This activity has been developed for dermatologists and other healthcare professionals who manage patients with psoriasis and other immune-mediated inflammatory diseases of the skin.

Educational Needs

Psoriasis is a relatively common skin disease affecting more than 2% of individuals in the United States. Although the exact pathogenesis has not been established, the evidence to date demonstrates that T lymphocytes and cytokines play a crucial role. The evidence is strong that tumor necrosis factor-α (TNF-α) is a critical component of the disease process and that inhibition of this cytokine is an effective strategy for managing psoriasis. For mild to moderate psoriasis, topical and light therapies may be effective. However, for moderate to severe psoriasis, systemic therapies such as cyclosporine and methotrexate have been more effective in bringing the disease under control. Unfortunately, cyclosporine and methotrexate are too toxic for sustained long-term use. The biologic agents that block TNF-α have proven safe and effective over the long term for the treatment of many patients with moderate to severe psoriasis. It is important for all clinicians who manage patients with psoriasis to understand the mechanisms of action of these new agents and to recognize their appropriate role in the treatment of selected patients.

Learning Objectives

After reading and studying this supplement, participants should be able to:

• Briefly explain what is known about the pathophysiology of psoriasis and describe the role of TNF-α in psoriasis and other dermatologic disorders.

• Explain the mechanism of action of the three anti-TNF-α agents currently available and list the current indications for each.

• Evaluate the efficacy and safety data of the agents that block TNF-α in patients with psoriasis.

• Discuss the optimum method for making the transition from cyclosporine or methotrexate to a biologic agent and for switching from one biologic agent to another.

CME Recognition

This Skin & Allergy News supplement is recognized by the American Academy of Dermatology for 1 hour of AAD Category 1 CME credit and may be used toward the American Academy of Dermatology's Continuing Medical Education Award. This program was developed in accordance with the Accreditation Council for Continuing Medical Education guidelines.

Term of Approval: July 2005-June 30, 2006.

Copyright © 2005 Elsevier Inc.

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