Expert Panel Discussion among Psoriasis and Psychodermatology Specialists: How Best to Manage Depressed Psoriasis Patients with Brodalumab
Main Article Content
psoriasis, depression, brodalumab
Psoriasis patients with comorbid depression represent a common therapeutic challenge for dermatologists. Depressed patients often require the practicing dermatologist to go outside of their comfort zone, and the FDA’s labeling of medications such as brodalumab have further complicated an already difficult-to-treat patient population. A multi-disciplinary work-group consisting of a board-certified psychiatrist, a licensed clinical psychologist, and multiple dermatologists was convened to formulate practical recommendations for the evaluation and treatment of this at-risk population. How to broach the subject of depression and when to refer patients for formal evaluation were discussed. The expert panel also produced a consensus statement regarding the use of brodalumab in patients with both psoriasis and depression.
2. Koo J, Marangell LB, Nakamura M, Armstrong A, Jeon C, Bhutani T, Wu JJ. 2017. Depression and suicidality in psoriasis: Review of the literature including the cytokine theory of depression. J Eur Acad Dermatol Venereol. 31(12):1999-2009.
3. Ortho dermatologics. Siliqtm [package insert] u.S. Food and drug administration website. Fda.Gov. Revised [february, 2017]. Accessed [august 11, 2019].
4. Lebwohl MG, Papp KA, Marangell LB, Koo J, Blauvelt A, Gooderham M, Wu JJ, Rastogi S, Harris S, Pillai R et al. 2018. Psychiatric adverse events during treatment with brodalumab: Analysis of psoriasis clinical trials. J Am Acad Dermatol. 78(1):81-89.e85.
5. Rusta-Sallehy S, Gooderham M, Papp K. 2018. Brodalumab: A review of safety. Skin Therapy Lett. 23(2):1-3.
6. Papp KA, Reich K, Paul C, Blauvelt A, Baran W, Bolduc C, Toth D, Langley RG, Cather J, Gottlieb AB et al. 2016. A prospective phase iii, randomized, double-blind, placebo-controlled study of brodalumab in patients with moderate-to-severe plaque psoriasis. Br J Dermatol. 175(2):273-286.
7. Pardridge WM. 2005. The blood-brain barrier: Bottleneck in brain drug development. NeuroRx. 2(1):3-14.
8. Gananca L, Oquendo MA, Tyrka AR, Cisneros-Trujillo S, Mann JJ, Sublette ME. 2016. The role of cytokines in the pathophysiology of suicidal behavior. Psychoneuroendocrinology. 63:296-310.
9. Gooderham M, Gavino-Velasco J, Clifford C, MacPherson A, Krasnoshtein F, Papp K. 2016. A review of psoriasis, therapies, and suicide. J Cutan Med Surg. 20(4):293-303.
10. Pavelka K, Chon Y, Newmark R, Lin SL, Baumgartner S, Erondu N. 2015. A study to evaluate the safety, tolerability, and efficacy of brodalumab in subjects with rheumatoid arthritis and an inadequate response to methotrexate. J Rheumatol. 42(6):912-919.
11. Targan SR, Feagan B, Vermeire S, Panaccione R, Melmed GY, Landers C, Li D, Russell C, Newmark R, Zhang N et al. 2016. A randomized, double-blind, placebo-controlled phase 2 study of brodalumab in patients with moderate-to-severe crohn's disease. Am J Gastroenterol. 111(11):1599-1607.
12. Kaushik SB, Lebwohl MG. 2019. Psoriasis: Which therapy for which patient: Focus on special populations and chronic infections. J Am Acad Dermatol. 80(1):43-53.
13. Kaushik SB, Lebwohl MG. 2019. Psoriasis: Which therapy for which patient: Psoriasis comorbidities and preferred systemic agents. J Am Acad Dermatol. 80(1):27-40.