Are psoriasis biologics safe during conception, pregnancy?
A study published in the Journal of the European Academy of Dermatology and Venereology suggests that exposure to biologics for women with psoriasis, during either pregnancy or conception, is not associated with an elevated risk of congenital malformation or miscarriage. The processes of psoriasis involve cytokine and chemokine dysfunction, with significantly elevated TNF-alpha. The investigators note that this can raise the risk of intrauterine growth restriction, preterm delivery, and even miscarriage.
[Dermatologists discuss the safety of common dermatologic drugs in pregnant patients in DermWorld.]
The researchers’ search yielded 51 observational studies, involving 739 pregnancies exposed to approved biologics. The administration of biologics was primarily limited to the initial trimester of pregnancy, and the most commonly used drug ended up being ustekinumab. Overall, the investigators found that the estimated prevalence of miscarriage among pregnant women exposed to biologics for psoriasis was shown to be 15.3%, while elective abortions accounted for 10.8%. The research team added that occurrence of congenital malformations in live births exposed to biologics was approximately 3%. However, they did not find evidence of a risk increase for miscarriage/abortion or congenital malformations linked to biologic drug exposure during pregnancy and/or conception.
As biologic therapies expand indications to children and adolescents, what do dermatologists need to know about balancing the risks and benefits? Read more in DermWorld.
DermWorld Insights and Inquiries: Promising therapeutic developments for cutaneous lupus erythematosus: Interfering with interferon – Part II – Focus on anifrolumab
Dr. Victoria Werth notes that “there are currently only two FDA-approved medications for CLE, hydroxychloroquine and glucocorticoids, both of which have been in use since before 1962, when the FDA grandfathered them in without clinical trials.” Part I focused on the anti-BDCA2 antibody litifilimab for CLE. This commentary is devoted to the expanding literature on anifrolumab, a monoclonal antibody that blocks type 1 interferon signaling, for CLE. During the past year, several papers touting the efficacy of anifrolumab for CLE have been published. The rapidity of response to anifrolumab in all types of CLE is striking. I just referred a patient with recalcitrant SLE with CLE for anifrolumab infusions. Anifrolumab may not be a panacea, but recent literature suggests that it may be a beneficial adjunctive therapy across the CLE spectrum, serving as a prelude to novel agents targeting IFN. Keep reading!
Acne vulgaris guidelines: Member comment period is open
AAD Pathways program highlights the Academy’s pipeline efforts
An article published in the Associated Press discusses the lack of diversity in the specialty of dermatology and the Academy’s pipeline efforts to address the issue. “The skin is a window to the rest of your health,” said Ginette Okoye, MD, FAAD, professor and chair of dermatology at Howard University, who is a programming lead for the Academy’s Pathways program. The article highlights dermatology residents who are underrepresented minorities in medicine whose decisions to pursue medical school and dermatology residency were significantly influenced by various pipeline efforts, including the Academy’s Pathways program, a collaboration with Johnson & Johnson Consumer Health and Janssen.
The Academy’s Pathways initiative engages students from Black, Latino, and Indigenous communities from high school through medical school. The program starts with building interest in dermatology as a career and continues to scholarships, workshops, and mentorship programs. The goal: Increase the number of underrepresented dermatology residents from about 100 in 2022 to 250 by 2027, and grow the share of dermatology faculty who are members with skin of color by 2%. Read the full article.
On Sept. 6, the AADA hosted a virtual Summit on Creating Momentum on Inflation Adjustment, Patient Access, and Medicare Payment. Physician leaders and key members of Congress came together to energize and equip physicians to educate policymakers on the impact of Medicare payment cuts on patient care access. The group discussed strategies to urge Congress to enact an inflation-based Medicare payment adjustment that would be created under the “Strengthening Medicare for Patients and Providers Act” (H.R. 2474).
The event included key supporters of the legislation, Reps. Larry Bucshon, MD (R-IN-08), Raul Ruiz, MD (D-CA-25), and Ami Bera, MD (D-CA-06). Physician speakers were led by AAD/A President Terrence A. Cronin, Jr., MD, FAAD, who moderated the question-and-answer session with Rep. Bucshon.
Dr. Cronin and Rep. Bucshon had a lively discussion about the importance of H.R. 2474 and how physicians can educate their representatives and senators about the need to stop the cycle of cuts and increase Medicare payments to physicians. The AADA was also pleased to have the involvement of the American Medical Association, American Academy of Family Physicians, American Association of Neurological Surgeons/Congress of Neurological Surgeons, American College of Physicians, and the Texas Medical Association. A recording will be available on the AADA website next week.
CMS offers resources, flexibilities in response to Hurricane Idalia
CMS announced additional resources and flexibilities that are available in response to Hurricane Idalia in Florida. Resources include waivers, special enrollment opportunities for hurricane victims, medical equipment and supplies replacements, and more. For more information, visit CMS’s website.
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