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Supplemental material, Supplementary Material, for Long-Term Multiple Center Experience in Treating Plaque Psoriasis With Halobetasol Propionate 0.01% and Tazarotene 0.045% Lotion by Abrahim Abduelmula and Melinda J. Gooderham in Journal of Cutaneous Medicine and Surgery

Contains fulltext : 251813.pdf (Publisher’s version ) (Closed access) IMPORTANCE: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. OBJECTIVE: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. DESIGN, SETTING, AND PARTICIPANTS: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). MAIN OUTCOMES AND MEASURES: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. RESULTS: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. CONCLUSIONS AND RELEVANCE: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.

Supplemental material, Supplementary material, for Practice Patterns Around the Management of Atopic Dermatitis in 2018 and 2020 by Melinda J. Gooderham and Chih-ho Hong in Journal of Cutaneous Medicine and Surgery

Supplemental material, Online supplementary file 1, for Real-World Moderate-to-Severe Hidradenitis Suppurativa: Decrease in Disease Burden With Adalimumab by Wayne Gulliver, Afsaneh Alavi, Marni C. Wiseman, Melinda J. Gooderham, Jaggi Rao, Maryam Shayesteh Alam, Kim A. Papp, Olivier Desjardins and Christine Jean in Journal of Cutaneous Medicine and Surgery

Milica Milakovic,1 Melinda J Gooderham2– 4 1Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 2Skin Centre for Dermatology, Peterborough, ON, K9J 5K2, Canada; 3Probity Medical Research, Waterloo, ON, N2J 1C4, Canada; 4Department of Medicine, Queen’s University, Kingston, ON, K7L 3N6, CanadaCorrespondence: Melinda J GooderhamSkin Centre for Dermatology, 775 Monaghan Road, Peterborough, ON, K9J 5K2, CanadaTel +1 705 775 7546Fax +1 705 775 3376Email mgooderham@centrefordermatology.comAbstract: Psoriasis is a chronic immune-mediated inflammatory disorder. Phosphodiesterase-4 (PDE-4) is an enzyme that mediates inflammatory responses and plays a role in psoriasis pathogenesis. PDE-4 degrades its substrate cyclic adenosine monophosphate (cAMP) to adenosine monophosphate (AMP), which subsequently leads to the production of pro-inflammatory mediators. Inhibitors of PDE-4 work by blocking the degradation of cAMP, which leads to a reduction in inflammation. Apremilast is the only approved oral PDE-4 inhibitor for the treatment of psoriasis. While it is effective for some patients, it may be limited by adverse effects in others. A topical PDE-4 inhibitor, roflumilast, is being investigated in psoriasis and showing promising results. Crisaborole, a topical PDE-4 inhibitor approved for use in atopic dermatitis, has also been investigated in psoriasis. This is an updated comprehensive review to summarize the currently available evidence for the PDE-4 inhibitors apremilast, roflumilast and crisaborole in the treatment of psoriasis, with a focus on data from randomized clinical trials.Keywords: psoriasis, PDE-4, phosphodiesterase inhibitors, topical therapies

Supplemental material, Supplementary Material 1, for Management of Plaque Psoriasis With Biologic Therapies in Women of Child-Bearing Potential Consensus Paper by Jensen Yeung, Melinda J. Gooderham, Parbeer Grewal, Chih-ho Hong, Perla Lansang, Kim A. Papp, Yves Poulin, Irina Turchin and Ronald Vender in Journal of Cutaneous Medicine and Surgery

Supplemental material, Supplementary Material 2, for Management of Plaque Psoriasis With Biologic Therapies in Women of Child-Bearing Potential Consensus Paper by Jensen Yeung, Melinda J. Gooderham, Parbeer Grewal, Chih-ho Hong, Perla Lansang, Kim A. Papp, Yves Poulin, Irina Turchin and Ronald Vender in Journal of Cutaneous Medicine and Surgery

Introduction: Generalized pustular psoriasis (GPP) is a rare, severe relapsing/remitting, multisystem disease that can be difficult to treat. Recent clinical, histological, and genetic evidence suggests that GPP is a distinct clinical entity from plaque psoriasis and requires a separate diagnosis. The interleukin-36 pathway appears to be central to GPP pathogenesis. As no therapeutic agents have been approved for GPP to date in the United States or Europe, the introduction of anti-IL-36 therapies may change disease management. Areas covered: Using PubMed and Google Scholar, we reviewed the literature for articles related to GPP, psoriasis, and the genetics, pathogenesis, and treatment thereof. Expert opinion: New therapeutic options and updated guidelines for GPP treatment are needed. Ideal agents would have rapid onset of action and rapid time to achieve disease clearance, have the ability to prevent acute flares and avert recurrence, and possess a favorable safety profile. Such therapies should be readily accessible via approval or listing on formularies. Scoring systems to establish GPP disease burden and objective outcome measures could also help with further evaluation of therapies and treatment access issues. IL-36 remains a promising target, as supported by early phase data suggesting efficacy and safety for a novel anti-IL-36 therapy. Read the transcript Watch the video on Vimeo Copyright is retained by Boehringer Ingelheim Pharmaceuticals, Inc., under a CC-BY license.

Panteha Eshtiaghi,1 Melinda J Gooderham2–4 1Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; 2SKiN Centre for Dermatology, Peterborough, ON, Canada; 3Probity Medical Research, Waterloo, ON, Canada;4Queen’s University, Kingston, ON, Canada Introduction: Atopic dermatitis (AD) is a recurrent, pruritic inflammatory skin disease with complex immunopathogenesis characterized by a dominant TH2 response. Dupilumab is an interleukin (IL)-4 receptor alpha antagonist that subsequently blocks IL-4 and IL-13 signaling. It has recently been approved for the treatment of adult patients with moderate-to-severe AD whose current treatment options are limited. Aim: This article reviews the evidence of clinical efficacy, safety, and patient-reported outcome (PRO) measures from Phase I–III trials of dupilumab in adult patients with moderate-to-severe AD. Evidence review: Results from clinical trials of dupilumab in adults with moderate-to-severe AD have shown that weekly or biweekly dupilumab injections significantly improve clinical and PROs. Transcriptome and serum analyses also found that dupilumab significantly modulates the AD molecular signature and other TH2-associated biomarkers, compared with placebo. Additionally, concomitant use of dupilumab with topical corticosteroids (TCS) results in a greater improvement in signs and symptoms of AD than with dupilumab use alone. Throughout the trials, common adverse events were headaches, conjunctivitis, and injection site reactions. These were consistently mild–moderate and occurred with similar frequency between the treatment and placebo groups. Place in therapy: In adult patients with moderate-to-severe refractory AD, monotherapy or concomitant use of dupilumab with TCS holds great promise to significantly improve clinical outcomes and quality of life of the patient. Ongoing studies of dupilumab will help determine the clinical efficacy and safety profile of its long-term use. Finally, further economic evidence is warranted to compare the long-term costs and benefits of dupilumab with other currently available treatments for moderate-to-severe AD. Keywords: moderate-to-severe atopic dermatitis, biologics, systemic therapy, interleukin-4, interleukin-13, dupilumab

Supplemental material, Hong_article_section_V__803625 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section V: Consensus Statements on the Assessment and Management of Adult Patients With Moderate-to-Severe Atopic Dermatitis by Chih-ho Hong, Melinda J. Gooderham, Lorne Albrecht, Robert Bissonnette, Gurbir Dhadwal, Robert Gniadecki, Parbeer Grewal, Mark G. Kirchhof, Ian Landells, Perla Lansang, Chuck W. Lynde, Kim A. Papp, Yves Poulin, Gordon Sussman, Irina Turchin, Marni Wiseman and Jensen Yeung in Journal of Cutaneous Medicine and Surgery

Supplemental material, 1329_Section_0_Supplementary_Appendix_A_19Jul18 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document by Melinda J. Gooderham, Chih-ho Hong, Lorne Albrecht, Robert Bissonnette, Gurbir Dhadwal, Robert Gniadecki, Parbeer Grewal, Mark G. Kirchhof, Ian Landells, Perla Lansang, Chuck W. Lynde, Kim A. Papp, Yves Poulin, Gordon Sussman, Irina Turchin, Marni Wiseman and Jensen Yeung in Journal of Cutaneous Medicine and Surgery

Supplemental Material, PROPEL_Manuscript_Supplementary_File_3 for Canadian Patients’ Preferences in Topical Psoriasis Care: Insights From the PROPEL Surveys by Ronald Vender, Melinda J. Gooderham, Lyn C. Guenther, Dimitrios Kyritsis, Jaggi Rao, Alice Kowalczyk and John Ashkenas in Journal of Cutaneous Medicine and Surgery

Supplemental material, JCMS_Gooderham_803627 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document by Melinda J. Gooderham, Chih-ho Hong, Lorne Albrecht, Robert Bissonnette, Gurbir Dhadwal, Robert Gniadecki, Parbeer Grewal, Mark G. Kirchhof, Ian Landells, Perla Lansang, Chuck W. Lynde, Kim A. Papp, Yves Poulin, Gordon Sussman, Irina Turchin, Marni Wiseman and Jensen Yeung in Journal of Cutaneous Medicine and Surgery

Supplemental Material, PROPEL_Manuscript_Supplementary_File_2 for Canadian Patients’ Preferences in Topical Psoriasis Care: Insights From the PROPEL Surveys by Ronald Vender, Melinda J. Gooderham, Lyn C. Guenther, Dimitrios Kyritsis, Jaggi Rao, Alice Kowalczyk and John Ashkenas in Journal of Cutaneous Medicine and Surgery

Supplemental material, JCMS_Dhadwal_805721 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section IV: Treatment Options for the Management of Atopic Dermatitis by Gurbir Dhadwal, Lorne Albrecht, Robert Gniadecki, Yves Poulin, Jensen Yeung, Chih-ho Hong and Melinda J. Gooderham in Journal of Cutaneous Medicine and Surgery

Supplemental material, JCMS_Gooderham_803628 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section II: Tools for Assessing the Severity of Atopic Dermatitis by Melinda J. Gooderham, Robert Bissonnette, Parbeer Grewal, Perla Lansang, Kim A. Papp and Chih-ho Hong in Journal of Cutaneous Medicine and Surgery

Supplemental material, JCMS_Kirchhof_803626 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section I: Pathophysiology of Atopic Dermatitis and Implications for Systemic Therapy by Mark G. Kirchhof, Ian Landells, Chuck W. Lynde, Melinda J. Gooderham and Chih-ho Hong in Journal of Cutaneous Medicine and Surgery

Supplemental material, 1329_Section_0_Supplementary_Appendix_A_23Oct18 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document by Melinda J. Gooderham, Chih-ho Hong, Lorne Albrecht, Robert Bissonnette, Gurbir Dhadwal, Robert Gniadecki, Parbeer Grewal, Mark G. Kirchhof, Ian Landells, Perla Lansang, Chuck W. Lynde, Kim A. Papp, Yves Poulin, Gordon Sussman, Irina Turchin, Marni Wiseman and Jensen Yeung in Journal of Cutaneous Medicine and Surgery

Supplemental Material, PROPEL_Manuscript_Supplementary_File_1 for Canadian Patients’ Preferences in Topical Psoriasis Care: Insights From the PROPEL Surveys by Ronald Vender, Melinda J. Gooderham, Lyn C. Guenther, Dimitrios Kyritsis, Jaggi Rao, Alice Kowalczyk and John Ashkenas in Journal of Cutaneous Medicine and Surgery

Supplemental material, 1329_Section_V_Supplementary_Table_1 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section V: Consensus Statements on the Assessment and Management of Adult Patients With Moderate-to-Severe Atopic Dermatitis by Chih-ho Hong, Melinda J. Gooderham, Lorne Albrecht, Robert Bissonnette, Gurbir Dhadwal, Robert Gniadecki, Parbeer Grewal, Mark G. Kirchhof, Ian Landells, Perla Lansang, Chuck W. Lynde, Kim A. Papp, Yves Poulin, Gordon Sussman, Irina Turchin, Marni Wiseman and Jensen Yeung in Journal of Cutaneous Medicine and Surgery

Supplemental material, JCMS_Hong_805709 for Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section III: Evaluation of Atopic Dermatitis Patients for Comorbidities by Chih-ho Hong, Gordon Sussman, Irina Turchin, Marni Wiseman and Melinda J. Gooderham in Journal of Cutaneous Medicine and Surgery