Focus on Psoriasis: A Report from the Psoriasis: From Gene to Clinic 10th International Congress

The Psoriasis: From Gene to Clinic 10th International Congress took place in London from Thursday, December 5, to Saturday, December 7, 2024. This triennial event brought together leading experts, researchers, and clinicians to discuss advances in psoriasis research and clinical care. The Congress featured keynote lectures, invited speaker sessions, free communications, and a sponsored lecture addressing genetic foundations, clinical features, and evolving therapeutic approaches for psoriasis. This blog post highlights key discussions and presentations from the meeting. Download the full Gene to Clinic Congress Report for a comprehensive review, or continue reading for session highlights.

KEYNOTE LECTURES

Dissecting the Psoriasis Transcriptome: From Molecular Endotypes to Treatment Resistance
Michel Gilliet, MD, IPC Councilor
Professor Michel Gilliet explored the application of transcriptomics in identifying immune pathways in psoriasis, enabling precision medicine approaches. His research emphasized dominant module expressions (e.g., IFN-I, Th17, and neutrophilic expressions) that guide treatment stratification for various psoriasis phenotypes. Resistance to anti-IL-23 or  anti-IL-17 was linked to IFN-I dominance, while opening pathways for therapies targeting IFN-I and related immune mechanisms.

Challenges of Managing Psoriasis in Low- and Middle-Income Countries
Mahira El Sayed, MSc, MD, IPC Board Member
Dr. Mahira El Sayed outlined the barriers to psoriasis care in resource-limited settings, including inadequate healthcare infrastructure, high treatment costs, and limited access to advanced therapies. She also discussed challenges in diagnosing psoriasis in patients with darker skin tones and emphasized the need for region-specific guidelines to improve care and access.

Psoriasis: Past, Present, and Future
Mark Lebwohl, MD
Dr. Mark Lebwohl provided an overview of psoriasis therapeutics, highlighting the evolution from early biologics to emerging treatments targeting IL-17 and IL-23 pathways. He also discussed unmet needs, such as treatments for nail psoriasis and palmoplantar pustulosis, and noted the potential benefits of glucagon-like peptide 1 (GLP-1) receptor agonists in managing psoriasis and associated obesity.

INVITED SPEAKERS

Redefining Psoriasis Severity and the Need for Systemic Therapy
Bruce Strober, MD, PhD, IPC Vice President/President-Elect
Dr. Bruce Strober proposed improving traditional psoriasis severity terms (mild, moderate, severe) with criteria emphasizing high-impact sites and quality-of-life considerations. He highlighted the limitations of PASI and BSA scores in real-world settings and advocated for treatment guidelines prioritizing patient-centered measures.

Harnessing the Power of Technology in Transforming Psoriasis Care
Justin Ko, MD, MBA
Dr. Justin Ko discussed the transformative role of technology, including artificial intelligence (AI) and teledermatology, in enhancing psoriasis care. AI applications in biomarker identification, disease monitoring, and personalized patient education were emphasized as tools to democratize access and improve efficiency in dermatology practices.

Changing Paradigms in the Science and Practice of Generalized Pustular Psoriasis
Siew Eng Choon, MBBS, FRCP, IPC Board Member
Dr. Siew Eng Choon reviewed the pathogenesis of generalized pustular psoriasis (GPP), highlighting the IL-36 pathway as a therapeutic target. She emphasized the efficacy of IL-36 inhibitors, such as spesolimab, in rapidly controlling GPP flares and stressed the importance of the newly established international diagnostic criteria for GPP.

Stratifying Biologics Based on Real-World Evidence
Lone Skov, MD, PhD, IPC Board Member
Professor Lone Skov discussed the stratification of biologics based on patient-specific factors, including genetic markers and treatment responses. She highlighted the role of therapeutic drug monitoring and real-world evidence in optimizing biologic therapies and ensuring personalized care for patients with psoriasis.

FREE COMMUNICATIONS

Higher IL-10+ T Cell and Treg Cell Counts in Psoriatic Skin are Associated with Super-Response to Guselkumab
Khusru Asadullah, Julianty Angsana, Kristen Kohler, Jocelyn Sendecki, Monica WL Leung, Sarah Tabori, Nenja Krüger, Sven Wegner, Yvonne Personke, Robert Sabat, Kerstin Wolk, Andreas Pinter, Peter Weisenseel, Knut Schäkel, Kilian Eyerich
This Phase 3b GUIDE trial sub-study revealed that higher baseline IL-10+ T cell and Treg cell counts predicted better responses to guselkumab treatment in patients with moderate to severe plaque psoriasis. These findings suggest potential biomarkers for identifying super-responders to IL-23 inhibitors.

Do We Need Oral Treatment Options?
Richard Warren, BSc, MBChB, PhD, IPC Councilor
The convenience of oral treatments over injections is emphasized, with new TYK-2 and PDE-4 agents showing promise, along with the IL-23R antagonist JNJ-77242113. Upadacitinib also demonstrates good efficacy for psoriatic arthritis.

High Induction Dosing of Risankizumab Leads to Suppression of Resident Memory T Cells in Resolved Psoriatic Skin
Andrew Blauvelt, Rundong Jiang, Benjamin Ehst, Robert Matheson, Lam C. Tosi, Rachael Bogle, Jennifer Fox, Mehrnaz Gharaee-Kermani, Allison C Billi, Linyu Shi, Huzefa Photowala, Johann Gudjonsson
The KNOCKOUT study demonstrated that higher induction doses of risankizumab significantly reduced resident memory T cells in psoriatic lesions, supporting prolonged therapeutic responses. These findings underscore the potential of high-dose regimens in improving long-term psoriasis management.

SPONSORED LECTURE

Targeting the IL-36 Pathway in GPP: From Gene to Clinic
David Burden, MD, FRCP, IPC Councilor
Dr. David Burden discussed the IL-36 pathway’s role in GPP pathogenesis and the success of IL-36 inhibitors, such as spesolimab, in rapidly clearing pustules and reducing inflammation. He emphasized the importance of distinguishing GPP from plaque psoriasis to optimize treatment strategies.

We encourage you to download the full 2024 Gene to Clinic Congress Report for a detailed review of the sessions and findings.

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