Novartis is deeply dedicated to the global effort to combat COVID-19 and doing our part to support the stability of global healthcare systems. We are contributing to research efforts, supporting communities and ensuring stable supply and price of essential medicines (see https://www.novartis.com/coronavirus for more information). In parallel, we continue to explore ways to improve patient care in other diseases. This challenge in particular is part of our longstanding commitment to improving treatment of Plaque Psoriasis.
The healthcare community is looking for solutions to improve treatment of Plaque Psoriasis (PsO), a chronic inflammatory skin disorder. PsO is characterized by painful red, raised, dry patches of skin usually covered by silvery or white scales. In addition, PsO isassociated with increased risk of Psoriatic Arthritis (PsA), a complex and potentially debilitating disease with multiple symptoms beyond skin such as joint pain, stiffness, and tenderness. Up to 30% of patients with PsO may also have PsA;, with likelihood of PsA diagnosis increasing as the severity of PsO increases. There is also an increased risk of developing PsA for PsO patients with nail dystrophy (~3 times higher risk) and scalp lesions (~4 times higher risk), when compared to patients without these symptoms. When left untreated, PsA can cause irreversible joint damage and lead to physical limitations.
There is a unique opportunity to improve PsO/PsA care by educating the PsO patient population to be aware of potential PsA systems. Here, we focus on patients diagnosed with PsO because in 80% of dual PsO/PsA patients, the psoriasis symptoms appear either before or at the same time as the joint symptoms. Yet despite existing educational efforts, many PsO patients are unaware that PsO can lead to PsA. PsO patients may not mention joint pain or stiffness to the dermatologist who is treating their PsO because they do not realize those symptoms could be linked to their skin disease. Meanwhile, dermatology providers are not always trained to, or may not have time to, ask their PsO patients about PsA symptoms. Educating psoriasis patients earlier in their journey will help them recognize the symptoms of PsA and seek care, which may reduce time to diagnosis, facilitate more effective treatment, and improve overall quality of life.
There are two parts to this challenge:
We are open to a broad range of potential solutions including health education material, patient risk assessments, or other awareness drivers. A successful solution will help patients recognize PsA symptoms that they may consider unrelated to their skin psoriasis, and prompt patients to take action regarding their risk of PsA (e.g., talking to their healthcare provider). Ultimately, patients who understand their own unique PsO / PsA symptoms will be able to better advocate for treatment plans that improve their overall quality of life.
 Mease PJ, Gladman DD, Papp KA, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69(5): 729-735.
 Alinaghi F, Calov M, Kristensen LE, et. al., Prevalence of psoriatic arthritis in patients with psoriasis: A systematic review and meta-analysis of observational and clinical studies. JAAD. 2018; 1-33
 Armstrong AW et al. The National Psoriasis Foundation biannual survey of patients with psoriasis and psoriatic arthritis. 2013: 149:1180-1185
 Wilson FC et al. Arthritis Rheum. 2009;61:233-239
 Mease PJ, Armstrong AW. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs. 2014;74:423-441.
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