International Psoriasis Council

Advancing Knowledge. Enhancing Care.

Advancing Knowledge. Enhancing Care.

Focus on Psoriasis: A Report from the 2021 Virtual ESDR Congress

ESDR annual meeting blog image

Due to the pandemic, the European Society for Dermatological Research (ESDR)’s 50th Annual Meeting was held virtually (September 22 – 25, 2021). The virtual format ensured that participation would be international and collaborative without putting anyone at greater risk of contracting the virus.

IPC opened with a symposium titled “Research on SARS-CoV-2 during the COVID-19 pandemic crisis: An IPC tribute to young researchers,” which gave sincere credit and appreciation to young researchers who continued high-level research despite the COVID-19 pandemic.

The ESDR congress also included many noteworthy psoriasis presentations from both IPC councilors and experts from around the world, including a special 50-year ESDR Anniversary Lecture from IPC Chief Medical Officer Peter van de Kerkhof. Thomas Sharnitz, MD, has written a report on several of these presentations. You can download the full report or read on for a brief look at some of the highlights.

50 YEAR ESDR ANNIVERSARY LECTURE

IPC Chief Medical Officer, Peter van de Kerkhof, was honored as one of five ESDR 50th-anniversary speakers. These lectures were intended to reflect the history of the ESDR, with Dr. van de Kerkhof speaking on Psoriasis: From empirical to pathogenesis-based treatment of psoriasis, covering the history of research and noteworthy discoveries from 1970 – present. The lecture was concluded with Dr. van de Kerkhof describing the critical shift over 50 years from categorizing psoriasis as a ‘skin-only disease’ to a vital recognition of its systemic inflammatory nature.

IPC SYMPOSIUM: RESEARCH ON SARS-COV-2 DURING THE COVID-19 PANDEMIC CRISIS: AN IPC TRIBUTE TO YOUNG RESEARCHERS

  • Dr. Paul Bastard presented, Autoantibodies to type I IFNs in patient with life threatening COVID-19, where he discussed which epidemiologic risk factors increase the threat of life-threatening COVID-19, such as age and male sex, however substantial interindividual variability remains. Dr. Bastard details his study, conducted together with The COVID Human Genetic Effort. Over 10,000 patients with asymptomatic/mild and severe/critical COVID-19 focusing on Type 1 interferons (IFNs), which trigger potent anti-viral responses and are implicated in other severe infections. The research discovered that type 1 IFNs appear to be essential for protective immunity against SARS-CoV-2; inborn errors or autoantibodies to type 1 IFNs place individuals at risk for life-threatening/critical COVID-19 and that autoantibodies neutralizing type 1 IFNs underlie at least 15% of critical COVID-19 cases, > 20% of cases in patients older than 80 years old, and > 20% in patients who died of COVID-19.
  • Dr. Zijun Wang presented B-cell responses to SARS-CoV-2 in the setting of COVID-19 infection and vaccination, which discussed a study on a group of convalescent individuals, looking at polyclonal and monoclonal B-cell and antibody responses to SARS-CoV-2 post-infection. The study found that approximately 10% of convalescent patients were hospitalized for SARS-CoV-2 infection. Regardless of vaccination status, neutralizing antibody titers remain relatively unchanged between 6 and 12 months after infection. However, vaccination boosts these significantly and immensely.
  • IPC Councilor Satveer Mahil presented COVID-19 infection in psoriasis patients: Lessons from real-life registries and discussed data collected from PsoProtect and PsoProtectMe, international registries for healthcare providers and patients to report outcomes of COVID-19 in individuals with psoriasis. Their data found that most cases reported fully recovered from infection and that biologic monotherapy is associated with a reduced risk of hospitalization. The COVID-19 pandemic may cause non-adherence and worsening psoriasis, which is associated with poor mental health, driven primarily by concerns about immunosuppressant risks of COVID-19.
  • Dr. Matthew Patrick presented, Interactions between skin inflammatory diseases and COVID-19: Lessons from genomic epidemiology studies, discussing an extensive study (n > 435,000) across encounters in 2019/2020 with recorded age, race, sex, BMI, and socioeconomic status. 1,115 (0.25%) had COVID-19, and of these, 150 (13.5%) required mechanical ventilation. His research found that skin disease patients have higher rates of COVID-19 than the general population but appear to have less severe cases. The study also found that skin diseases and SARS-CoV-2 share upregulated genes, including IL-6, IL-1B, TNF-α, and IL-17C, and psoriasis and SARS-CoV-2 share high gene expression inside the epidermal differentiation complex (EDC) locus, involved in keratinocyte differentiation and molecular physiology of psoriasis.

PUSTULAR PSORIASIS

  • IPC Chief Medical Officer Dr. Peter van de Kerkhof presented Discovery: Understanding of generalized pustular psoriasis from bench to bedside, where he discussed that generalized pustular psoriasis (GPP) is phenotypically, genetically, and clinically distinct from plaque psoriasis, and much evidence supports the central role of the IL-36 pathway in GPP pathophysiology. Further research to explicate the GPP pathogenesis could produce effective treatment options.
  • IPC Councilor Dr. Jörg Prinz presented Innovations in generalized pustular psoriasis treatment, where he discussed the development of two IL-36R antibody antagonists IFN-Ω currently in clinical trials: imsidolimab and spesolimab. Studies have found IL-36 is a key cytokine in generalized pustular psoriasis (GPP). Blockade of the IL-36 receptor signaling, central to the pathogenesis of GPP, is a novel, targeted therapeutic approach. Early data suggest promising results for both imsidolimab and spesolimab in treating GPP independent of IL-36RN mutation status.
    Addendum: A previous version of this summary incorrectly stated that secondary endpoint of GPPGA response was insignificant, with p = 0.12. The above correctly represents that the study found a significant response, with p = 0.012. Additionally, the previous version suggested in error that adverse events increased in the treatment arm compared to placebo. The comparison was not possible due to all patients receiving spesolimab after week 1.
  • IPC Councilor Dr. Siwe Eng Choon presented Impact of generalized pustular psoriasis: Disease burden and unmet needs, where she discussed that, although generalized pustular psoriasis (GPP) is rare, it is potentially life-threatening and has huge impacts on physical and mental health. Unfortunately, we lack high-quality evidence to guide the treatment of GPP, and treatment often provides an inadequate response.

OTHER

  • Dr. Lajos Kemeny presented on Mesenchymal stromal cell therapy for psoriasis. Dr. Kemeny explained that Mesenchymal stromal/stem cells (MSCs) are highly immunomodulatory and can be harvested and systemically administered to patients who autoimmune diseases. MSC therapy offers a promising future option for patients with recalcitrant or severe psoriasis, and trials are underway to further study and perfect this technique for use in psoriasis.
  • Dr. Frank Behrens presented, Detection and management of psoriatic arthritis: Spot the signs, act fast, and discussed the importance of early detection of psoriatic arthritis (PsA) to slow progression and joint damage. Screening for joint stiffness, edema, nail changes, and resting pain can be early clues. Future serum biomarkers may assist in early detection, and IL-23 inhibition shows great promise in treating PsA, including in those who failed other therapies.
  • IPC Councilor Dr. Wolf-Henning Boehncke presented New MOAs in the psoriasis pipeline, which focused on novel treatment targets in the plaque psoriasis pipeline, including those targeting ROR-γ, A3AR, Tyk2, and the newly approved IL-17A/F medications. Notably, TYK2 inhibition with deucravacitinib shows superior clinical efficacy to apremilast, and similarly, the IL-17A and F inhibitors sonelokimab and bimekizumab display superior efficacy to established IL-17A inhibitors.

For a more in-depth summary of these lectures, please download the full report.

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