Dr Patrick Burnett on Shared Decision-Making for Moderate to Severe Psoriasis

Patrick Burnett, MD, PhD, FAAD, chief medical officer of Arcutis Biotherapeutics, discusses clinical recommendations for patients with moderate to severe psoriasis, particularly the need for shared decision-making.

Clinicians should conduct shared decision-making with patients who have moderate to severe psoriasis to ensure they understand the disease and establish their goals for treatment, said Patrick Burnett, MD, PhD, FAAD, chief medical officer of Arcutis Biotherapeutics.


What clinical recommendations do you have for patients with moderate to severe psoriasis with uncontrolled disease?

I would say moderate to severe psoriasis is a subgroup of psoriasis that is oftentimes treated with systemic therapies. I believe that as the severity of the psoriasis worsens, and especially if it's coupled with, let's say, psoriatic arthritis or some kind of systemic aspect to their disease, that these are patients that probably should seek some kind of systemic treatment for their disease.

And oftentimes, this may need adjunctive therapy as well in order to get to complete clearance. So, I would say the recommendation is really to make sure that patients are being heard by their doctors, and if they're not getting to the level of clearance that they're looking for—and this really gets back to the kind of impact on quality of life and psychological burden. I think patients have, in their mind, a goal for where it is that they want to be.

I think we should really ask patients, what are your goals? What are your goals for your treatment? Patients with very severe disease, they may not be looking to get to complete clearance. They may be just looking to return to a higher level of functionality. Or some patients may feel like they really want zero psoriasis on their skin.

So, asking them and then being able to try and provide them with what it is that is their expectation, I think will help with that psychological burden of the disease. And that really is about having a conversation with your doctor and making sure that they understand the disease that you have and your expectations for treatment.

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