Dr. Armstrong Discusses Combination Therapies for Psoriasis

The quality and variety of biologic therapeutic options available today should give dermatologists more confidence than ever in treating psoriasis, according to April Armstrong, MPH, MPH.

Speaking at the Winter Clinical Hawaii 2025 meeting in Waikoloa Village, Hawaii, Dr. Armstrong discussed not only biologics themselves but also the numerous options for utilizing them as part of combination therapy for psoriasis.

“These days, our biologics are so effective that, if they don’t budge at all, then I really question the diagnosis,” Dr. Armstrong said.

She recommended trying biologics in combination with topical therapies, intralesional corticosteroid injections, oral therapies, and/or phototherapy.

For patients with recalcitrant moderate-to-severe psoriasis despite being on biologics, Dr. Armstrong recommended four options for adding oral therapies to the regimen:

• Deucravacitinib 6mg once daily, potentially decreasing to every other day
• Apremilast 30mg twice daily
• Acitretin 25mg once daily
• Methotrexate 15mg/week