Whitney McKnight

WASHINGTON – After 60 weeks of continuous therapy with the investigational drug ixekizumab, 722 patients who initially had moderate to severe plaque psoriasis had Psoriasis Area Severity Index (PASI) 75, 90, and 100 response rates of 87%, 78%, and 57%, respectively, based on study results presented by Dr. Andrew Blauvelt at the annual meeting of the American Academy of Dermatology.

Additionally, the rate of complete clearance or mild severity of plaque psoriasis based on the Physician Global Assessment measure was 79% in the study patients. Dr. Blauvelt said “these were tremendous results over time.”

The findings come from the open-label continuation study of ixekizumab in UNCOVER-3. At week 12 of that study, 722 ixekizumab-treated patients were continued on or converted to a regimen of 80 mg ixekizumab every 4 weeks.

In UNCOVER-3, all study participants initially received induction therapy with ixekizumab and then were randomized to placebo (193 patients), etanercept 50 mg twice weekly (382 patients), 80 mg ixekizumab every 4 weeks (386 patients) after a 160 mg starting dose, or 80 mg ixekizumab every 2 weeks (385 patients) after an initial 160 mg starting dose. After 12 weeks, patients entered open-label treatment with the study drug once every 4 weeks.

The long-term safety and tolerability profile was similar to the one seen during the induction period and cited in previously published data. Dr. Blauvelt, President of the Oregon Medical Research Center, said the finding was “good news, in that there were no unexpected safety signals [not already] seen with initial therapy.”

Ixekizumab is an IgG4 monoclonal antibody that selectively binds with interleukin 17A (IL-17A) cytokines, inhibiting interaction with the IL-17 receptor.

According to a spokesperson from Eli Lilly, sponsor of the UNCOVER trial and maker of ixekizumab, a decision from the U.S. Food and Drug Administration on whether to approve ixekizumab for use in psoriasis is expected during the first quarter of 2016.

Dr. Blauvelt is an advisor or consultant for and has received research grants from a wide variety of drug companies including Eli Lilly.

[email protected]

On Twitter @whitneymcknight

WASHINGTON – After 60 weeks of continuous therapy with the investigational drug ixekizumab, 722 patients who initially had moderate to severe plaque psoriasis had Psoriasis Area Severity Index (PASI) 75, 90, and 100 response rates of 87%, 78%, and 57%, respectively, based on study results presented by Dr. Andrew Blauvelt at the annual meeting of the American Academy of Dermatology.

Additionally, the rate of complete clearance or mild severity of plaque psoriasis based on the Physician Global Assessment measure was 79% in the study patients. Dr. Blauvelt said “these were tremendous results over time.”

The findings come from the open-label continuation study of ixekizumab in UNCOVER-3. At week 12 of that study, 722 ixekizumab-treated patients were continued on or converted to a regimen of 80 mg ixekizumab every 4 weeks.

In UNCOVER-3, all study participants initially received induction therapy with ixekizumab and then were randomized to placebo (193 patients), etanercept 50 mg twice weekly (382 patients), 80 mg ixekizumab every 4 weeks (386 patients) after a 160 mg starting dose, or 80 mg ixekizumab every 2 weeks (385 patients) after an initial 160 mg starting dose. After 12 weeks, patients entered open-label treatment with the study drug once every 4 weeks.

The long-term safety and tolerability profile was similar to the one seen during the induction period and cited in previously published data. Dr. Blauvelt, President of the Oregon Medical Research Center, said the finding was “good news, in that there were no unexpected safety signals [not already] seen with initial therapy.”

Ixekizumab is an IgG4 monoclonal antibody that selectively binds with interleukin 17A (IL-17A) cytokines, inhibiting interaction with the IL-17 receptor.

According to a spokesperson from Eli Lilly, sponsor of the UNCOVER trial and maker of ixekizumab, a decision from the U.S. Food and Drug Administration on whether to approve ixekizumab for use in psoriasis is expected during the first quarter of 2016.

Dr. Blauvelt is an advisor or consultant for and has received research grants from a wide variety of drug companies including Eli Lilly.

[email protected]

On Twitter @whitneymcknight

WASHINGTON – After 60 weeks of continuous therapy with the investigational drug ixekizumab, 722 patients who initially had moderate to severe plaque psoriasis had Psoriasis Area Severity Index (PASI) 75, 90, and 100 response rates of 87%, 78%, and 57%, respectively, based on study results presented by Dr. Andrew Blauvelt at the annual meeting of the American Academy of Dermatology.

Additionally, the rate of complete clearance or mild severity of plaque psoriasis based on the Physician Global Assessment measure was 79% in the study patients. Dr. Blauvelt said “these were tremendous results over time.”

The findings come from the open-label continuation study of ixekizumab in UNCOVER-3. At week 12 of that study, 722 ixekizumab-treated patients were continued on or converted to a regimen of 80 mg ixekizumab every 4 weeks.

In UNCOVER-3, all study participants initially received induction therapy with ixekizumab and then were randomized to placebo (193 patients), etanercept 50 mg twice weekly (382 patients), 80 mg ixekizumab every 4 weeks (386 patients) after a 160 mg starting dose, or 80 mg ixekizumab every 2 weeks (385 patients) after an initial 160 mg starting dose. After 12 weeks, patients entered open-label treatment with the study drug once every 4 weeks.

The long-term safety and tolerability profile was similar to the one seen during the induction period and cited in previously published data. Dr. Blauvelt, President of the Oregon Medical Research Center, said the finding was “good news, in that there were no unexpected safety signals [not already] seen with initial therapy.”

Ixekizumab is an IgG4 monoclonal antibody that selectively binds with interleukin 17A (IL-17A) cytokines, inhibiting interaction with the IL-17 receptor.

According to a spokesperson from Eli Lilly, sponsor of the UNCOVER trial and maker of ixekizumab, a decision from the U.S. Food and Drug Administration on whether to approve ixekizumab for use in psoriasis is expected during the first quarter of 2016.

Dr. Blauvelt is an advisor or consultant for and has received research grants from a wide variety of drug companies including Eli Lilly.

[email protected]

On Twitter @whitneymcknight

Depression is one of the top chronic illnesses treated by primary care practices, but providers may be ill-equipped to manage it, compared with other conditions such as asthma, heart failure, and diabetes.

In a new study, Dr. Tara F. Bishop and her colleagues write that their findings show that more attention should be given “to developing policies and incentives to increase the use of care management processes for depression in primary care.”

Drawing upon data collected in 2012 and 2013 from the National Study of Physician Organizations survey, the researchers assessed whether 1, 070 practices used at least one of five established care management processes across depression, asthma, heart failure, and diabetes. The practice sizes of the physicians surveyed varied, although academic faculty practices and those that had less than 33% primary care physicians were excluded (Health Aff. 2016;35[3]:394-400), Dr. Bishop, a health policy analyst affiliated with Cornell University, New York, and her colleagues wrote.

When compared against an overall mean score of 4.8 on a 20-point scale for care management, the mean score for depression was 0.8, which was significantly lower than the other three chronic conditions (P less than .001). This means that when depression was treated in primary care practices, less than one established management strategy was used.

Registries were the most common care management process employed for depression treatment, but at 30%, was much lower for depression than in the other conditions, which ranged from 33% to 52%. Patient education and patient reminders were virtually unused in depression (P less than .0001).

In addition to registries, the care processes evaluated were nurse care managers, quality data, patient reminders, and patient education provided by support staff. Diabetes scored the highest at 1.7 (standard error, 0.13). Asthma and heart failure each had a score of 1.1 (SE, 1.13 and .07, respectively). Also included in the primary analysis were characteristics such as the extent to which the practice operated according to value-based measures such as patient satisfaction and other external incentives, and the level of health information technology employed.

For a secondary analysis, Dr. Bishop and her colleagues drew from additional data collected from an earlier round of the survey, as well as 2007-2010 data from the National Study of Small and Medium-Sized Physician Practices. A noted limitation of the study was that while all data were derived from responses given by the one person from each practice surveyed who was deemed to be the most knowledgeable overall, this was not verifiably the case. In all, the investigators compared 83 practices from across the country of 20 or more physicians with 719 practices nationwide that had fewer than 20 physicians.

The profile of a typical primary care setting in which depression is treated that emerged from the data was a practice that had been established for at least 2 decades, with an average of 21 physicians (SE, 11.2), 81% of whom were nonspecialists. The mean pay-for-performance score was 0.85 (SE, 0.05), the mean health IT score was 7.22 (SE, 0.28), and the mean score for public reporting was 0.87 (SE, .03).

Among larger practices, when controlling for practice characteristics, diabetes care management was the only one to have increased significantly across the years examined: from 2.57 in 2006-2007 to 3.22 in 2012-2013. In practices with fewer than 20 physicians, there were no significant changes in the care management processes scores for any of the chronic care delivered. However, in all practice sizes, higher pay-for-performance scores were associated with the use of depression care management processes. Smaller, hospital-owned practices that offered multispecialty care and greater levels of health IT were associated with lower depression care management scores.

Additionally, Dr. Bishop and her colleagues found that scores for depression treatment positively correlated with a practice having been established longer, being in the South vs. the Northeast, and having higher health IT scores. Negative correlations were found for depression care management and a practice being multispecialty rather than primary care only, and the practice being in the Midwest vs. the Northeast.

It is unclear whether the minimal use of chronic care processes for depression is attributable to what the authors called “the historical separation between mental and physical health care” or other factors, Dr. Bishop and her colleagues wrote.

The Robert Wood Johnson Foundation funded the study. Dr. Bishop declared support from a National Institute on Aging career development award.

[email protected]

On Twitter @whitneymcknight

Depression is one of the top chronic illnesses treated by primary care practices, but providers may be ill-equipped to manage it, compared with other conditions such as asthma, heart failure, and diabetes.

In a new study, Dr. Tara F. Bishop and her colleagues write that their findings show that more attention should be given “to developing policies and incentives to increase the use of care management processes for depression in primary care.”

Drawing upon data collected in 2012 and 2013 from the National Study of Physician Organizations survey, the researchers assessed whether 1, 070 practices used at least one of five established care management processes across depression, asthma, heart failure, and diabetes. The practice sizes of the physicians surveyed varied, although academic faculty practices and those that had less than 33% primary care physicians were excluded (Health Aff. 2016;35[3]:394-400), Dr. Bishop, a health policy analyst affiliated with Cornell University, New York, and her colleagues wrote.

When compared against an overall mean score of 4.8 on a 20-point scale for care management, the mean score for depression was 0.8, which was significantly lower than the other three chronic conditions (P less than .001). This means that when depression was treated in primary care practices, less than one established management strategy was used.

Registries were the most common care management process employed for depression treatment, but at 30%, was much lower for depression than in the other conditions, which ranged from 33% to 52%. Patient education and patient reminders were virtually unused in depression (P less than .0001).

In addition to registries, the care processes evaluated were nurse care managers, quality data, patient reminders, and patient education provided by support staff. Diabetes scored the highest at 1.7 (standard error, 0.13). Asthma and heart failure each had a score of 1.1 (SE, 1.13 and .07, respectively). Also included in the primary analysis were characteristics such as the extent to which the practice operated according to value-based measures such as patient satisfaction and other external incentives, and the level of health information technology employed.

For a secondary analysis, Dr. Bishop and her colleagues drew from additional data collected from an earlier round of the survey, as well as 2007-2010 data from the National Study of Small and Medium-Sized Physician Practices. A noted limitation of the study was that while all data were derived from responses given by the one person from each practice surveyed who was deemed to be the most knowledgeable overall, this was not verifiably the case. In all, the investigators compared 83 practices from across the country of 20 or more physicians with 719 practices nationwide that had fewer than 20 physicians.

The profile of a typical primary care setting in which depression is treated that emerged from the data was a practice that had been established for at least 2 decades, with an average of 21 physicians (SE, 11.2), 81% of whom were nonspecialists. The mean pay-for-performance score was 0.85 (SE, 0.05), the mean health IT score was 7.22 (SE, 0.28), and the mean score for public reporting was 0.87 (SE, .03).

Among larger practices, when controlling for practice characteristics, diabetes care management was the only one to have increased significantly across the years examined: from 2.57 in 2006-2007 to 3.22 in 2012-2013. In practices with fewer than 20 physicians, there were no significant changes in the care management processes scores for any of the chronic care delivered. However, in all practice sizes, higher pay-for-performance scores were associated with the use of depression care management processes. Smaller, hospital-owned practices that offered multispecialty care and greater levels of health IT were associated with lower depression care management scores.

Additionally, Dr. Bishop and her colleagues found that scores for depression treatment positively correlated with a practice having been established longer, being in the South vs. the Northeast, and having higher health IT scores. Negative correlations were found for depression care management and a practice being multispecialty rather than primary care only, and the practice being in the Midwest vs. the Northeast.

It is unclear whether the minimal use of chronic care processes for depression is attributable to what the authors called “the historical separation between mental and physical health care” or other factors, Dr. Bishop and her colleagues wrote.

The Robert Wood Johnson Foundation funded the study. Dr. Bishop declared support from a National Institute on Aging career development award.

[email protected]

On Twitter @whitneymcknight

Depression is one of the top chronic illnesses treated by primary care practices, but providers may be ill-equipped to manage it, compared with other conditions such as asthma, heart failure, and diabetes.

In a new study, Dr. Tara F. Bishop and her colleagues write that their findings show that more attention should be given “to developing policies and incentives to increase the use of care management processes for depression in primary care.”

Drawing upon data collected in 2012 and 2013 from the National Study of Physician Organizations survey, the researchers assessed whether 1, 070 practices used at least one of five established care management processes across depression, asthma, heart failure, and diabetes. The practice sizes of the physicians surveyed varied, although academic faculty practices and those that had less than 33% primary care physicians were excluded (Health Aff. 2016;35[3]:394-400), Dr. Bishop, a health policy analyst affiliated with Cornell University, New York, and her colleagues wrote.

When compared against an overall mean score of 4.8 on a 20-point scale for care management, the mean score for depression was 0.8, which was significantly lower than the other three chronic conditions (P less than .001). This means that when depression was treated in primary care practices, less than one established management strategy was used.

Registries were the most common care management process employed for depression treatment, but at 30%, was much lower for depression than in the other conditions, which ranged from 33% to 52%. Patient education and patient reminders were virtually unused in depression (P less than .0001).

In addition to registries, the care processes evaluated were nurse care managers, quality data, patient reminders, and patient education provided by support staff. Diabetes scored the highest at 1.7 (standard error, 0.13). Asthma and heart failure each had a score of 1.1 (SE, 1.13 and .07, respectively). Also included in the primary analysis were characteristics such as the extent to which the practice operated according to value-based measures such as patient satisfaction and other external incentives, and the level of health information technology employed.

For a secondary analysis, Dr. Bishop and her colleagues drew from additional data collected from an earlier round of the survey, as well as 2007-2010 data from the National Study of Small and Medium-Sized Physician Practices. A noted limitation of the study was that while all data were derived from responses given by the one person from each practice surveyed who was deemed to be the most knowledgeable overall, this was not verifiably the case. In all, the investigators compared 83 practices from across the country of 20 or more physicians with 719 practices nationwide that had fewer than 20 physicians.

The profile of a typical primary care setting in which depression is treated that emerged from the data was a practice that had been established for at least 2 decades, with an average of 21 physicians (SE, 11.2), 81% of whom were nonspecialists. The mean pay-for-performance score was 0.85 (SE, 0.05), the mean health IT score was 7.22 (SE, 0.28), and the mean score for public reporting was 0.87 (SE, .03).

Among larger practices, when controlling for practice characteristics, diabetes care management was the only one to have increased significantly across the years examined: from 2.57 in 2006-2007 to 3.22 in 2012-2013. In practices with fewer than 20 physicians, there were no significant changes in the care management processes scores for any of the chronic care delivered. However, in all practice sizes, higher pay-for-performance scores were associated with the use of depression care management processes. Smaller, hospital-owned practices that offered multispecialty care and greater levels of health IT were associated with lower depression care management scores.

Additionally, Dr. Bishop and her colleagues found that scores for depression treatment positively correlated with a practice having been established longer, being in the South vs. the Northeast, and having higher health IT scores. Negative correlations were found for depression care management and a practice being multispecialty rather than primary care only, and the practice being in the Midwest vs. the Northeast.

It is unclear whether the minimal use of chronic care processes for depression is attributable to what the authors called “the historical separation between mental and physical health care” or other factors, Dr. Bishop and her colleagues wrote.

The Robert Wood Johnson Foundation funded the study. Dr. Bishop declared support from a National Institute on Aging career development award.

[email protected]

On Twitter @whitneymcknight

WASHINGTON – Research is honing in on the best dose for a therapeutic vaccine shown to reduce shedding of herpes simplex virus 2 in subjects with genital herpes infections, based on results presented at the annual meeting of the American Academy of Dermatology.

The vaccine could prove an alternative to antiviral therapy for infected patients.

In a phase II study of 310 HSV-2 infected adults, the subjects who received 60 mcg of recombinant HSV antigens gD and ICP4 and 75 mcg of Matrix M-2 adjuvant had the best response, which was a 58% reduction in viral shedding at 6 months, reported Dr. Zeena Nawas, a researcher at the Center for Clinical Studies in Houston.

The vaccine, GEN 003 (Genocea) is an HSV-2 protein subunit vaccine consisting of two recombinant T-cell antigens: internal fragment of the immediate early (IE) protein ICP and glycoprotein D. The vaccine had a “profound and durable” effect on viral shedding and could become “the first therapeutic vaccine for genital herpes,” Dr. Nawas said.

Previously, Dr. Nawas and her colleagues demonstrated GEN 003 was associated with significant reductions in genital lesions and viral shedding. The new phase II data indicates a best dose combination of antigen and adjuvant for a vaccine candidate for future trials.

For the dose-finding study, seven cohorts were derived from 310 adults with symptomatic genital herpes. Subjects were randomly assigned to receive 30 mcg or 60 mcg each of the recombinant HSV antigens gD and ICP4, plus 25, 50, or 75 mcg of the Matrix M-2 adjuvant; one cohort received a placebo vaccine.

At 6 months after immunization, genital HSV-2 shedding was significantly reduced compared to baseline values in all vaccine groups who received 60 mcg of HSV-2 antigens. The highest reduction at 58% (P less than .0001) was observed in group given the 60/75 mcg dose. With the exception of the group given the 30/25 mcg dose, all study groups had a reduction from baseline measures in genital lesions that ranged from 43% to 69% (P less than .0001).

In response to a question from session comoderator Dr. Andrew Blauvelt, president of the Oregon Medical Research Center, Dr. Nawas said that the placebo group did not have any reduction in viral shedding, making the reductions in viral shedding “clinically and statistically significant. If we have less shedding, that means that the risk of transmission is way less.”Data used to determine the clinically significant correlation between shedding and transmission were derived frompreviously reported dataon antiviral therapies. Few participants across the cohort reported adverse events, according to Dr. Nawas. Myalgia, fatigue, and erythema at the injection site were the most common adverse events. The details of the studyare available at ClinicalTrials.gov. The study is sponsored by Genocea Biosciences, maker of GEN-003.

WASHINGTON – Research is honing in on the best dose for a therapeutic vaccine shown to reduce shedding of herpes simplex virus 2 in subjects with genital herpes infections, based on results presented at the annual meeting of the American Academy of Dermatology.

The vaccine could prove an alternative to antiviral therapy for infected patients.

In a phase II study of 310 HSV-2 infected adults, the subjects who received 60 mcg of recombinant HSV antigens gD and ICP4 and 75 mcg of Matrix M-2 adjuvant had the best response, which was a 58% reduction in viral shedding at 6 months, reported Dr. Zeena Nawas, a researcher at the Center for Clinical Studies in Houston.

The vaccine, GEN 003 (Genocea) is an HSV-2 protein subunit vaccine consisting of two recombinant T-cell antigens: internal fragment of the immediate early (IE) protein ICP and glycoprotein D. The vaccine had a “profound and durable” effect on viral shedding and could become “the first therapeutic vaccine for genital herpes,” Dr. Nawas said.

Previously, Dr. Nawas and her colleagues demonstrated GEN 003 was associated with significant reductions in genital lesions and viral shedding. The new phase II data indicates a best dose combination of antigen and adjuvant for a vaccine candidate for future trials.

For the dose-finding study, seven cohorts were derived from 310 adults with symptomatic genital herpes. Subjects were randomly assigned to receive 30 mcg or 60 mcg each of the recombinant HSV antigens gD and ICP4, plus 25, 50, or 75 mcg of the Matrix M-2 adjuvant; one cohort received a placebo vaccine.

At 6 months after immunization, genital HSV-2 shedding was significantly reduced compared to baseline values in all vaccine groups who received 60 mcg of HSV-2 antigens. The highest reduction at 58% (P less than .0001) was observed in group given the 60/75 mcg dose. With the exception of the group given the 30/25 mcg dose, all study groups had a reduction from baseline measures in genital lesions that ranged from 43% to 69% (P less than .0001).

In response to a question from session comoderator Dr. Andrew Blauvelt, president of the Oregon Medical Research Center, Dr. Nawas said that the placebo group did not have any reduction in viral shedding, making the reductions in viral shedding “clinically and statistically significant. If we have less shedding, that means that the risk of transmission is way less.”Data used to determine the clinically significant correlation between shedding and transmission were derived frompreviously reported dataon antiviral therapies. Few participants across the cohort reported adverse events, according to Dr. Nawas. Myalgia, fatigue, and erythema at the injection site were the most common adverse events. The details of the studyare available at ClinicalTrials.gov. The study is sponsored by Genocea Biosciences, maker of GEN-003.

WASHINGTON – Research is honing in on the best dose for a therapeutic vaccine shown to reduce shedding of herpes simplex virus 2 in subjects with genital herpes infections, based on results presented at the annual meeting of the American Academy of Dermatology.

The vaccine could prove an alternative to antiviral therapy for infected patients.

In a phase II study of 310 HSV-2 infected adults, the subjects who received 60 mcg of recombinant HSV antigens gD and ICP4 and 75 mcg of Matrix M-2 adjuvant had the best response, which was a 58% reduction in viral shedding at 6 months, reported Dr. Zeena Nawas, a researcher at the Center for Clinical Studies in Houston.

The vaccine, GEN 003 (Genocea) is an HSV-2 protein subunit vaccine consisting of two recombinant T-cell antigens: internal fragment of the immediate early (IE) protein ICP and glycoprotein D. The vaccine had a “profound and durable” effect on viral shedding and could become “the first therapeutic vaccine for genital herpes,” Dr. Nawas said.

Previously, Dr. Nawas and her colleagues demonstrated GEN 003 was associated with significant reductions in genital lesions and viral shedding. The new phase II data indicates a best dose combination of antigen and adjuvant for a vaccine candidate for future trials.

For the dose-finding study, seven cohorts were derived from 310 adults with symptomatic genital herpes. Subjects were randomly assigned to receive 30 mcg or 60 mcg each of the recombinant HSV antigens gD and ICP4, plus 25, 50, or 75 mcg of the Matrix M-2 adjuvant; one cohort received a placebo vaccine.

At 6 months after immunization, genital HSV-2 shedding was significantly reduced compared to baseline values in all vaccine groups who received 60 mcg of HSV-2 antigens. The highest reduction at 58% (P less than .0001) was observed in group given the 60/75 mcg dose. With the exception of the group given the 30/25 mcg dose, all study groups had a reduction from baseline measures in genital lesions that ranged from 43% to 69% (P less than .0001).

In response to a question from session comoderator Dr. Andrew Blauvelt, president of the Oregon Medical Research Center, Dr. Nawas said that the placebo group did not have any reduction in viral shedding, making the reductions in viral shedding “clinically and statistically significant. If we have less shedding, that means that the risk of transmission is way less.”Data used to determine the clinically significant correlation between shedding and transmission were derived frompreviously reported dataon antiviral therapies. Few participants across the cohort reported adverse events, according to Dr. Nawas. Myalgia, fatigue, and erythema at the injection site were the most common adverse events. The details of the studyare available at ClinicalTrials.gov. The study is sponsored by Genocea Biosciences, maker of GEN-003.

WASHINGTON – Research is honing in on the best dose for a therapeutic vaccine shown to reduce shedding of herpes simplex virus 2 in subjects with genital herpes infections, based on results presented at the annual meeting of the American Academy of Dermatology.

The vaccine could prove an alternative to antiviral therapy for infected patients.

In a phase II study of 310 HSV-2 infected adults, the subjects who received 60 mcg of recombinant HSV antigens gD and ICP4 and 75 mcg of Matrix M-2 adjuvant had the best response, which was a 58% reduction in viral shedding at 6 months, reported Dr. Zeena Nawas, a researcher at the Center for Clinical Studies in Houston.

The vaccine, GEN 003 (Genocea) is an HSV-2 protein subunit vaccine consisting of two recombinant T-cell antigens: internal fragment of the immediate early (IE) protein ICP and glycoprotein D. The vaccine had a “profound and durable” effect on viral shedding and could become “the first therapeutic vaccine for genital herpes,” Dr. Nawas said.

Previously, Dr. Nawas and her colleagues demonstrated GEN 003 was associated with significant reductions in genital lesions and viral shedding. The new phase II data indicates a best dose combination of antigen and adjuvant for a vaccine candidate for future trials.

For the dose-finding study, seven cohorts were derived from 310 adults with symptomatic genital herpes. Subjects were randomly assigned to receive 30 mcg or 60 mcg each of the recombinant HSV antigens gD and ICP4, plus 25, 50, or 75 mcg of the Matrix M-2 adjuvant; one cohort received a placebo vaccine.

At 6 months after immunization, genital HSV-2 shedding was significantly reduced compared to baseline values in all vaccine groups who received 60 mcg of HSV-2 antigens. The highest reduction at 58% (P less than .0001) was observed in group given the 60/75 mcg dose. With the exception of the group given the 30/25 mcg dose, all study groups had a reduction from baseline measures in genital lesions that ranged from 43% to 69% (P less than .0001).

In response to a question from session comoderator Dr. Andrew Blauvelt, president of the Oregon Medical Research Center, Dr. Nawas said that the placebo group did not have any reduction in viral shedding, making the reductions in viral shedding “clinically and statistically significant. If we have less shedding, that means that the risk of transmission is way less.”Data used to determine the clinically significant correlation between shedding and transmission were derived frompreviously reported dataon antiviral therapies. Few participants across the cohort reported adverse events, according to Dr. Nawas. Myalgia, fatigue, and erythema at the injection site were the most common adverse events. The details of the studyare available at ClinicalTrials.gov. The study is sponsored by Genocea Biosciences, maker of GEN-003.

[email protected]

On Twitter @whitneymcknight

WASHINGTON – Research is honing in on the best dose for a therapeutic vaccine shown to reduce shedding of herpes simplex virus 2 in subjects with genital herpes infections, based on results presented at the annual meeting of the American Academy of Dermatology.

The vaccine could prove an alternative to antiviral therapy for infected patients.

In a phase II study of 310 HSV-2 infected adults, the subjects who received 60 mcg of recombinant HSV antigens gD and ICP4 and 75 mcg of Matrix M-2 adjuvant had the best response, which was a 58% reduction in viral shedding at 6 months, reported Dr. Zeena Nawas, a researcher at the Center for Clinical Studies in Houston.

The vaccine, GEN 003 (Genocea) is an HSV-2 protein subunit vaccine consisting of two recombinant T-cell antigens: internal fragment of the immediate early (IE) protein ICP and glycoprotein D. The vaccine had a “profound and durable” effect on viral shedding and could become “the first therapeutic vaccine for genital herpes,” Dr. Nawas said.

Previously, Dr. Nawas and her colleagues demonstrated GEN 003 was associated with significant reductions in genital lesions and viral shedding. The new phase II data indicates a best dose combination of antigen and adjuvant for a vaccine candidate for future trials.

For the dose-finding study, seven cohorts were derived from 310 adults with symptomatic genital herpes. Subjects were randomly assigned to receive 30 mcg or 60 mcg each of the recombinant HSV antigens gD and ICP4, plus 25, 50, or 75 mcg of the Matrix M-2 adjuvant; one cohort received a placebo vaccine.

At 6 months after immunization, genital HSV-2 shedding was significantly reduced compared to baseline values in all vaccine groups who received 60 mcg of HSV-2 antigens. The highest reduction at 58% (P less than .0001) was observed in group given the 60/75 mcg dose. With the exception of the group given the 30/25 mcg dose, all study groups had a reduction from baseline measures in genital lesions that ranged from 43% to 69% (P less than .0001).

In response to a question from session comoderator Dr. Andrew Blauvelt, president of the Oregon Medical Research Center, Dr. Nawas said that the placebo group did not have any reduction in viral shedding, making the reductions in viral shedding “clinically and statistically significant. If we have less shedding, that means that the risk of transmission is way less.”Data used to determine the clinically significant correlation between shedding and transmission were derived frompreviously reported dataon antiviral therapies. Few participants across the cohort reported adverse events, according to Dr. Nawas. Myalgia, fatigue, and erythema at the injection site were the most common adverse events. The details of the studyare available at ClinicalTrials.gov. The study is sponsored by Genocea Biosciences, maker of GEN-003.

[email protected]

On Twitter @whitneymcknight

WASHINGTON – Research is honing in on the best dose for a therapeutic vaccine shown to reduce shedding of herpes simplex virus 2 in subjects with genital herpes infections, based on results presented at the annual meeting of the American Academy of Dermatology.

The vaccine could prove an alternative to antiviral therapy for infected patients.

In a phase II study of 310 HSV-2 infected adults, the subjects who received 60 mcg of recombinant HSV antigens gD and ICP4 and 75 mcg of Matrix M-2 adjuvant had the best response, which was a 58% reduction in viral shedding at 6 months, reported Dr. Zeena Nawas, a researcher at the Center for Clinical Studies in Houston.

The vaccine, GEN 003 (Genocea) is an HSV-2 protein subunit vaccine consisting of two recombinant T-cell antigens: internal fragment of the immediate early (IE) protein ICP and glycoprotein D. The vaccine had a “profound and durable” effect on viral shedding and could become “the first therapeutic vaccine for genital herpes,” Dr. Nawas said.

Previously, Dr. Nawas and her colleagues demonstrated GEN 003 was associated with significant reductions in genital lesions and viral shedding. The new phase II data indicates a best dose combination of antigen and adjuvant for a vaccine candidate for future trials.

For the dose-finding study, seven cohorts were derived from 310 adults with symptomatic genital herpes. Subjects were randomly assigned to receive 30 mcg or 60 mcg each of the recombinant HSV antigens gD and ICP4, plus 25, 50, or 75 mcg of the Matrix M-2 adjuvant; one cohort received a placebo vaccine.

At 6 months after immunization, genital HSV-2 shedding was significantly reduced compared to baseline values in all vaccine groups who received 60 mcg of HSV-2 antigens. The highest reduction at 58% (P less than .0001) was observed in group given the 60/75 mcg dose. With the exception of the group given the 30/25 mcg dose, all study groups had a reduction from baseline measures in genital lesions that ranged from 43% to 69% (P less than .0001).

In response to a question from session comoderator Dr. Andrew Blauvelt, president of the Oregon Medical Research Center, Dr. Nawas said that the placebo group did not have any reduction in viral shedding, making the reductions in viral shedding “clinically and statistically significant. If we have less shedding, that means that the risk of transmission is way less.”Data used to determine the clinically significant correlation between shedding and transmission were derived frompreviously reported dataon antiviral therapies. Few participants across the cohort reported adverse events, according to Dr. Nawas. Myalgia, fatigue, and erythema at the injection site were the most common adverse events. The details of the studyare available at ClinicalTrials.gov. The study is sponsored by Genocea Biosciences, maker of GEN-003.

[email protected]

On Twitter @whitneymcknight

PHILADELPHIA – Better patient care means seeing to a patient’s overall health, according to Dr. Michael L. Kochman, chair of the American Gastroenterological Association’s Center for GI Innovation and Technology.

Dr. Kochman says that, thanks to recent innovations, different management strategies for certain diseases such as Barrett’s esophagus has meant gastroenterology has seen “rapid progress and significant change,” all of which are leading to better patient outcomes. Ablative techniques, for example, have helped reduce the number of thoracotomies performed in patients with Barrett’s.

Hear about other innovations in GI in this video. You can also visit the center’s website.

[email protected]

On Twitter @whitneymcknight

PHILADELPHIA – Better patient care means seeing to a patient’s overall health, according to Dr. Michael L. Kochman, chair of the American Gastroenterological Association’s Center for GI Innovation and Technology.

Dr. Kochman says that, thanks to recent innovations, different management strategies for certain diseases such as Barrett’s esophagus has meant gastroenterology has seen “rapid progress and significant change,” all of which are leading to better patient outcomes. Ablative techniques, for example, have helped reduce the number of thoracotomies performed in patients with Barrett’s.

Hear about other innovations in GI in this video. You can also visit the center’s website.

[email protected]

On Twitter @whitneymcknight

PHILADELPHIA – Better patient care means seeing to a patient’s overall health, according to Dr. Michael L. Kochman, chair of the American Gastroenterological Association’s Center for GI Innovation and Technology.

Dr. Kochman says that, thanks to recent innovations, different management strategies for certain diseases such as Barrett’s esophagus has meant gastroenterology has seen “rapid progress and significant change,” all of which are leading to better patient outcomes. Ablative techniques, for example, have helped reduce the number of thoracotomies performed in patients with Barrett’s.

Hear about other innovations in GI in this video. You can also visit the center’s website.

[email protected]

On Twitter @whitneymcknight

PHILADELPHIA – For those who seek to shape rather than react to the future of gastroenterology, attendance at the American Gastroenterological Association annual Tech Summit is essential.

While personalized medicine is poised to revolutionize medicine across the specialties, “We have some surprises upcoming in how we can really leverage and apply [personalized medicine] in gastroenterology,” says Dr. Michael L. Kochman, AGAF, chair of the AGA Center for GI Innovation and Technology.

Among new devices that will be featured at this year’s Tech Summit will be some from the bariatric and antireflux spaces, according to Dr. Kochman.

“Our ability to influence the future, rather than react to it is critical,” he says.

To learn more visit www.techsummit.gastro.org. Look out for the AGA’s Tech Summit report with videos and articles highlighting the most interesting talks from the summit.

[email protected]

On Twitter @whitneymcknight

PHILADELPHIA – For those who seek to shape rather than react to the future of gastroenterology, attendance at the American Gastroenterological Association annual Tech Summit is essential.

While personalized medicine is poised to revolutionize medicine across the specialties, “We have some surprises upcoming in how we can really leverage and apply [personalized medicine] in gastroenterology,” says Dr. Michael L. Kochman, AGAF, chair of the AGA Center for GI Innovation and Technology.

Among new devices that will be featured at this year’s Tech Summit will be some from the bariatric and antireflux spaces, according to Dr. Kochman.

“Our ability to influence the future, rather than react to it is critical,” he says.

To learn more visit www.techsummit.gastro.org. Look out for the AGA’s Tech Summit report with videos and articles highlighting the most interesting talks from the summit.

[email protected]

On Twitter @whitneymcknight

PHILADELPHIA – For those who seek to shape rather than react to the future of gastroenterology, attendance at the American Gastroenterological Association annual Tech Summit is essential.

While personalized medicine is poised to revolutionize medicine across the specialties, “We have some surprises upcoming in how we can really leverage and apply [personalized medicine] in gastroenterology,” says Dr. Michael L. Kochman, AGAF, chair of the AGA Center for GI Innovation and Technology.

Among new devices that will be featured at this year’s Tech Summit will be some from the bariatric and antireflux spaces, according to Dr. Kochman.

“Our ability to influence the future, rather than react to it is critical,” he says.

To learn more visit www.techsummit.gastro.org. Look out for the AGA’s Tech Summit report with videos and articles highlighting the most interesting talks from the summit.

[email protected]

On Twitter @whitneymcknight

WASHINGTON – Just because mental health parity laws exist, doesn’t mean they are enforced.

Speakers at this year’s second annual State of the Union in Mental Health & Addiction, cosponsored by the Kennedy Forum, the Satcher Health Leadership Institute, and the Morehouse School of Medicine, Atlanta, singled out insurers, employers, politicians, and philanthropists as not doing enough to ensure the same access to mental and behavioral health care as exists for physical care. The Mental Health Parity and Addiction Equity Act was passed in 2008.

Whitney McKnight/Frontline Medical News

Former congressman Patrick J. Kennedy, who spoke at the event, said it is time “to frame this issue as one of medical civil rights, because the [health care] system we all have all grown up with is one of separate but unequal care.” Likening it to pre–civil rights era separate drinking fountains for black and white Americans, Mr. Kennedy said, “We need to eliminate the notion we need to send people all the way down the hall to drink from the colored water fountain of a mental health system that is ill-equipped, ill-reimbursed, and relegated to the margins of our health care system.”

Former U.S. Surgeon General David Satcher also spoke at the event, describing how as a young protester jailed in the 1960s for participating in Rev. Martin Luther King Jr.’s organized acts of civil disobedience, he learned that “leadership is a team sport.” Dr. Satcher said he is now dedicated to working with others to bring about equal rights for those with brain illnesses.

“Mental health parity is another step forward in the struggle to advance the civil rights of those with mental health and substance use disorders,” Dr. Satcher said.

Dr. Satcher and other panelists agreed on five key elements essential to creating a health care system that will bring physical and mental health into alignment:

• Substance use and mental health screening performed at the time of the annual physical check-up.

• “Brain fitness” programs, such as mindfulness meditation and other emotional resilience training, in schools and workplaces.

• Smartphone technologies that can deliver remote mental and behavioral health care for those who are not always able to access it in person.

• Coordinated team-based mental and physical health care services delivered in the primary care setting, in place of siloed specialty care.

• Implementation of policies and procedures for mental health care services on par with those for oncology, cardiology, diabetes, and other serious or chronic conditions.

According to Mr. Kennedy, because employers are not well-informed enough about what health benefits meet the legal standards, third-party administrators don’t always stretch themselves to provide adequate in-network care for mental health services.

“We need the self-insured companies to pressure [their third-party benefits administrators] to do what they ought to be doing and actually insure adequate access to care,” Mr. Kennedy said. He called for an end to insurers creating “phantom networks” that ostensibly provide adequate coverage under stated policy premiums, while in practice, forcing people to “pay extra, huge copays and deductibles for the mental health services” not actually included in their plans.

Mr. Kennedy also said political parties should expect a large mental health advocacy presence this year at both parties’ conventions, and in an interview noted that he and Dr. Satcher intended to help create an advocacy movement so strong that it will supersede whichever political party wins in November.

“It might be a medical issue, but it takes political will for things to change,” Mr. Kennedy said in the interview.During the question and answer portion of the event, Dr. Patrick Conway, deputy administrator for innovation and quality, and chief medical officer at the Centers for Medicare & Medicaid Services, did not demur when panel moderator Linda Rosenberg, president and CEO of the National Council for Behavioral Health, referred to him as leading an “amazingly activist CMS.”

Dr. Conway agreed, saying, “We are trying to be a catalyst for change. We’re trying to [promote] that culture at CMS.”

He emphasized how CMS is focused on measurement-based mental health care, including symptom-rating scales such as the PHQ-9 (Patient Health Questionnaire 9, a measure of depressive symptoms), which is a required metric in Medicaid-funded accountable care organizations.

Dr. Conway also pointed to CMS spending more than $650 million this year to help physicians integrate mental and physical health care in their practices. Additional funds are being spent, he said, on so-called accountable health communities that address the social determinants of health, such as homelessness. “We know that integrating mental and behavioral health will be critical to the success of these communities,” Dr. Conway said, adding that Medicare providers can expect to see a rollout of a collaborative care modelin January 2017 that will include integrated mental, behavioral, and physical health.

“Our fundamental issue is the ‘scale and spread’ question,” Dr. Conway said, speaking about all CMS-funded programs.

Behavioral health facilities and some primary care facilities seeking accreditation from the Joint Commission also were put on notice by Margaret VanAmringe, the commission’s executive vice president of public policy and government relations. Ms. VanAmringe told the audience that, as of this year, the commission is adding a measurement-based requirement for behavioral health facility accreditation using a patient-tracer method that will collect data on what kind of interaction occurred between a patient and every provider at the facility. The commission will be taking public comment on the change, but Ms. VanAmringe said the decision to include the requirement already had been made.

“We want to get it in place by CMS’s [new collaborative] reimbursements in 2017,” she said.

Philanthropists also were called out for not doing their part to improve parity. “Philanthropists, get in the game! They’re absent,” Mr. Kennedy said. “It’s an outrage that grant makers in health [care] ... fail to [insist] that everything they fund has a mental health dimension. What a revolution [it would be] ... if philanthropy had a gold standard for best practices in funding parity.”

[email protected]

On Twitter @whitneymcknight

WASHINGTON – Just because mental health parity laws exist, doesn’t mean they are enforced.

Speakers at this year’s second annual State of the Union in Mental Health & Addiction, cosponsored by the Kennedy Forum, the Satcher Health Leadership Institute, and the Morehouse School of Medicine, Atlanta, singled out insurers, employers, politicians, and philanthropists as not doing enough to ensure the same access to mental and behavioral health care as exists for physical care. The Mental Health Parity and Addiction Equity Act was passed in 2008.

Whitney McKnight/Frontline Medical News

Former congressman Patrick J. Kennedy, who spoke at the event, said it is time “to frame this issue as one of medical civil rights, because the [health care] system we all have all grown up with is one of separate but unequal care.” Likening it to pre–civil rights era separate drinking fountains for black and white Americans, Mr. Kennedy said, “We need to eliminate the notion we need to send people all the way down the hall to drink from the colored water fountain of a mental health system that is ill-equipped, ill-reimbursed, and relegated to the margins of our health care system.”

Former U.S. Surgeon General David Satcher also spoke at the event, describing how as a young protester jailed in the 1960s for participating in Rev. Martin Luther King Jr.’s organized acts of civil disobedience, he learned that “leadership is a team sport.” Dr. Satcher said he is now dedicated to working with others to bring about equal rights for those with brain illnesses.

“Mental health parity is another step forward in the struggle to advance the civil rights of those with mental health and substance use disorders,” Dr. Satcher said.

Dr. Satcher and other panelists agreed on five key elements essential to creating a health care system that will bring physical and mental health into alignment:

• Substance use and mental health screening performed at the time of the annual physical check-up.

• “Brain fitness” programs, such as mindfulness meditation and other emotional resilience training, in schools and workplaces.

• Smartphone technologies that can deliver remote mental and behavioral health care for those who are not always able to access it in person.

• Coordinated team-based mental and physical health care services delivered in the primary care setting, in place of siloed specialty care.

• Implementation of policies and procedures for mental health care services on par with those for oncology, cardiology, diabetes, and other serious or chronic conditions.

According to Mr. Kennedy, because employers are not well-informed enough about what health benefits meet the legal standards, third-party administrators don’t always stretch themselves to provide adequate in-network care for mental health services.

“We need the self-insured companies to pressure [their third-party benefits administrators] to do what they ought to be doing and actually insure adequate access to care,” Mr. Kennedy said. He called for an end to insurers creating “phantom networks” that ostensibly provide adequate coverage under stated policy premiums, while in practice, forcing people to “pay extra, huge copays and deductibles for the mental health services” not actually included in their plans.

Mr. Kennedy also said political parties should expect a large mental health advocacy presence this year at both parties’ conventions, and in an interview noted that he and Dr. Satcher intended to help create an advocacy movement so strong that it will supersede whichever political party wins in November.

“It might be a medical issue, but it takes political will for things to change,” Mr. Kennedy said in the interview.During the question and answer portion of the event, Dr. Patrick Conway, deputy administrator for innovation and quality, and chief medical officer at the Centers for Medicare & Medicaid Services, did not demur when panel moderator Linda Rosenberg, president and CEO of the National Council for Behavioral Health, referred to him as leading an “amazingly activist CMS.”

Dr. Conway agreed, saying, “We are trying to be a catalyst for change. We’re trying to [promote] that culture at CMS.”

He emphasized how CMS is focused on measurement-based mental health care, including symptom-rating scales such as the PHQ-9 (Patient Health Questionnaire 9, a measure of depressive symptoms), which is a required metric in Medicaid-funded accountable care organizations.

Dr. Conway also pointed to CMS spending more than $650 million this year to help physicians integrate mental and physical health care in their practices. Additional funds are being spent, he said, on so-called accountable health communities that address the social determinants of health, such as homelessness. “We know that integrating mental and behavioral health will be critical to the success of these communities,” Dr. Conway said, adding that Medicare providers can expect to see a rollout of a collaborative care modelin January 2017 that will include integrated mental, behavioral, and physical health.

“Our fundamental issue is the ‘scale and spread’ question,” Dr. Conway said, speaking about all CMS-funded programs.

Behavioral health facilities and some primary care facilities seeking accreditation from the Joint Commission also were put on notice by Margaret VanAmringe, the commission’s executive vice president of public policy and government relations. Ms. VanAmringe told the audience that, as of this year, the commission is adding a measurement-based requirement for behavioral health facility accreditation using a patient-tracer method that will collect data on what kind of interaction occurred between a patient and every provider at the facility. The commission will be taking public comment on the change, but Ms. VanAmringe said the decision to include the requirement already had been made.

“We want to get it in place by CMS’s [new collaborative] reimbursements in 2017,” she said.

Philanthropists also were called out for not doing their part to improve parity. “Philanthropists, get in the game! They’re absent,” Mr. Kennedy said. “It’s an outrage that grant makers in health [care] ... fail to [insist] that everything they fund has a mental health dimension. What a revolution [it would be] ... if philanthropy had a gold standard for best practices in funding parity.”

[email protected]

On Twitter @whitneymcknight

WASHINGTON – Just because mental health parity laws exist, doesn’t mean they are enforced.

Speakers at this year’s second annual State of the Union in Mental Health & Addiction, cosponsored by the Kennedy Forum, the Satcher Health Leadership Institute, and the Morehouse School of Medicine, Atlanta, singled out insurers, employers, politicians, and philanthropists as not doing enough to ensure the same access to mental and behavioral health care as exists for physical care. The Mental Health Parity and Addiction Equity Act was passed in 2008.

Whitney McKnight/Frontline Medical News

Former congressman Patrick J. Kennedy, who spoke at the event, said it is time “to frame this issue as one of medical civil rights, because the [health care] system we all have all grown up with is one of separate but unequal care.” Likening it to pre–civil rights era separate drinking fountains for black and white Americans, Mr. Kennedy said, “We need to eliminate the notion we need to send people all the way down the hall to drink from the colored water fountain of a mental health system that is ill-equipped, ill-reimbursed, and relegated to the margins of our health care system.”

Former U.S. Surgeon General David Satcher also spoke at the event, describing how as a young protester jailed in the 1960s for participating in Rev. Martin Luther King Jr.’s organized acts of civil disobedience, he learned that “leadership is a team sport.” Dr. Satcher said he is now dedicated to working with others to bring about equal rights for those with brain illnesses.

“Mental health parity is another step forward in the struggle to advance the civil rights of those with mental health and substance use disorders,” Dr. Satcher said.

Dr. Satcher and other panelists agreed on five key elements essential to creating a health care system that will bring physical and mental health into alignment:

• Substance use and mental health screening performed at the time of the annual physical check-up.

• “Brain fitness” programs, such as mindfulness meditation and other emotional resilience training, in schools and workplaces.

• Smartphone technologies that can deliver remote mental and behavioral health care for those who are not always able to access it in person.

• Coordinated team-based mental and physical health care services delivered in the primary care setting, in place of siloed specialty care.

• Implementation of policies and procedures for mental health care services on par with those for oncology, cardiology, diabetes, and other serious or chronic conditions.

According to Mr. Kennedy, because employers are not well-informed enough about what health benefits meet the legal standards, third-party administrators don’t always stretch themselves to provide adequate in-network care for mental health services.

“We need the self-insured companies to pressure [their third-party benefits administrators] to do what they ought to be doing and actually insure adequate access to care,” Mr. Kennedy said. He called for an end to insurers creating “phantom networks” that ostensibly provide adequate coverage under stated policy premiums, while in practice, forcing people to “pay extra, huge copays and deductibles for the mental health services” not actually included in their plans.

Mr. Kennedy also said political parties should expect a large mental health advocacy presence this year at both parties’ conventions, and in an interview noted that he and Dr. Satcher intended to help create an advocacy movement so strong that it will supersede whichever political party wins in November.

“It might be a medical issue, but it takes political will for things to change,” Mr. Kennedy said in the interview.During the question and answer portion of the event, Dr. Patrick Conway, deputy administrator for innovation and quality, and chief medical officer at the Centers for Medicare & Medicaid Services, did not demur when panel moderator Linda Rosenberg, president and CEO of the National Council for Behavioral Health, referred to him as leading an “amazingly activist CMS.”

Dr. Conway agreed, saying, “We are trying to be a catalyst for change. We’re trying to [promote] that culture at CMS.”

He emphasized how CMS is focused on measurement-based mental health care, including symptom-rating scales such as the PHQ-9 (Patient Health Questionnaire 9, a measure of depressive symptoms), which is a required metric in Medicaid-funded accountable care organizations.

Dr. Conway also pointed to CMS spending more than $650 million this year to help physicians integrate mental and physical health care in their practices. Additional funds are being spent, he said, on so-called accountable health communities that address the social determinants of health, such as homelessness. “We know that integrating mental and behavioral health will be critical to the success of these communities,” Dr. Conway said, adding that Medicare providers can expect to see a rollout of a collaborative care modelin January 2017 that will include integrated mental, behavioral, and physical health.

“Our fundamental issue is the ‘scale and spread’ question,” Dr. Conway said, speaking about all CMS-funded programs.

Behavioral health facilities and some primary care facilities seeking accreditation from the Joint Commission also were put on notice by Margaret VanAmringe, the commission’s executive vice president of public policy and government relations. Ms. VanAmringe told the audience that, as of this year, the commission is adding a measurement-based requirement for behavioral health facility accreditation using a patient-tracer method that will collect data on what kind of interaction occurred between a patient and every provider at the facility. The commission will be taking public comment on the change, but Ms. VanAmringe said the decision to include the requirement already had been made.

“We want to get it in place by CMS’s [new collaborative] reimbursements in 2017,” she said.

Philanthropists also were called out for not doing their part to improve parity. “Philanthropists, get in the game! They’re absent,” Mr. Kennedy said. “It’s an outrage that grant makers in health [care] ... fail to [insist] that everything they fund has a mental health dimension. What a revolution [it would be] ... if philanthropy had a gold standard for best practices in funding parity.”

[email protected]

On Twitter @whitneymcknight

GRAND CAYMAN – Emerging data increasingly link psoriasis with cardiovascular disease, diabetes, and depression, leading one expert to suggest a more integrated approach to care in patients with these comorbid conditions.

“I think people are starting to understand that the skin is just a marker for inflammation,” Dr. J. Mark Jackson of the University of Louisville (Ky.), said at this year’s annual Caribbean Dermatology Symposium, provided by Global Academy for Medical Education, a sister company to this news organization.

Growing evidence suggests cardiovascular disease is more common in patients with severe psoriasis. The overlap between the two disease states is thought to occur through similar patterns of inflammation, which Dr. Jackson said indicates that patient outcomes for both could be better if clinicians take an integrated approach to treatment. “Skin disease is an excellent way to study new therapies for other diseases,” said Dr. Jackson. “We can actually look at the skin, so it’s a lot easier to study it than the kidney, heart, or lung” (J Am Acad Dermatol. 2012 Nov 12;67[3]:357-62).

Screening for CVD, as well as for other comorbidities, such as diabetes and depression – both of which tend to occur at higher rates in persons with psoriasis – could also help improve compliance rates, according to Dr. Jackson (Dermatology. 2012;225[2]:121-6). .

“Especially if patients are heavy, if they smoke, if their lipids are high, if they have high blood pressure, or a history of heart disease, it’s important to remember that all of these things are connected to chronic inflammation. I think if we keep that in mind, we can have a better health outcome overall,” Dr. Jackson said.

A survey of 163 psoriasis patients published in 2012 found that comorbidities significantly affected patients’ preferences for psoriasis treatments: Those with psoriatic arthritis were more focused on the probability of benefit (P = .037), those with CVD worried about the probability of side effects (P = .046), and those with depression were concerned about treatment duration (P = .047), and cost (P = .023) (J Am Acad Dermatol. 2012 Oct 19;67[3]:363-72).

Because psoriasis is also associated with higher prevalence and incidence rates of type 2 diabetes and metabolic syndrome, particularly in patients with severe psoriasis, Dr. Jackson recommended screening for these diseases when monitoring patients during their follow-up visits (JAMA Dermatol. 2013 Jan;149[1]:84-91).

“Metabolic syndrome gives you more trouble controlling psoriasis and vice versa,” Dr. Jackson said. “It’s important to tell patients that the better health they are in, the better their medicines will work, and the better response their psoriasis will have.”

Dr. Jackson has financial ties to several pharmaceutical companies, including AbbVie, Amgen, Dermira, Galdera, Merck, Novartis, Pfizer, and others.

GRAND CAYMAN – Emerging data increasingly link psoriasis with cardiovascular disease, diabetes, and depression, leading one expert to suggest a more integrated approach to care in patients with these comorbid conditions.

“I think people are starting to understand that the skin is just a marker for inflammation,” Dr. J. Mark Jackson of the University of Louisville (Ky.), said at this year’s annual Caribbean Dermatology Symposium, provided by Global Academy for Medical Education, a sister company to this news organization.

Growing evidence suggests cardiovascular disease is more common in patients with severe psoriasis. The overlap between the two disease states is thought to occur through similar patterns of inflammation, which Dr. Jackson said indicates that patient outcomes for both could be better if clinicians take an integrated approach to treatment. “Skin disease is an excellent way to study new therapies for other diseases,” said Dr. Jackson. “We can actually look at the skin, so it’s a lot easier to study it than the kidney, heart, or lung” (J Am Acad Dermatol. 2012 Nov 12;67[3]:357-62).

Screening for CVD, as well as for other comorbidities, such as diabetes and depression – both of which tend to occur at higher rates in persons with psoriasis – could also help improve compliance rates, according to Dr. Jackson (Dermatology. 2012;225[2]:121-6). .

“Especially if patients are heavy, if they smoke, if their lipids are high, if they have high blood pressure, or a history of heart disease, it’s important to remember that all of these things are connected to chronic inflammation. I think if we keep that in mind, we can have a better health outcome overall,” Dr. Jackson said.

A survey of 163 psoriasis patients published in 2012 found that comorbidities significantly affected patients’ preferences for psoriasis treatments: Those with psoriatic arthritis were more focused on the probability of benefit (P = .037), those with CVD worried about the probability of side effects (P = .046), and those with depression were concerned about treatment duration (P = .047), and cost (P = .023) (J Am Acad Dermatol. 2012 Oct 19;67[3]:363-72).

Because psoriasis is also associated with higher prevalence and incidence rates of type 2 diabetes and metabolic syndrome, particularly in patients with severe psoriasis, Dr. Jackson recommended screening for these diseases when monitoring patients during their follow-up visits (JAMA Dermatol. 2013 Jan;149[1]:84-91).

“Metabolic syndrome gives you more trouble controlling psoriasis and vice versa,” Dr. Jackson said. “It’s important to tell patients that the better health they are in, the better their medicines will work, and the better response their psoriasis will have.”

Dr. Jackson has financial ties to several pharmaceutical companies, including AbbVie, Amgen, Dermira, Galdera, Merck, Novartis, Pfizer, and others.

GRAND CAYMAN – Emerging data increasingly link psoriasis with cardiovascular disease, diabetes, and depression, leading one expert to suggest a more integrated approach to care in patients with these comorbid conditions.

“I think people are starting to understand that the skin is just a marker for inflammation,” Dr. J. Mark Jackson of the University of Louisville (Ky.), said at this year’s annual Caribbean Dermatology Symposium, provided by Global Academy for Medical Education, a sister company to this news organization.

Growing evidence suggests cardiovascular disease is more common in patients with severe psoriasis. The overlap between the two disease states is thought to occur through similar patterns of inflammation, which Dr. Jackson said indicates that patient outcomes for both could be better if clinicians take an integrated approach to treatment. “Skin disease is an excellent way to study new therapies for other diseases,” said Dr. Jackson. “We can actually look at the skin, so it’s a lot easier to study it than the kidney, heart, or lung” (J Am Acad Dermatol. 2012 Nov 12;67[3]:357-62).

Screening for CVD, as well as for other comorbidities, such as diabetes and depression – both of which tend to occur at higher rates in persons with psoriasis – could also help improve compliance rates, according to Dr. Jackson (Dermatology. 2012;225[2]:121-6). .

“Especially if patients are heavy, if they smoke, if their lipids are high, if they have high blood pressure, or a history of heart disease, it’s important to remember that all of these things are connected to chronic inflammation. I think if we keep that in mind, we can have a better health outcome overall,” Dr. Jackson said.

A survey of 163 psoriasis patients published in 2012 found that comorbidities significantly affected patients’ preferences for psoriasis treatments: Those with psoriatic arthritis were more focused on the probability of benefit (P = .037), those with CVD worried about the probability of side effects (P = .046), and those with depression were concerned about treatment duration (P = .047), and cost (P = .023) (J Am Acad Dermatol. 2012 Oct 19;67[3]:363-72).

Because psoriasis is also associated with higher prevalence and incidence rates of type 2 diabetes and metabolic syndrome, particularly in patients with severe psoriasis, Dr. Jackson recommended screening for these diseases when monitoring patients during their follow-up visits (JAMA Dermatol. 2013 Jan;149[1]:84-91).

“Metabolic syndrome gives you more trouble controlling psoriasis and vice versa,” Dr. Jackson said. “It’s important to tell patients that the better health they are in, the better their medicines will work, and the better response their psoriasis will have.”

Dr. Jackson has financial ties to several pharmaceutical companies, including AbbVie, Amgen, Dermira, Galdera, Merck, Novartis, Pfizer, and others.