• Psoriasis is now recognized as a systemic inflammatory metabolic disease.
• The International Psoriasis Council outlined a plan for dermatologists to be involved in the metabolic care of their patients.

The International Psoriasis Council has released a list of five recommendations for prioritized action items that will help dermatologists incorporate metabolic disease considerations into psoriasis care.

Researchers attending the 2025 International Psoriasis Council Think Tank symposium identified metabolic disease management as the primary unmet need and future priority of psoriasis treatment, according to a summary paper published in the Journal of the American Academy of Dermatology. Based on feedback from more than 150 survey responses from dermatologists, the five finalized action items are:

• develop practical screening algorithms for metabolic and cardiovascular comorbidities in psoriasis to guide routine practice, enhance early identification and interventions for cardiometabolic risks and strengthen dermatologists’ roles in coordinating appropriate and timely specialty referrals for patients;
• advocate for international guidelines to explicitly emphasize the necessity of comorbidities screening in psoriasis, addressing frequent denials of coverage and payment by private and governmental payers;
• conduct properly powered, randomized, placebo-controlled clinical trials evaluating GLP-1 agonists as monotherapy versus placebo in patients with mild to moderate psoriasis, assessing efficacy on disease severity, mechanisms of action, weight loss and cardiometabolic outcomes, while identifying patient subgroups most likely to benefit;
• develop guidance and educational programs for dermatologists on responsibly endorsing, communicating and integrating GLP-1 agonists with multitargeted therapies for managing obesity and metabolic comorbidities in psoriasis patients, without overstating the evidence; and
• assess efficacy and synergistic impacts of GLP-1 agonists on psoriasis and cardiometabolic outcomes, utilizing data mining to identify biologic-treated or comorbid subgroups most likely to benefit.

These recommendations highlight the shifting understanding of psoriatic disease among physicians, according to Joel M. Gelfand, MD, MSCE, FAAD, Healio Dermatology’s Chief Medical Editor and one of the paper’s authors.

“The modern view of psoriasis is that it is a systemic inflammatory metabolic disease,” Gelfand told Healio. “The International Psoriasis Council has prioritized key areas of action and research to address the rapidly developing data in this area that has important implications for clinical practice.”

The authors called the priorities a “practical roadmap” that will help promote multidisciplinary collaboration, identify cardiometabolic risk factors early and spur more targeted research, particularly for younger patients who may not receive timely follow-up care.

During the council’s symposium, dermatologists reported that psoriasis is associated with elevated risks for metabolic and cardiovascular diseases, with psoriasis severity levels directly impacting these odds, according to the paper. Obesity can similarly impact psoriasis severity as well as the effectiveness of psoriasis therapies, according to the authors.

“Mendelian randomization studies show obesity/visceral adiposity and CVD risk contribute to psoriasis pathogenesis,” the authors wrote. “Adiposity should be considered a primary target of effective psoriasis therapy in overweight or obese patients.”

Genetic studies and clinical observations have demonstrated that GLP-1 receptor agonists, initially approved for type 2 diabetes, can protect against psoriatic disease, suggesting combination treatment with biologics may improve patient outcomes, according to the authors.

“Dermatologists, rather than acting as primary care providers, are well-positioned to screen for increased metabolic risk in psoriasis patients by leveraging the frequent dermatology visits these patients already attend,” the authors wrote. “Subsequent coordination with other specialties would increase preventative benefit.”

Joel M. Gelfand, MD, MSCE, FAAD, is the James J. Leyden Professor of Clinical Investigation and professor of dermatology and epidemiology at University of Pennsylvania’s Perelman School of Medicine and Healio Dermatology’s Chief Medical Editor. Gelfand can be reached at dermatology@healio.com.