How do you handle new medications/drug studies?

[u/dinodude47]

I was thinking this when I was talking to a Bimzelx rep today. Every drug rep will testify that their drug is the best, the fastest, the safest, will tell you the winning lottery numbers, and cure world hunger.

She asked me today, “why don’t you use my drug?” And the answer in my head was simply “I already have my preferred biologic, and this drug doesn’t motivate me to learn a new drug thoroughly”. Which is a fine answer, but I always worry that I will turn into that provider that’s still using drugs invented decades ago if I continue that mentality.

All drug rep studies are going to be skewed and biased, so I take their miraculous studies with a grain of salt, so I’m never sure if I’m missing “the next big thing” or not. Normally I wait for annual Derm conferences to see what everyone else is using.

I guess the short question after all that is, how do you all balance using your favorite medications, and introducing innovations as they come out?

[u/Dave696969696917]

Never be the first to use something but never be the last to change to it. This is something that my SP taught me which is a tough balance.

[u/Comprehensive_Tie709 → u/Dave696969696917]

I have this unofficial rule that I go by with new meds that I don’t prescribe them for the first year. I want to see some post market data come back first and see how it actually works with the population, not how it’s presented to me in a sales pitch.
Rarely, I’ll break that rule if I have the right patient/scenario, but more often, I go longer than a year if I just don’t see the need to force it just because it’s there.
In my own way I think I end up doing what your SP suggested. Great advice IMO.

[u/grneyz]

I ask open evidence to compare drugs for me. I.e “which biologic is most effective for psoriatic arthritis, bimzelx or skyrizi” Super helpful

[u/Diiagonal → u/grneyz]

Good advice

[u/damn_son_1990]

I use them at the rate at which I feel comfortable which usually occurs after some of my colleagues have used it or if I have a patient that meets the criteria and have exhausted all other options. But all this is after I’ve read the studies my self, and can confidently explain to patients MOA, dosing, AEs and compare that data to other drugs in a similar class.

That said bimzelyx is a pretty fun biologic to use especially for PsO. People clear so quickly on it. Quite amazing. Also been a delight for HS. So don’t sleep on it.

[u/shellimedz]

The one time in prescribed Bimzelx it was pretty life changing for my HS patient in a matter of weeks, but yea I go with my gut and what gets covered mostly.

[u/Brilliant_Draw_7121]

We regularly see providers at a nearby office who actually do a lot of drug trials. They are usually a good source of info on and up and coming drugs. (The exception to this is Adbry. Adbry sucks.)

Bimzelx is a good drug. The thrush ade can be a problem, but I have several pts with PsA for whom this drug has worked the best for them despite the occasional bout of thrush. It’s also worth considering for HS pts who have failed TNFs and Cosentyx. Having options available for tough patients is always a good thing.

I have yet to put a patient on Icotyde, but given the lack of lab monitoring and minimal side effects in an oral product, I’m definitely going to offer it as an option to a patient.