How would you approach management of a patient with longstanding history of SLE, but having active psoriasis?

1. Since methotrexate (MTX) worked well before, I'd revisit other possible ways to use it in ways that minimize GI issues. For example, splitting up oral MTX over 24 hours can help alleviate GI side effects (eg 2.5 mg q 12 hours for 3 doses), yet have greater efficacy due to a larger area under the cu...

In addition to above, I would consider deucravicitinib. It has PASI75 scores that are in the 60s, and is in trials for SLE. Its phase 2 trials seemed promising. Other PO JAK inhibitors should be efficacious but may carry worse side effect profile.

I have also employed PDE4 inhibitors such as po apre...

I agree with @Dr. First Last, Sotyktu is likely to help with both disease processes. I would also add that Rinvoq being approved for PsA and also having been used off label for cutaneous lupus has worked very well in my hands and with a cleaner safety profile than methotrexate. When I worked with Dr...