Psoriasis Patients: Now Is the Time To “Try Again”
Todd Minars, M.D.
DermatologyPsoriasis typically first strikes between the ages of 15 and 35, but it can affect anyone at any age. The main defect is that the skin’s cells regenerate too quickly. Extra skin cells build up on the skin’s surface, forming red, flaky lesions. Psoriasis can appear anywhere on the body, covering some people from head to toe, but other cases are so mild that people don’t even know they have it.
The new drugs being used to treat psoriasis are interesting for six reasons:
1. They’re very high-tech (these are custom-made drugs that target specific steps in a disease pathway).
2. They’re very expensive (often costing $10,000 to $12,000 per year).
3. They represent a completely different class of medications for the treatment of psoriasis, perhaps marking the beginning of a new era for the treatment of this and other diseases.
4. They’re very new: patients can now be helped by treatment options that simply did not exist 3 or 4 years ago.
5. They are all injected, not swallowed or sprayed onto the skin.
6. You have probably seen ads for these drugs, they include: Enbrel, Raptiva, and Amevive. Each has its own set of pros and cons.
These drugs, as a group, are referred to as the “biologics”, because they are molecules that occur naturally in the body, but have been altered (or “customized” if you will) in the laboratory to suit our purposes. I can oversimplify with an example: if psoriasis was caused by molecule A binding to molecule B, then we take a piece of molecule B and use it to design a drug that will block molecule A from binding. That’s the theory, but do they work? The answer is “YES and NO”. Most trials of these drugs show 50% of patients achieving between 40 and 60% improvement. Not a “home run” in my book, but not bad for the treatment of psoriasis. The safety data, on the other hand seems to be overwhelming. Thousands of patients treated and very few serious adverse events (and that is a “home run” compared to older drugs for psoriasis like methotrexate and cyclosporine).For more information, call Dr. Todd Minars at 954-987-7512.
