Latest Breakthroughs For Psoriasis Treatment

Besides pain, discomfort and embarrassment, psoriasis researchers are now linking the skin disease to heart disease, stroke and other serious conditions.  A class of drugs called “biologics” can offer relief – and sometimes complete remission – for even the toughest cases. And because they target the offending cells themselves, they don’t cause the same side effects as older medications. 

 Out-of-Control Skin Cells
Psoriasis typically strikes between ages 15 and 25, and lasts a lifetime. It’s the most common autoimmune disease, affecting up to 7.5 million Americans (more than 2% of the population).  Experts say the disease may be caused by a combination of genetic, immune-related and environmental factors.  In psoriasis patients, the immune system misfires, causing skin cells to multiply faster than normal, maturing in just three or four days, rather than the usual 28-30 days.  Rather than sloughing off the body, the skin cells pile up, forming scaly plaques that may itch and burn. Making matters worse, blood vessels also can expand and multiply in the affected areas, triggering bleeding. Scratching may increase bleeding and raise risk of infection.  Just living with psoriasis can be difficult – even devastating. Patients are often stared at, accused of bad grooming, and sometimes even turned away from restaurants and hair salons.  Psoriasis patients have a 39% greater risk of clinical depression, 31% increase in risk of anxiety, and 44% rise in risk of suicidal thoughts, according to a 2010 University of Pennsylvania study published in the Archives of Dermatology.

 Serious Health Risks
Besides cosmetic issues, psoriasis is related to a variety of health problems too. Researchers have suspected for decades that psoriasis patients have a higher risk of heart attack and weight-related conditions. But more recently, several studies have connected psoriasis itself with serious health conditions. A 2010 German study found that psoriasis patients were almost three times more likely to have metabolic syndrome – a cluster of symptoms including excess stomach fat, high blood pressure and elevated blood fats – that can increase the risk for coronary artery disease and type 2 diabetes.  The study also found that more than 35% had high blood pressure.  According to a 2010 Harvard Medical School study, patients with moderate to severe psoriasis are 12% more likely to have a stroke and, over 10 years, a 28% greater risk for developing heart disease.

New Treatments Bring Hope
Until recently, psoriasis patients had limited treatment options. The most common are topical steroid ointments and creams that slow skin-cell growth and reduce itch. Another standard treatment is ultraviolet light therapy, where a patient stands naked in a “light box” (a chamber lined with UVB lamps) as light wavelengths penetrate the skin. This slows skin-cell growth, but its effectiveness is mixed.  For tough cases, dermatologists traditionally relied on two medications – methotrexate and cyclosporine. Both are still frequently prescribed, and they’re effective for some patients. But they suppress the entire body’s immune system.  Biologics have caused a huge shift in psoriasis treatment.  Biologics target the offending cells, leaving most of the body’s immune system intact. There are six biologics on the market, and finding the right one for each patient may require trial and error. While older drugs are taken orally, biologics are given by injection or intravenous (IV) infusion. Some can be injected at home, while others must be administered at a dermatologist’s office.  Biologics’ immediate side effects are typically mild, such as flu-like symptoms. But their long-term effects are unknown and there are some concerns.  One is a potential elevated risk of lymphoma.

The High Cost of Treatment
Despite the benefits of biologics, their steep price – $15,000-$27,000 a year, according to the National Psoriasis Foundation – makes it tough for many patients to get their treatment covered by insurance.  Biologics are classified as “specialty drugs” that are expensive to develop and produce, adding to the high cost, according to the American Pharmacists Association. Some insurance companies require patients to fail on two other treatments before they’ll cover biologics.  Other insurers require patients on biologics to pay a greater portion of the bill.  Before approving patients for a biologic, some insurers require them to have been diagnosed for one year.  Plus, insurers often approve the drugs for only 12 months, even if patients need to take them for years to keep psoriasis at bay.