What Are The Recent Advances In Psoriasis Treatment?

What Treatments Work For Psoriasis? 

Changing how psoriasis is treated are biologic drugs. Slowing down the growth of skin cells is because they affect your immune system. 

As Robert Brodell, MD, FAAD, dermatology professor and chair at the University of Mississippi Medical Centre say, this comes as a dramatic improvement. It was a pretty good target as they used to get somebody 50% to 75% better. Making them better a lot faster is now the drugs we have making people 90% to 100% better. 

Laura Ferris, MD, Ph.D., associate professor of dermatology at the University of Pittsburgh, agrees that here biologics have been life-changing for those people with psoriasis. She then explains, for most of their life, they have had patients with psoriasis. In the summer they have never worn shorts. As they couldn’t have clear skin, they have had limited social lives. To give these people a normal life, now they have the opportunity. 

Biologic Drugs

To treat moderate to severe plaque psoriasis, there are now multiple medicines. Blocking different proteins in your immune system are different types of biologics. Leading to psoriasis symptoms, all of these proteins help your body create inflammation. 

Called tumour necrosis factor-alpha(TNF- alpha), some block this protein. The following are included: 

Etanercept (Enbrel)

Infliximab (Remicade)

Adalimumab (Humira)

Certolizumab (Cimzia)

Working on a protein called interleukin 17 (IL-17), the others include: 

Brodalumab (Siliq)

Ixekizumab (Taltz)

Secukinumab (Cosentyx)

Called Interleukin 23 (IL-23), still others target a protein. Here they include: 

Guselkumab (Tremfya)

Tildrakizumab (Ilumya)

Risankizumab-rzaa (Skyrizi)

Ustekinumab (Stelara)

It's hard to know if one works better than another as there aren’t a lot of studies that compare biologics according to Brodell. Stronger than older ones are as he believes the newer-generation biologics. Thinking that it is a pretty good indication that these drugs are stronger was all of them looking at 90% and 100% clearing. 

Some biologics can raise the chances of infection or illness while most people who take biologics tolerate their treatment well and have excellent results. 

They will choose one based on your symptoms and any other conditions you might have if your doctor prescribes a biologic for you. 

As an example, 

Making people who have rheumatoid arthritis more likely to get infections are some TNF-alpha inhibitors. Which may be sitting dormant in your body, they can also activate infections like tuberculosis. 

You might be more likely to get shingles if you are taking methotrexate along with a biologic. 

Making it more likely that you will get a candida infection like a yeast infection are drugs that work on IL-17. 

Another factor is cost. Running more than $50,000 per year are some of these drugs. For some people, biosimilar drugs might be an option. It can cost up to 30% less as the name suggests a biosimilar drug then acts like a biologic. 

For psoriasis, the FDA has approved five biosimilar drugs. 

Biosimilars to adalimumab (Humira) are Adalimumab-atto (Amjevita) and adalimumab-adbm (Cyltezo).

A biosimilar to etanercept (Enbrel), is Etanercept-szzs (Erelzi)

Biosimilars to infliximab (Remicade) are Infliximab-dyyb (Inflectra) and infliximab-abda (Renflexis)

Apremilast (Otezla)

Treating adults with active psoriasis is this. Linked to inflammation, it blocks an enzyme. You take it by mouth, unlike biologics which are given as shots. Ferris says often preferring a pill are patients. As it doesn’t require lab tests, also the safety profile is good. Apremilast generally doesn’t work as well as a biologic. 

Topical Drugs

A foam that combines a vitamin D-based drug and a steroid is a recent advancement in these medications. One of the strongest drugs for psoriasis that’s not given as a shot according to Brodell is the combination of calcipotriene (Calcitrene, Dovonex, Sorilux) and betamethasone dipropionate (Enstilar, Taclonex). For people with psoriasis in areas like their knees, elbows, or scalp who don’t need a drug that works throughout their bodies like a biologic does he recommends it. 

For areas where it's hard to use creams or ointments, like your scalp, the foam is also good. As Ferris puts it, through the thicker psoriasis skin, the foams probably penetrate better. As they aren’t messy, they are more pleasing to patients. 

Phototherapy

One of the mainstays of psoriasis treatment is this. On affected areas of skin, ultraviolet B therapy shines the same light rays found in sunlight. 

On small areas of psoriasis plaques, doctors can now use a thinner beam called an excimer laser. Just to where the psoriasis is, it lets you specifically target the light. Ferris then says delivering a higher intensity of light is also this. 

You need fewer laser phototherapy treatments than traditional phototherapy as the light is more focused and also it causes less damage to the healthy skin nearby. 

New Treatments In The Pipeline

Including ones that block inflammation in different ways, scientists are working on a few new biologics. Where researchers test the effects of the drugs on a group of volunteers, some are being used in clinical trials.

Keeping the skin clear longer than the ones that are available now are these new drugs. 

That which can make certain people more likely to get psoriasis are researchers also studying changes in genes. Scientists can learn how the immune system is affected by the disease and now how do they lead to skin plaques by finding genes linked to psoriasis. 

They can try to find out how to fix them once researchers figure these things out. As Brodell now explains, into people who have a defect and repair certain conditions, there are early indications that you could take genes and splice them. That could potentially be a cure if doctors could fix the root genetic cause of psoriasis.