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PsoriasisNet Article
 Thinking About Other Ways to Treat Your Psoriasis?

Here’s what the latest research shows

Information about psoriasis treatments seems to be everywhere these days - from magazine articles and chat rooms to billboards and TV ads. Keeping up on the latest findings can be a challenge. To help you reap the benefits of staying current - making informed decisions about your treatment options and getting tips that may make a therapy more effective for you - key findings from recent clinical trials and case reports are summarized below. Much of this focuses on the biologics, a new class of medications being used to treat moderate to severe psoriasis. Recent research also has investigated new oral therapies and expanded existing knowledge of treatments applied to the skin.

What We’re Learning About the Biologics
In less than two years, three biologics - alefacept, efalizumab, and etanercept - were approved by the U.S. Food and Drug Administration (FDA) for the treatment of adults who have moderate to severe plaque psoriasis and are candidates for phototherapy or systemic treatment. Etanercept also has been approved for treating psoriatic arthritis. Clinical trials continue to investigate the use of these medications in treating psoriasis and psoriatic arthritis. Several other biologics also are being studied in clinical trials. Two of these, adalimumab and infliximab, may soon join the list of FDA-approved treatments for psoriasis.

Research efforts are focusing on the biologics because of the potential these medications may have to provide safe and effective long-term treatment. Data shows that the biologics being used to treat psoriasis may have a better safety profile than either cyclosporine or methotrexate - two systemic medications approved for the treatment of moderate to severe psoriasis. None of the biologics has shown the potential to cause the serious kidney or liver problems that limit long-term use of cyclosporine and methotrexate. Here are recent key findings:

If You are Considering a Biologic
Anyone considering treatment with a biologic should know:

New Oral Therapies for Plaque Psoriasis
Two oral therapies are proving effective in clinical trials for treating moderate to severe plaque psoriasis:

“Use as Directed” Key to Effectiveness of Topical Medications
If your dermatologist has ever prescribed a topical medication, you’ve probably heard, “Be sure to apply this as prescribed.” In real life this straightforward instruction can be difficult to follow. Applying the medication as prescribed can be time-consuming, messy, inconvenient, and sometimes it just slips your mind.

However, dermatologists continue to stress the importance of using medication exactly as prescribed because research shows that a majority of treatment failures are caused by patients not using the medication as prescribed. Many studies have been conducted to find out just how often patients apply prescribed medication. Most of these studies have weighed ointment tubes and asked patients to record their usage at home. While compliance problems were found, researchers believed more accurate measurement was needed to assess how patients really used topical medications.

A more recent study monitored patients’ usage by fitting a bottle cap with a microprocessor that could record the date and time of each opening. Ten patients with psoriasis who were already enrolled in another study and using topical medication were instructed to apply a psoriasis medication twice a day and keep a log of their use. The researchers found that not one patient actually achieved 100% compliance over the one-week period and the electronic cap indicated a greater number of missed doses than did the patients’ logs. While larger studies are needed, the study does reinforce the point that patients do not use medication as prescribed. It is estimated that 30% to 40% of medications taken for chronic conditions are not taken as prescribed and the cost of non-compliance in the United States alone exceeds $100 billion annually.

If you are using a topical medication, you may want to make a resolution to use it as prescribed in order to gain maximum benefit. If using the medication as prescribed is a problem, be sure to let your dermatologist know. Without compliance, there is a significant chance that the treatment will not work.

Talk with a Dermatologist
Should you consider any of the therapies described above, be sure to discuss this with a dermatologist. As new therapies for skin conditions emerge, dermatologists are typically the first to learn about these. Dermatologists’ in-depth knowledge of the skin, various treatment options for psoriasis, and the outcome of these treatments make them uniquely qualified to treat psoriasis.

Information contained in this article was presented during lectures and in posters displayed at the American Academy of Dermatology’s summer scientific meeting, ACADEMY ’04.

Reference:
Balkrishnan B., et al., “Electronic monitoring of medication adherence in skin disease: results of a pilot study.” Journal of the American Academy of Dermatology. 2003 October;49(4):651-4.


An educational program brought to you by the American Academy of Dermatology.
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