Stelara Gets the Green Light
Monday September 28, 2009
A new option in the fight against psoriasis -- Stelara (ustekinumab). The FDA -- after two long years of talks -- has approved the use of this drug for psoriasis patients who are candidates for phototherapy or systemic treatment, reports MedPage Today. It is to be used for moderate to severe cases. In trials, patients who followed the regimen recommended were able to achieve significantly clear skin for about a year. This is an injectible drug. A few heads up before you talk to your doctor and seek Stelara -- use may cause the immunosupression, and you'll need a TB test before starting to use it.
Raptiva (efalizumab) Pulled From the Market
Monday April 13, 2009
Biologics are one of the
treatment options available for psoriasis. However, psoriasis sufferers will now have to cope with one less option.
Raptiva (efalixumab), a well-know biologic, will no longer be available, according to a press release published by manufacturer Genentech last week.
Genentech is voluntarily pulling the drug from the market in the United States because of, "an increased risk of progressive multifocal leukoencephalopathy (PML), a rare and usually fatal disease of the central nervous system." This will occur in phases, so that doctors have time to safely transition patients to an alternative.
If you're on Raptiva, don't stop taking the medication on your own. Doing so may cause a flare-up, so be sure to contact your healthcare provider to determine your next best steps. Your doctor may recommend that you transition to another biologic psoriasis drug, such as Amevive, Enbrel, Humira or Remicade.
Psoriasis and the Risk of Diabetes
Sunday January 18, 2009
an article in the British Journal of Dermatology (Br J Dermatol. 2008;159(6):1331-1337) looked at the rate of new-onset diabetes developing in patients with psoriasis. They took their data from the UK -based General Practice Research Database. The Risk of developing diabetes was higher in those patients with psoriasis. The severity of the psoriasis was what related to the risk of diabetes, not the BMI (body mass index) which would have related it to obesity instead (another common finding in diabetes). Psoriasis is being looked at more and more as a marker or risk factor for many other serious conditions.
More on Psoriasis and Heart Disease
Sunday January 11, 2009
The current issue of the American Journal of Cardiology contains a consensus document by dermatologists and cardiologists regarding the increased risk of cardiovascular disease in patients with psoriasis. The relationship between heart disease and psoriasis has been noted since 1961. Large epidemiological studies done since then have added support to the idea that psoriasis patients are indeed at risk for heart disease.
The consensus statement recommends that two groups of psoriasis patients be evaluated for vascular disease: those with moderate to severe psoriasis; and those with mild psoriasis plus a recognized risk factor for vascular disease such as abdominal obesity or hypertension.
Psoriasis, Homocysteine and Heart Disease
Sunday January 11, 2009
A really interesting
study from Turkey looked at serum homocysteine levels in patients with psoriasis. Elevated homocysteine levels are a recognized risk factor for heart disease. More recently, psoriasis itself has been proposed as
an independent risk factor for heart disease. Two interesting finding from the study should be mentioned. Firstly, overally homocysteine levels did not differ significantly between psoriasis patients and controls. Second, and of possible clinical importance to patients is that homocysteine levels did correlate with the severity of psoriasis. Once conclusion that could possibly be raised by such data is that reducing the severity of psoriasis may in fact reduce the severity of heart disease. Although this has not been studied in and of itself, it may change the risk/benefit profiles of many treatments. The side effects of some psoriasis treatments may be more acceptable if in fact heart disease risk is also being mitigated.
Antibiotics for Guttate Psoriasis
Sunday January 11, 2009
Sometimes
guttate psoriasis responds to antibiotics. The rational is that the guttate flare was triggered by a strep infection, possibly a strep throat.
Researchers in Bulgaria tested the antibiotic rifampin in 52 patients with guttate psoriasis. Over 60 days they noted about 2/3 improvement in
PASI scores. The improvement was similar whether or not the patients had a strep infection. Their hypothesis is that in this instance, the antibiotic rifampin may have acted as a mild immunosuppressant.
Ustekinumab Anticipation
Thursday January 8, 2009
The
FDA has decided to review information on ustekinumab due to concerns about risks the drug may pose. Of course all biologics have their risks - most of them may increase the chance of infection of malignancy. No additional research will be needed to help the FDA with its approval decision, rather a more extensive review of the existing data is underway. Until they're convinced that ustekinumab is safe enough to use (benefits outweigh risks) then we'll just have to keep waiting.
It shouldn't be long now.Is Psoriasis More Common than Previously Thought?
Sunday December 28, 2008
Most sources say that psoriasis affects 2% of the Western population. But
a study in the Journal of the American Academy of Dermatology indicates that there may be many more people suffering from psoriasis than previously thought. Looking at patients with lower socioeconomic status revealed that many more patients had psoriasis that was not diagnosed. As a result, it may be that up to 5% of people has psoriasis, just that many have not been "officially" diagnosed with the disease.
Indigo Plant Ointment for Psoriasis
Sunday December 28, 2008
In
a study out of China published in the Archives of Dermatology, scientists used an ointment compounded from Indigo plant extract to reduct the redness and scaling of psoriasis. The ointment itself is apparently a bit smelly and temporarily stains the skin. However, no medical side effects were noted during the twelve-week study.
Obesity and Psoriasis Symptoms
Sunday November 16, 2008
In
a study looking at siblings with and without psoriasis, researchers found that psoriasis was more common in an obese sibling, at least among women. For both men and women however, an increased BMI (body mass index) was associated with worsening psoriasis. Just another peek at the association between obesity and psoriasis.
