New "Biologic" Drug Shows Hope for Psoriasis
(MAYWOOD, Ill; 12/17/03): A new "biologic" drug, efalizumab, has been shown
to reduce the thick, red, scaly skin lesions of psoriasis and to improve patient
quality of life, according to a study in the Journal of the American Medical
Association (12/17/03). "Biologics are a new approach to treating psoriasis,"
said lead author Dr. Kenneth Gordon, director, Loyola Psoriasis Center, Loyola
University Health System, Maywood, Ill. "The symptom relief with biologics is
achieved without many of the side effects of traditional psoriasis treatment."
Gordon and colleagues conducted a double-blind, placebo-controlled
study of efalizumab on 556 adult psoriasis patients at 30 centers in the U.S.
and Canada. Patients received weekly injections of the drug or a placebo for
three months. Researchers assessed the extent of the psoriasis on the head,
upper and lower limbs, and trunk of each patient. In addition, they rated the
degree of scaling and thickness.
"Psoriasis is triggered by an immune system response
that induces skin cells to grow too quickly," said Gordon, associate professor
of medicine, division of dermatology, Loyola University Chicago Stritch School
of Medicine, Maywood, Ill. "The skin cells also do not mature normally. As
a result, the skin piles up and forms red, scaly, thick plaque lesions."
For the study, patients completed a questionnaire asking how psoriasis affects
their daily life, work and their relationships. They also reported symptoms,
including pain, itching, bleeding, burning and scaling. The researchers
evaluated the effects of efalizumab on health-related quality of life measures
from both patient and physician perspective. "Psoriasis can compromise physical,
social and emotional well-being," said Gordon.
Results of the study showed that the patients who
received the biologic therapy achieved significant improvement vs. placebo.
"The efalizumab treatment reduced the frequency and severity of psoriasis symptoms,
particularly in the severity of itching and scaling," said Gordon.
"Biologics are injected, instead of swallowed, and block immune cells that
produce the dry, flaky skin," said Gordon, who serves on the National Psoriasis
Foundation's medical board. Efalizumab modulates T-cells. Found in the blood
supply, T-cells bolster the body's immune response.
Psoriasis can develop at any age, although it usually shows up in 15- to 35-year-olds.
The average age at the time of diagnosis is 28 years. Earlier medicines for
psoriasis had side effects, such as liver or kidney toxicity. Psoriasis can
be triggered by stress, certain medicines or injury to the skin. It also has
a strong genetic component: 33 percent of people with psoriasis have a family
history of the disease.
Created: 12/17/2003  - Donnica Moore, M.D.