"Biologics are a new approach to treating psoriasis," said lead author Dr. Kenneth Gordon, director of the 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.
"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.
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 shows that the patients who received the biologic therapy achieve 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.
Psoriasis can develop at any age, although it usually shows up in 15- to 35-year-olds. Average age at diagnosis: 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. Because 33 percent of people with psoriasis have a family history of the disease, it is impossible to know who will get psoriasis.
Affecting five million Americans (average age at diagnosis: 28 years), psoriasis has no cure but effective new treatments are emerging with medications called "biologics."
"No medicine is appropriate for everyone," said Gordon. "Individuals must check with their doctor before pursuing any psoriasis therapy."
Visit the Loyola University Health System Web site http://www.luhs.org for more information. To schedule an appointment with Gordon, call (708) 216-3835.
Gordon has received research finding from Genentech, Inc.
Loyola University Health System, a wholly owned subsidiary of Loyola University Chicago, includes Loyola University Medical Center (LUMC), 18 specialty and primary care centers in the western and southwestern suburbs, the Loyola Ambulatory Surgery Center at Oakbrook, the Loyola Imaging Center at Oakbrook Terrace, a joint venture with the Rehabilitation Institute of Chicago, and serves as co-owner-operator of RML Specialty Hospital, a long-term-care facility for ventilator-dependent patients in suburban Hinsdale, Ill. LUMC, a private, academic health care institution, is nationally recognized for its specialty care and research in such areas as cancer, cardiology and cardiovascular surgery, pediatrics, neonatology and neurosciences, burn and trauma care and organ transplantation. The 73-acre campus in Maywood, Ill., includes the 523-bed licensed Loyola Hospital with a Level I trauma center, Russo Surgical Pavilion, Cardiovascular Institute, Cardinal Bernardin Cancer Center, Ronald McDonald Children's Hospital of LUMC, Loyola University Chicago Stritch School of Medicine, the Loyola Outpatient Center, 24-bed RIC & LOYOLA acute rehabilitation unit, the region's largest burn unit and one of the Midwest's largest and most comprehensive organ transplant programs.
Journal
JAMA