DOCTOR'S VIEW ARCHIVE
Psoriasis Drugs Strike Immune Targets
Medical Editor: Barbara K. Hecht, Ph.D.
Nov. 20, 2003 -- Psoriasis is a common skin disease that cannot be cured but can be treated. There are a growing number of options for the treatment of psoriasis. Among them are two drugs called Raptiva (efalizumab) and Enbrel (etanercept). Reports of the efficacy of these two drugs appear today along with an editorial in The New England Journal of Medicine.
Psoriasis is an autoimmune disease. The immune system attacks the skin and causes new skin cell growth to be too rapid. This produces thick, red, scaly, inflamed patches on the skin. Psoriasis affects about 4.5 million Americans. Plaque psoriasis, the most common form of the disease, is characterized by inflamed patches of skin topped with silvery white scales. Psoriasis can be limited to a few spots or involve extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.
What's New: A randomized trial has shown the efficacy of Raptiva as a treatment for moderate-to-severe plaque psoriasis. After 12 weeks, 25% of the patients who received Raptiva had an improvement in a psoriasis index of at least 75%, as compared with 5% of those who received placebo.
Comment: Studies of longer duration are needed to determine whether Raptiva is a useful therapy for psoriasis.
What's New: Treatment with Enbrel resulted in significant improvement for patients with moderate-to-severe plaque psoriasis who participated in a 24-week randomized trial The rates of adverse events were similar in the Enbrel and placebo groups.
Comment: Enbrel is an effective treatment for plaque psoriasis. However, the safety and efficacy of the long-term use of this drug for psoriasis have not yet been studied.
Last Editorial Review: 12/29/2004