The Newest Treatments for Psoriasis

By Jane Farrell

People who suffer from psoriasis know how aggravating it can be, but treatments for the persistent skin condition are improving.

“As we better understand the disease, researchers know more about what specific factors to target in order to develop effective treatments,” Melinda L. McCord, M.D., a dermatologist at the Food and Drug Administration, told the FDA’s Consumer Updates page.

Psoriasis is a condition in which skin becomes red and irritated, often developing thick silver flakes called scales, according to the National Library of Medicine. An estimated 7.5 million people in the United States have psoriasis. There is no cure for psoriasis, although symptoms can be managed with the right therapy.

Traditionally, treatment has been gradual, the FDA says, with patients starting with from creams and ointments all the way to phototherapy and systemic medicines. But now, the FDA says, doctors often try to “optimize” treatment – i.e. start at a higher level – right from the beginning. And treatments will become more tailored to the needs of each patient.

“Tomorrow’s treatments will become even more personalized because the drugs in development now are targeting different aspects of the immune system,” McCord noted. Psoriasis is an autoimmune disorder, meaning that the immune system mistakenly believes it is being attacked and then damages or inflames tissue that is actually healthy.

Therapies for psoriasis include topical treatments (i.e. those applied to the skin; light treatment (phototherapy) and medicines taken orally or via injection.

In the past, the FDA says, doctors treated psoriasis using a “step-wise approach.” Patients who had only mild to moderate psoriasis would start with topical treatments and, if necessary, move on to phototherapy or systemic drugs. People who had moderate to severe psoriasis were immediately treated with phototherapy or systemic drugs before being offered biologic therapies, a treatment that works with your immune system.
But that strategy is changing, the FDA says. Today, patients can choose a treatment based on a number of conditions include lifestyle considerations, risk factors, and other diseases.

Most recently, the FDA approved a biologic product called Stelara (ustekinumab). This contains an antibody that’s designed to bind to a specific target in the immune system. “When given to patients, this antibody blocks the action of two proteins (interleukin 12 and 23) that contribute to the inflammation and the overproduction of skin cells,” McCord said. “By targeting these proteins, ustekinumab can interrupt the inflammatory pathway.”

Researchers are also exploring medicines that target another protein, interleukin 17, McCord said. “Looking forward,” she added, “the drugs in development are targeting different pathways in the immune system. “

For the best treatment, McCord recommends a team approach in treating psoriasis, saying that different health-care providers need to work with patients to address the other diseases that might occur at the same time as psoriasis. These conditions can include lymphoma, heart disease and/or depression. “We do not completely understand the relationship of these…to psoriasis, but it is an area of active research,” she said.

While patients can treat some symptoms, such as itching, with over-the-counter moisturizers, it’s best to see a doctor if you have persistent scaling or redness. McCord suggests going to treatment early; a dermatologist will have the most experience with the illness.

For more information on developments in medicine and other consumer products, visit FDA Consumer Updates.