Saturday, August 13, 2022

New Treatment For Plaque Psoriasis

Many People On Vtama Achieved Clear Or Almost Clear Skin

New Agents Provide Better Treatment for Plaque Psoriasis

The FDA approval of tapinarof was based on data from two identical phase 3 studies that included over 1,000 patients aged 18 to 75 years with plaque psoriasis. Participants were randomly assigned to receive tapinarof cream or placebo once daily for 12 weeks, applied to any lesion anywhere on their body.

At the end of the trials, 36 to 40 percent of patients achieved clear or almost clear skin as measured by their physician global assessment score.

Following 12 weeks of treatment, over 90 percent of patients elected to continue taking Vtama for 40 more weeks in the long-term safety study. Of those, almost 10 percent of the patients treated with tapinarof achieved complete disease clearance and so were instructed to stop using the drug.

Those people continued to have clear or almost clear skin for an average of approximately four months after stopping treatment.

What Are The Symptoms Of Scalp Psoriasis

Symptoms of scalp psoriasis vary.

Mild scalp psoriasis symptoms may involve only small, thin scales or flaking that looks like dandruff.

Moderate or severe scalp psoriasis symptoms include:

  • Raised, discolored plaques with a white or silvery surface of dead skin cells.
  • Plaques on most of your scalp or your entire scalp.
  • Plaques along your hairline, forehead, the back of your neck or on the skin around your ears.
  • Dryness.
  • Irritation or pain.

New Oral Treatment For Plaque Psoriasis

A new oral treatment for psoriasis was approved in November 2014 by Health Canada. The drug called OTEZLA®, or apremilast tablets, treats patients with moderate to severe plaque psoriasis.

OTEZLA represents a significant advance because it approaches the chronic inflammation differently from previous oral treatment options, by inhibiting an enzyme known as PDE4. This enzyme controls inflammatory responses associated with psoriasis. It also provides another effective treatment option for Canadians struggling with managing the disease.

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The Causes Of Plaque Psoriasis Arent Entirely Understood

Psoriasis is an autoimmune skin disease, according to the Centers for Disease Control and Prevention . 2 This means that the immune system acts out in a way that ultimately leads to excess inflammationin this case, in the skinand causes symptoms. Usually, inflammation occurs when the immune system activates against a threat, like an injury or infection, and sends out special cells to attack that threat. Dr. Hicks-Graham explains that, in psoriasis, the ensuing inflammation changes the way that skin cells are shed and replaced .

With psoriasis, the skin layers are signaled by inflammatory cells within the skin to remain in place, she explains. At the same time, new skin cells continue to be produced. This causes the skin to become thicker, leading to elevated plaques that are often painful. Researchers believe that both genetics and environment play a role in the development of immune-related conditions like plaque psoriasis.3 So, you may be at a higher risk of developing psoriasis if you have a close family member who also has psoriasis, according to the AAD.

Presence Of Psoriatic Arthritis

New treatment for psoriasis

People with psoriasis should be screened for psoriatic arthritis annually. This is best achieved in primary care and specialist settings through the use of a validated tool, such as the Psoriasis Epidemiology Screening Tool . Consider a non-urgent rheumatology referral or seeking rheumatology advice if the score is > 2 .

Psoriasis Epidemiology Screening Tool

Question
Consider referral to rheumatology with a score > 2

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How Does Scalp Psoriasis Affect My Body

Scalp psoriasis causes thick, rough, scaly, dry, discolored plaques to develop on your scalp and the skin around your scalp. The plaques can be itchy or painful. Scalp psoriasis can cause hair loss , and scratching your plaques may worsen that hair loss.

Scalp psoriasis can make you worry about how others look at you. It can also affect your behavior and how you think about yourself. You may become self-conscious or experience stress, anxiety and depression.

Moderate To Severe Psoriasis Treatments

Your doctor may prescribe steroids, lotions, solutions, sprays, or foams to treat moderate to severe scalp psoriasis. Some topical treatments are applied directly to the skin, then shampooed and rinsed out, including:

  • Anthralin . Apply this cream once a day for 10 to 30 minutes.
  • Calcipotriene . This is a prescription form of vitamin D. Apply it at night and cover your scalp with a shower cap. Leave it on overnight. Don’t get it in your eyes.
  • Calcipotriene and betamethasone dipropionate . This is a combination of a type of vitamin D and a strong steroid in a suspension or ointment. You use it once a day. Don’t get it in your eyes.
  • Tazarotene . This vitamin A treatment comes in a cream, foam, or gel form. If using it at night, put it on clean, dry skin, and let the medication dry before you go to sleep. Applying a moisturizer after the medication may help prevent drying.

Follow your doctor’s directions for all medications. Don’t use stronger steroids for more than a 2-week cycle without your doctor giving you the OK.

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Tablets Capsules And Injections

If your psoriasis is severe or other treatments have not worked, you may be prescribed systemic treatments by a specialist. Systemic treatments work throughout the entire body.

These medications can be very effective in treating psoriasis, but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them.

If you’re planning for a baby, become pregnant or are thinking of breastfeeding, you should also speak to your doctor first before taking any new medicine to check it’s suitable for use during pregnancy or breastfeeding.

There are 2 main types of systemic treatment, called non-biological and biological .

What Questions Should I Ask My Healthcare Provider

User shares experience with new blue light plaque psoriasis treatment
  • How can you tell that I have plaque psoriasis?
  • If I dont have plaque psoriasis, what other skin condition might I have?
  • How can I prevent flare-ups and control my symptoms?
  • What medicines do you recommend?
  • Do the medicines have any side effects?
  • What at-home treatments do you recommend?
  • Do the at-home treatments have any side effects?
  • What else should I do to improve my symptoms?
  • Is there a cream or ointment that you can prescribe?
  • Should I see a dermatologist or another specialist?

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Gut Bugs And Your Skin

You’re far from alone in your body. You share it with trillions of bacteria, fungi, and other tiny bugs, most of which live in your gut. Scientists call this miniature community the “microbiome.” This is natural, and having your inner environment in balance may be a key to good health.

Some of the bugs in your microbiome make fatty acids that control inflammation. . They also help to keep your immune system response under control. Researchers are now studying whether drugs made from helpful bacteria called probiotics might prove to be an effective psoriasis treatment.

Is A Cure For Psoriasis Possible

No one knows for certain whether a psoriasis cure will ever be available. However, experts appear hopeful.

With todays available treatments, a person in remission can go years without a relapse in symptoms. However, most remissions last 112 months. After remission, psoriasis may come back worse than before.

Still, future treatment advances may, one day, effectively keep psoriasis under more permanent control or even cure it.

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Vtama Side Effects Appear To Be Mild

Overall, the side effect profile seems pretty minimal mostly a little local irritation. Its the perfect topical: Its anti-inflammatory effects work on the skin, but it doesnt accumulate in the body or have any internal side effects, says Feldman.

An estimated 20 percent of study participants reported folliculitis, which is inflammation of the hair follicles like the small, white-headed pimples that can appear after shaving. Seven percent reported contact dermatitis , and 4 percent reported headache.

Doctors can usually help patients manage these side effects by cutting back on the amount of medication prescribed, Feldman adds.

Symptoms Of Plaque Psoriasis

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The symptoms of plaque psoriasis include raised, scaly patches of inflamed skin can appear anywhere on the body and can cause pain and itching. They most often form on the torso, scalp, elbows, and knee, and they typically develop in the same areas on the right and left side of the body.

In people with lighter skin tones, these plaques look red and are covered with dead skin cells that appear silvery white. In people with dark skin tones, the plaques may look thicker and appear dark gray, purple, or brown.

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Vtama May Be Used By Itself To Treat Mild To Moderate Psoriasis Or As An Add

If used on its own, Vtama is appropriate for mild disease, but its not meant to replace systemic therapy in people with severe disease, says Feldman. Systemic therapies for psoriasis are given by mouth or injection, such as a biologic treatments. Topical treatment is simply not practical for people with severe plaque psoriasis with large areas of involvement, he says.

That being said, even with biologic treatments, a lot of people still have residual spots of psoriasis, so you could use this product along with biologics, just as we sometimes use topical steroids to help clear up the last few spots, Feldman says.

What Do 4 New Psoriasis Drugs Mean For Specialty Costs

We know that the cost of specialty medicines continues to spiral upward. What may be less well-known is that the autoimmune category leads the way.

In the last decade, spending on autoimmune treatments has increased 402%.1Thatâs 75% more than the overall specialty class.

And we can dig a layer deeper.

Among all autoimmune diseases, psoriasis ranks as one of the top three types.2Approximately 6 million Americans experience plaque psoriasis.3

With plenty of treatment options, market analysts expect psoriasis treatment sales to soar. Projections see a 40% increase in just four years. Thatâs over 5 billion dollars by 2026.4

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Treatment Of Associated Conditions

Health conditions associated with psoriasis include psoriatic arthritis, sleep disturbance, and depression. Treatment for these may help skin disease.

Due to the association between psoriasis and metabolic syndrome, weight loss, smokingcessation, moderation of alcohol intake, and blood pressure control may also lead to improvements in skin disease .

New Era Of Psoriasis Treatment

New psoriasis treatment uses light therapy, how to get in on the study

In the 1960s and ’70s, new info about how the immune system — your body’s defense against germs — plays a role in psoriasis led to several new treatments. Drugs like corticosteroids, cyclosporine, and methotrexate became mainstays for managing the disease. For the next few decades, though, advances in treatment slowed down.

Thanks to recent progress in research, that’s history.

Scientists studying other autoimmune diseases found new insights about the immune system. It turns out that some of the problems in those conditions are active in psoriasis, as well.

The new info brought treatments that target specific areas of your immune system. Called biologics, these drugs launched a new era of psoriasis treatment. New biologic therapies work well to treat psoriasis, and other new treatments are close to FDA approval.

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Steroid Creams Or Ointments

Steroid creams or ointments are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces itching.

Topical corticosteroids range in strength from mild to very strong. Only use them when recommended by your doctor.

Stronger topical corticosteroids can be prescribed by your doctor and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin thinning.

Psoralen Plus Ultraviolet A

For this treatment, you’ll first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light.

Your skin is then exposed to a wavelength of light called ultraviolet A . This light penetrates your skin more deeply than ultraviolet B light.

This treatment may be used if you have severe psoriasis that has not responded to other treatment.

Side effects include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet to prevent the development of cataracts.

Long-term use of this treatment is not encouraged, as it can increase your risk of developing skin cancer.

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Seal Of Recognition Products

The National Psoriasis Foundationâs Seal of Recognition highlights OTC products and recognizes products that have been created or are intended to be non-irritating and safe for people with psoriasis, psoriatic arthritis and/or individuals living with severe sensitive skin or joint mobility limitations.

What Is The Difference Between Eczema And Plaque Psoriasis

Phototherapy safe, effective for psoriasis

Eczema and plaque psoriasis look and feel different. Eczema is very itchy. Plaque psoriasis may be itchy, but it also may burn or sting.

Eczema irritates your skin and makes it change color, and it may cause tough, swollen, dark patches of skin. Plaque psoriasis patches are often white or silvery, and they rise above your skin. Plaque psoriasis is also thicker than eczema.

A note from Cleveland Clinic

Plaque psoriasis is an autoimmune disease that causes thick patches to develop on your skin or scalp. You may feel self-conscious, and it can be unpleasant if it itches or is painful. But it isnt contagious, and treatments can help your symptoms improve.

Its important to pay attention to your skin. Contact your health provider as soon as you notice any plaques develop on your skin.

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Fda Approves Vtama For Adults With Psoriasis

A new non-steroidal topical medication option is coming to the market.

On May 24, 2022, the U.S. Food and Drug Administration approved VTAMA® cream, 1%, an aryl hydrocarbon receptor agonist, indicated for the topical treatment of plaque psoriasis in adults. VTAMA® cream is the first and only FDA-approved steroid-free topical medication in its class.

This approval is based on findings from PSOARING 1, 2, and 3, with PSOARING 3 being a long-term extension study. During Phase 3 LTE, over 40% of study patients achieved complete disease clearance at least once during the study period.

âTapinarof is a novel non-steroidal topical cream approved for psoriasis. It offers once-daily application and a high chance of clearance of the localized psoriasis. Some patients will experience a folliculitis of the skin at the treatment areas, but very few will stop treatment due to this relatively mild side effect. Finally, some patients who clear with the use of tapinarof will note a long period of time that the psoriasis remains clear while not using the medication before having to use the cream again,â shared Bruce Strober, M.D., Ph.D., a Clinical Professor in the department of dermatology at Yale University School of Medicine, New Haven, Connecticut, and a board certified dermatologist at Central Connecticut Dermatology Research, Cromwell, Connecticut.

Furthermore, data from the Phase 3 LTE study showed consistent and positive patient satisfaction.

Are There Any Home Remedies For Scalp Psoriasis

While home remedies are safe for most people, its a good idea to check with your healthcare provider before trying some of the following options. You may be at risk of developing an allergic reaction.

  • Aloe vera. Aloe vera is a wound care gel. It can keep your skin hydrated while treating itchiness and irritation. Gently apply aloe vera to your plaques two to three times per day.
  • Baking soda. Mix 2 teaspoons of baking soda with a small amount of warm water to make a paste. Gently apply the paste to your plaques and leave it on for up to 10 minutes to treat itchiness and irritation. Baking sodas gritty texture also helps remove dead skin cells . Gently rub it on your affected areas to soften your plaques.
  • Coconut oil. Coconut oil moisturizes your skin. It also contains anti-inflammatory and antibacterial properties that help reduce inflammation.
  • Olive oil. Olive oil helps moisturize your dry skin and minimize irritation and itching.

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New Plaque Psoriasis Treatment

Sun Pharma Canada Inc., a wholly owned subsidiary of Sun Pharmaceuticals Industries Limited including its subsidiaries and/or associate companies) announced PrILUMYA , a treatment for adults living with moderate-to-severe plaque psoriasis, is now available in Canada.

We are excited to introduce this important biologic treatment to Canadians living with this common, inhibiting and often-overlooked disease. This launch is an important milestone for Sun Pharma, as we expand our dermatology portfolio into Canada, said Abhay Gandhi, CEO North America, Sun Pharma. With five years of effective treatment of moderate-to-severe plaque psoriasis, ILUMYA demonstrates our commitment to providing innovative medicines to support patient lifestyle and physician choice.

Plaque psoriasis is a chronic autoimmune disease that appears on the skin as red, raised areas of the skin covered with flaky white scales that can crack and bleed. It affects approximately one million Canadians. Moderate-to-severe plaque psoriasis affects about 35% of patients. A key challenge is that many treatments stop working overtime and symptoms return. Durability of treatment in the long-term is an unmet need for many patients.

In a published peer reviewed journal of the pooled analyses of the two trials reSURFACE 1 and reSURFACE 2, the data shows that most patients on ILUMYA maintained response and a reassuring safety profile through 5 years of treatment.

Plaque Psoriasis Treatment Goals

Topical Therapy to Treat Plaque Psoriasis

Jerry Bagel, MD, MS: The 3 most recent FDA-approved biologic agents for psoriasis are Skyrizi , Tremfya , and Ilumya . None of them have any blackbox warnings. None of them have box warnings. Theres no longer that fear people had when they watched between the end of ABC World News Tonight and Jeopardy! and there would be 3 commercials about psoriasis and they would say, My psoriasis is affecting my life, I cant live happily, I went on this new biologic agent and I feel great but I might die from tuberculosis or lymphoma. You dont see that anymore because these newer drugs dont have lymphoma as a risk, they dont have tuberculosis as a risk, they dont have serious infections as a risk. And they work 90% of the time. What happens by getting into the IL-23 group you dont have to worry about the inhibition of IL-12 that would increase infections. We got rid of that and we work with a much more selective group of molecules that can make psoriasis improve quicker, stay improved longer with a much better safety profile than before.

Transcript edited for clarity.

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