Dec. 24, 2003 MAYWOOD, Ill. – A new "biologic" drug, efalizumab, reduces the thick, red, scaly skin lesions of psoriasis, and improves patient quality of life, according to a study in the Dec. 17 Journal of the American Medical Association.
"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.
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