Enbrel: From Arthritis to Psoriasis
Enbrel is a man-made protein that blocks a chemical messenger called TNF (tumor necrosis factor). Blocking TNF quiets the abnormal immune responses seen in arthritis -- and in psoriasis.
Craig L. Leonardi, MD, of St. Louis University, and colleagues tested three different doses of Enbrel in 652 adult patients with moderate-to-severe psoriasis. After 24 weeks of treatment:
- 59% of high-dose patients (50 mg injections twice a week) had at least 75% improvement -- 55% reported "clear" or "almost clear" status.
- 44% of medium-dose patients (25 mg injections twice a week) had at least 75% improvement -- 39% reported "clear" or "almost clear" status.
- 25% of low-dose patients (25 mg injections once a week) had at least 75% improvement -- 26% reported "clear" or "almost clear" status.
"Rapid clearing of skin lesions is an important aspect of effective psoriasis management and may correlate with the patient's satisfaction with treatment," Leonardi and colleagues write. "After two weeks of treatment, [Enbrel] produced statistically significant and clinically meaningful improvements in patients' global assessments of disease and in the quality of life."
Raptiva: Targeting T Cells
Raptiva is a man-made antibody. It goes against T cells, the quarterbacks of the immune system. It doesn't kill the T cells -- instead, it blocks T cells from moving from the blood into the skin.
Mark Lebwohl, MD, of Mt. Sinai School of Medicine in New York, and colleagues treated nearly 600 moderate-to-severe psoriasis patients with two different doses of Raptiva. After 12 weeks of treatment:
- 28% of high-dose patients (2 mg/kg body weight injections once a week) had at least 75% improvement.
- 22% of low-dose patients (2 mg/kg body weight injections every other week) had at least 75% improvement.
"Continued [Raptiva] therapy provided continued benefit," Lebwohl and colleagues report. "In addition, extending the [Raptiva] treatment from 12 to 24 weeks resulted in improved responses in many subjects who did not initially have improvement of 75% or more."
Treatments, Not Cures
Both studies -- and earlier reports of Amevive's efficacy -- are good news for psoriasis patients. None of the treatments offers a cure. But they offer significant relief. And they're a sign of more good things to come.
"One thing is certain -- we have not seen the last of biologic therapies for psoriasis," Kupper notes. "This will ultimately be a boon to patients with this chronic, debilitating disease."