Lebwohl says he's not surprised by the study's outcome. "We've been hearing about [Stelara] for years." It has been on the market in Europe and Canada for one year.
The study was sponsored by Centocor, the pharmaceutical company that makes Stelara. Lebwohl has served as an investigator for both Centocor and Amgen, the company that manufactures Enbrel.
Lebwohl's advice to people with psoriasis is to weigh their options. Many patients do well on Enbrel, and it has a long safety track record. Stelara, on the other hand, is more effective than Enbrel, but it has not been around long enough to fully gauge how safe it is, he notes.
Data from the 12-week study found that within this short frame, the safety of the two drugs was generally similar. However, Lebwohl cautions that three months is too short a time to determine if Stelara will eventually increase the risk for infections or cancer. Biologic agents affect the body's immune system, which explains this potential risk.
Sonia Fiorenza, Amgen's director of corporate communications, echoes these safety concerns in an email. Dermatologists' No. 1 concern in treating psoriasis is long-term safety. While Enbrel has an established safety profile with more than 17 years of collective clinical experience, this study does not provide comparative efficacy and safety data beyond three months, she writes.
Psoriasis affects at least 2% of the world's population. For the most part it is a young person's disease, with three-quarters of cases appearing before the age of 40. It is not contagious and there is no cure.
People with moderate to severe psoriasis face significant psychosocial difficulties including depression and isolation. Often they will avoid public places like swimming pools or gyms because even though psoriasis is not contagious, the public perceives it to be so, Griffiths says.
"The advent of the biologic therapies has been life transforming for a lot of patients," he notes.