Treatment Options Expand for Psoriasis Patients

There's no cure, but experts cite reasons for hope for 7.5 million Americans with the disease

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Light therapy can also help people with psoriasis. "There are certain wavelengths in the UVA and UVB spectrum that help suppress inflammation," she said. The problem with light therapy, though, is that it must be administered in a doctor's office two to three times a week, which makes it inconvenient.

Oral medications also are available and are often the first ones tried for widespread psoriasis. "If someone is covered from head to toe with psoriasis," Lebwohl said, "it's useless to try topical treatments."

Examples of oral medications are acitretin, cyclosporine and methotrexate. He said that most insurance companies prefer that people start with methotrexate because it's effective and considerably less expensive than some of the alternative treatments. Most oral drugs, however, are not considered advisable for use by women during their childbearing years.

The newest and perhaps most helpful drugs for people with psoriasis are called biologics and include such drugs as Enbrel, Humira, Remicade and Stelara. They work by suppressing certain parts of the immune system, and are given by injection or intravenously, Lebwohl said. Because they affect the immune system, however, they carry some increased risks.

"People usually do very well on these medications," Lin said, but she added that "they may see an increase in colds or in infections like strep throat."

For people with psoriatic arthritis, Lebwohl said, methotrexate and most of the biologics are the preferred treatments.

Many people end up using a combination of medications -- a biologic and topical corticosteroids, for instance.

Even more options are in the treatment pipeline.

Lebwohl said there are "at least two pills on the near horizon, and at least five new biologics in the works." And, according to the foundation, more oral medications and new topical treatments are currently being tested in clinical trials.

"There are good medications to control psoriasis, but there's no cure yet," Lin said, but she added that, with all the new medications in development, there's reason to be hopeful.

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SOURCES: Mark Lebwohl, M.D., chairman, medical board, National Psoriasis Foundation, and Sol and Ciara Kest professor and chairman of dermatology, Icahn School of Medicine at Mount Sinai, New York City; Janet Lin, M.D., dermatologist, Mercy Medical Center, Baltimore

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