Aug. 4, 2004 -- Three months ago, the rheumatoid arthritis drug Enbrel became the first drug of its kind to win FDA approval for the treatment of psoriasis. Now, early research suggests that the similarly acting arthritis drug Humira is also highly effective in treating the debilitating skin condition.
After 24 weeks of treatment with every-other week injections of Humira, 42% of patients with moderate or severe psoriasis treated experienced improvements in symptoms of 90% or more. Two thirds of patients experienced a 75% or greater reduction in symptoms.
After 24 weeks of treatment, the patients also reported that their quality of life was no longer affected by psoriasis.
"Patients often feel liberated (on these therapies)," study researcher Kenneth B. Gordon, MD, tells WebMD. "They are often reluctant to start on medication, but once they start taking (these drugs) and realize how much better they feel, they don't want to stop taking them."
Between 4 million and 6 million Americans suffer from psoriasis, characterized by scaly and cracked skin, pain, and patches of itchy, red, inflamed skin. Until recently, treatment was limited to topical steroid creams, ultraviolet light therapy, and drugs such as Accutane, methotrexate, and cyclosporine. Though these drugs work for many patients, their use is limited by potentially serious long-term side effects.
In January 2003, the drug Amevive became the first biologic agent approved for the treatment of moderate to severe psoriasis, and the drug Raptiva was approved for the same purpose last fall. Both drugs are called biologics and work by suppressing the hyperactive immune system response that triggers psoriasis.
Enbrel and Humira are biologics that target a protein in the body called tumor necrosis factor alpha (TNF-alpha), which is a key player in the inflammatory process that triggers psoriasis.
Gordon tells WebMD that the early experience with the biologic drugs like Enbrel, Raptiva, and now Humira suggests that the drugs continue to suppress psoriasis outbreaks for long periods with few side effects.
Gordon says starting on a biologic has changed the lives of many of his patients. He tells the story of one man who had not taken a vacation in years because his skin condition embarrassed him so badly. After eight weeks in the Humira study, Gordon says, the man took his entire family to Costa Rica.
Three years ago, 40-year-old Tom Morris' psoriasis was worse than it had ever been, with patches or red, scaly skin covering his entire body with the exception of his face and neck. Today, the Silver Spring, Md., resident says his skin is clearer than it has been in the two decades that he has had psoriasis, after almost four months on the biologic Raptiva.
Morris tells WebMD that taking a biologic has made all the difference for him.
"This has been the only real effective medication I have taken," he says. "Now, except for one little spot on my leg, I look like I have never had psoriasis. I wear shorts wherever I want, I jump in a pool when I want, and I don't worry about people staring at the spots on my skin. It has been fantastic."
The newly updated data on Humira, from a trial sponsored by manufacturer Abbott Laboratories, was presented last week in New York City at the summer meeting of the American Academy of Dermatology.
Patients who had received 40 mg injections of the drug every two weeks for three months continued on the treatment for a total of six months. Others who had been started on a placebo injection were switched to the active drug.
Researchers reported that 64% of patients who got the twice-monthly injections achieved at least a 75% improvement in disease severity at six months. Significant improvements in quality of life were also recorded, with 40% of patients on the treatment reporting that their quality of life was "not at all" affected by their skin condition.
National Psoriasis Foundation spokesman Michael Paranzino tells WebMD that as effective as the biologics are, they will not replace traditional therapies for all patients.
"The biologics hold the promise of potentially fewer side effects, but the exciting thing is that we now have many more treatment options than we have had in the past," he says. "There is no one drug that is clearly superior and will work for everyone, but the good news is that most patients can be helped with treatment."
August is Psoriasis Awareness Month, and Paranzino says a goal is to convince people who abandoned treatment or never started it to see their doctors and learn about the therapeutic advances.
"We want to get the message out to people who were frustrated with earlier treatments or couldn't take them because of other medical conditions that there are a lot of new options out there," he says.