More Relief for Psoriasis Sufferers
- There is good news for people out there suffering from plaque psoriasis, as the FDA just approved a new oral medication that has so far proven to have little to no side effects compared to existing drugs on the market, which come with more potential side effects and “box warnings.”
- Plaque psoriasis is the most common of all psoriasis types that make up around 80-90% of all cases. It’s characterized by thick and raised patches of skin known as plaques, dry white or silvery scales covering these plaques.
- With the new FDA-approved drug SOTYKTU™ (deucravacitinib), people with moderate to severe plaque psoriasis can find even more relief than ever before with oral medications. The advantage of this new drug compared to others is its high efficacy without the side effects that can typically come along with other types of oral drugs for psoriasis.
Psoriasis is an autoimmune disease that results when the overactive immune system mistakenly attacks its own skin cells. It’s classified as a chronic inflammatory disease that drives inflammation throughout the body causing rapid skin cell growth which in turn leads to plaque and scale formation.Read More
“It can occur anywhere on the body, including the scalp, elbows and knees,” Dr. Armstrong tell us. “It can also affect intimate areas, such as the area under the breast, the skin folds and the genital areas. It really affects patients quality of life.”
What is Plaque Psoriasis?
Plaque psoriasis is the most common of all psoriasis types that make up around 80-90% of all cases. It’s characterized by thick and raised patches of skin known as plaques, dry white or silvery scales covering these plaques.
In the early stages, people may notice raised, red, and swollen areas that feel itchy and scratchy.
Understandably, psoriasis can be a highly uncomfortable and often embarrassing condition for those who develop it, and many people report that the emotional side effects can be the same, if not worse than the physical symptoms that they experience. Additionally, many people are not aware that psoriasis can affect your internal organs as well.
“Psoriasis is an inherited condition that affects the immune system, the skin, the joints, and other organs, including the heart. It is inherited by a combination of genes that you can get from both parents—and that, together with environmental factors, causes the cells of the skin to grow too quickly,” Dr. Mark G. Lebwohl, Dean of Clinical Therapeutics at the Kimberly and Eric J. Waldman Department of Dermatology at the Icahn School of Medicine at Mount Sinai, tells SurvivorNet.
“Because it’s visible and apparent to the world, it’s associated with a lot of emotional stress. Depression is increased, suicidal thoughts are increased, and suicides increase, too.”
The New FDA Approval for Plaque Psoriasis
With the new FDA-approved drug SOTYKTU (deucravacitinib), people with moderate to severe plaque psoriasis can find even more relief than ever before with oral medications. The advantage of this new drug compared to others is its high efficacy without the side effects that can typically come along with other types of oral drugs for psoriasis.
“So deucravacitinib is a pill that blocks an enzyme called TYK2, which is responsible for the generation of certain cytokines that play a key role in the development of psoriasis,” Dr. Lebwohl explains to SurvivorNet. “So by blocking TYK2, they reduce those cytokines and psoriasis improves. It is remarkable in that it is a pill that has biologic type efficacy.”
“There are two other pills that are quite effective, Cyclosporine (Gengraf, Neoral, SandIMMUNE) and Methotrexate (Trexall), but they have a lot of side effects and a lot of box warnings,” he continues. “Deucravacitinib has no box warnings, and very good efficacy—similar to biologics. Great efficacy without having to worry about side effects as much as you do with the other drugs.
Dr. Lebwohl, who is also chairman emeritus of the National Psoriasis Foundation medical board, says that the prescribed dose of this new medication is 6 milligrams a day.
“Since it comes from your genes, unless you change one of your parents, we’re just treating it, not curing it. And so you continue to take it. And even if your skin clears—and it may clear for a while—we are always thinking about, what is the psoriasis doing to your joints, what is the psoriasis doing to your heart, or other organs. For those reasons, we often do try to continue patients on treatment.”
Deucravacitinib has been in clinical research for approximately five years. From beginning to end, that’s about the amount of time that it takes to get an approval for this type of drug. It is not supposed to used with other immunosuppressants.
Dr. Armstrong also weighed in on this exciting new drug option.
“This is a significant breakthrough medication for our patients for a number of reasons. Number one, it has what we call the novel mechanism action. So it works differently from other medications that we have seen,” she tells SurvivorNet. “And importantly, as an oral medication, it has very high efficacy, so it works quite well, and also it has a good safety profile.”
Because the drug fulfills all these different criteria that are important to patients in the short term and long term, such as the daily dosage, safety profile, and efficacy, Dr. Armstrong thinks “it will be quite revolutionary for our psoriasis patients to have this particular option.”
“Untreated plaque psoriasis can damage interior organs, not just the skin, not just psychological,” Dr. Lebwohl concludes. “Patients with bad psoriasis have an increase in heart attacks, increase in a form of arthritis called psoriatic arthritis, and it affects may other organs as well. So if patients have symptoms of psoriasis, they should not be ignored, they should be treated.”
The Emotional Side of Psoriasis
People with moderate to severe psoriasis are facing challenges that many others may not be able to understand.
Many of those facing a bad flare-up will want to stay indoors, cover up their entire body when going out, even when it’s hot outside, and in general, find it hard to have a dating or social life.
“So the mental burden of psoriasis is quite significant and we’ve had years studies now looking at this particular area,” Dr. Armstrong says of this delicate topic. “We know, for example, patients with psoriasis are about three times more likely to develop depression. And they’re also more likely to have suicidal thoughts or even carry out suicides.”
Due to the potential severity of emotional symptoms, Dr. Armstrong will ask patients how they’re dealing with it or handling it on a daily basis.
“And oftentimes, you know, this leads to a long conversation as one may imagine, but I really welcome that because I want to know if there are other things that I could do to help patients, not just in terms of the physical manifestations of their psoriasis.”
In certain instances, Dr. Armstrong says she has had to refer patients over to a mental health professional for people who may need additional help navigating how the disease affects their thoughts, actions, and every day lives.
“Psoriasis is kind of like a marathon at this point … this is a long-term relationship and we are gonna work together to find the best treatment for you so that you can actually focus on things that are most important to you rather than psoriasis.”
Following the approval of SOTYKTU (deucravacitinib), Dr. Armstrong is even more hopeful for all of the people facing challenges due to this condition, which will now hopefully be much easier to manage.
“Innovations such as this can really change our patient’s lives,” she says of the groundbreaking new treatment. “And our ultimate goal is to make sure that the medications that we bring to you are effective—and safe in the long run—so that you can live the best life that you wish to.”