What are the Latest Medications and Treatments for Psoriasis?

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Psoriasis is a skin problem that stays forever with remissions or continuously. A permanent cure for this psoriasis has not been found, yet there has been extensive research going on in this field on that aspect. Meanwhile, a great line of treatment options is being used to put off the symptoms of psoriasis. The skin cells overproduce and pile up into stacks within no time. This is the underlying problem of this condition. Hence, all the studies treatments, and research ultimately focus on stopping the skin cells from growing excessively. Apart from the treatments, managing psoriasis is only possible with lifestyle changes.

Diagnosis:

The diagnosis of psoriasis does not take a range of tests or investigations. A skin examination and a brief medical history are sufficient for a doctor to trace psoriasis. Unless needed one goes for a skin biopsy, in which the sample of skin is examined under a microscope, and the type of psoriasis is determined.

The latest medications and Treatments for Psoriasis

In recent years, the pharmaceutical industry has witnessed the emergence of several innovative treatments for psoriasis, offering new hope for patients seeking effective relief. Traditional therapies like topical corticosteroids, phototherapy, and systemic medications have been complemented by newer biologic agents and small molecules. Biologics, such as tumor necrosis factor (TNF) inhibitors and interleukin inhibitors, have shown remarkable efficacy in controlling the symptoms of psoriasis by targeting specific pathways in the immune system.

Moisturizers

Psoriasis symptoms are effectively treated by topical treatments, oral medications, light therapies, and systemic doses. Starting from the basic treatments, moisturizers come first. It is a handy remedy for relief from painful sores and scaly dry skin. They are not a medicine for psoriasis though they reduce the dryness and scales on the skin. Applying moisturizer after bath all over the body keeps it moistened and hydrated.

Medicated shampoos

Medicated shampoos containing salicylic acid come next. Salicylic acid along with coal tar is the best combination one looks for when choosing a medicated shampoo. The action of salicylic acid is removing dead cells from the skin and reducing the scales. It is combined with corticosteroids often to treat psoriasis. The salicylic acid compositions can be taken without a prescription or on instruction by the doctor.

Topical retinoids

Topical retinoids like vitamin A derivatives such as tazarotene(Tazorac and avage) are used to reduce inflammation during psoriasis. Their action makes the skin sensitive to sunlight thus promoting the absorption of vitamin D. But still, the usage of these topical retinoids has its own side effects.

Nevertheless, these are much lower when compared to oral medications. Irritation occurs on the skin as a sign of the ill effect. As we talked about the sensitivity to sunlight above, we shall talk about the vitamin D analogues.

Vitamin D Analogues

The vitamin D in its synthetic form reduces cell growth. When exposed to sunlight, vitamin D absorption increases. This reduces skin cell overproduction reduce.

There are various forms of vitamin D like solutions and creams which need a prescription for their usage. Calcipotriene drugs called Dovonex and calcitriol drugs known as vectical are the vitamin D analogues available for treating psoriasis. For milder psoriasis, Dovonex is prescribed. This irritates the skin as a side effect. Vectical is very less irritating when compared to the Dovonex. But it is more pricey.

To reduce the inflammation and piling up of the plaque and scales calcineurin inhibitors such as tacrolimus and pimecrolimus for a few days dosage. Prolonged usage of these days can cause skin cancers and lymph node cancers. Thin areas of skin, under the eyes, are effectively healed by this. Steroids and retinoid usage in this area irritates the skin. Like vitamin D anthralin also slows down the process of cell growth. Dithro scalp a form of anthralin removes scales from scalp psoriasis and makes it smooth.

As in calcineurin inhibitors, the dosages of anthralin are taken for only short periods. Amongst all the treatments mentioned a derivative of coal tar proved most effective in reducing inflammation, scales, and irritation. This has a strong smell and stains the clothes. It irritates the skin on application. The forms of usage are oils, creams, and coal tar shampoo. Topical retinoids, coal tar, and topical corticosteroids are not prescribed for pregnant and breastfeeding women.

Topical Corticosteroids

Topical corticosteroids are used in treating mild psoriasis conditions. Folds of skin, face, and most damaged parts of skin need this ointment. They reduce the itching, irritation, and inflammation. Prolonged usage of these corticosteroids may not work on the skin and also damage the skin.

For severe psoriasis, that does not yield to the topical medications, injectable drugs or oral medications will be given that would be changing for brief periods. To suppress the attacking autoimmune responses by the immune system, cyclosporine drugs such as neoral and Gengraf are used. But this brings along with it the risks of cancers, high blood pressure, and renal diseases. Hence only a short-term usage of the drug is prescribed.

Biologics

The other drugs that act as the immune system are the biologics. They are injected when the psoriasis is severe, or moderate. They strongly act on the immune system hence they should be taken on prescription and caution. Side effects are life-risking diseases. Psoriasis arthritis patients can take these injections. Pregnant and people with pulmonary diseases are exceptional from this. A few biologics are enbel a form of etanercept, simponi form of golimumab, otezia a composition of apremilast an oral drug, Humira containing the adalimumab, cosentyx a form of secukinumab etc.

Talking about the psoriasis arthritis treatments, along with the biologics, retinoids are used. As derivatives of vitamin A, these are more effective on psoriatic arthritis than all other treatments. Prolonged causes inflammation and hair fall and inflammation. Women planning for conception are not suggested as they cause birth defects. Eg: Soriatane a form of acitretin. Methotrexates also act reducing inflammation and reducing cell growth. Because of this property, they are used in treating psoriatic arthritis too. On prolonged usage, they welcome liver problems and fluctuations in blood composition.

Light therapies

Light therapies use sunlight artificial or natural ultraviolet rays. More exposure to sun rays can cause sunburn which makes psoriasis worse. Hence limited and controlled amounts of UV rays that are efficient to deal with the disease are used as light therapies. There are kinds of ultraviolet light therapies for moderate psoriasis with small areas of skin patches, and inflammation cannot be treated by topical treatments given broadband UVB air UVB phototherapy. This procedure uses an artificial source that is focused on the affected surfaces. Temporary itching and redness can be suppressed by using moisturizers.

Narrowband UVB phototherapy is given in 3 sessions per week until the symptoms reduce. Depending on the progression, the sessions can be confined to a couple of weeks or more.

Psoralen plus ultraviolet A(PUVA) procedure involves a psoralen medication before exposure to UVA light. This makes the skin more responsive to the rays. These go deeper into the skin and heal the symptoms. It is given on more severity of the disease. Wrinkles, folding, and freckles can be seen post-treatment.

Goeckerman therapy is a combination of broadband UV rays and coal tar for more response by the skin.

The excimer laser is the most efficient light therapy as it does not harm the surrounding healthy skin of the patient. It reduces the inflammation more effectively. However, redness and irritation are common after the treatment.

Above all, sunlight is the most important medication. Exposing to sunlight for a limited time in a day can make the impacts decrease. Vitamin absorption, reducing the inflammation and scales, etc are noticeable on a regular regime of sunlight exposure.

Amongst the treatments available, apremilast is the latest one approved in 2014, which is an oral pill, this directly acts as an immunosuppressive as PDE4, unlike others, it can be taken during light therapy and topical treatments.

Biologics have also marked notable advancements with drugs like brodalumab, guselkumab, secukinumab, ixekizumab approved in the last 4 years. FDA approved these drugs in 2015, 2017, and 2016. They have proved their efficiency in a couple of years. Guselkumab is given as an underskin injection for 8 weeks approximately and acts on interleukins-23. Secukinumab has a history of making the skin clear in almost 44 percent of the cases treated. These shots are given twice a week for up to a month. Taltz or the ixekizumab also has a notable history of clear skin.

Although these have their most effective sides, they bring in diarrhea, pulmonary problems, joint pain, etc… as drawbacks.

Biosimilars

Another new treatment approach is biosimilars, which are similar to biological but reversible in function nevertheless with the same results. They are made to be an affordable replacement for biologics. A few examples of biosimilars are inflectra, and Remicade, which are similar to infliximab, amjevita and cyltezo similar to Humira. Etalizumab has been a drug in usage for a long while in the market. It was targeted against the LFA-1 though it was most efficient in its way of treating severe psoriasis, due to lifeline-risking effects it has been withdrawn from the market.

Upcoming new treatments under development are ISA247 called cyclosporin, which is a calcineurin inhibitor which is without the current side effects. This has shown very few drawbacks than the usual calcineurin inhibitor. BZ-423 is another benzodiazepine drug, that has been approved for psoriasis treatments. It targets the cells and causes cell death by a complex signaling pathway, this is under research yet.

Though there is a lot of research and advancement happening in the medical world to find a permanent cure for psoriasis, it is still far away.

What to expect from latest psoriasis treatments?

While there is no permanent cure from latest psoriasis treatments the medications for psoriasis have raised expectations for improved outcomes and enhanced quality of life for patients.

Biologics, in particular, have been praised for their targeted approach, which minimizes the impact on healthy cells while effectively suppressing the overactive immune response responsible for psoriatic symptoms.

Additionally, small molecules like Janus kinase (JAK) inhibitors offer an oral alternative to injectable biologics, providing patients with greater flexibility and convenience.

Despite these promising developments, it is essential to acknowledge the limitations and potential drawbacks associated with these treatments.

Side-Effects of Psoriasis Medications

Immunosuppression: One of the primary concerns with many psoriasis medications, especially biologics, is their impact on the immune system. By suppressing specific immune responses, these medications may increase the risk of infections. Patients on immunosuppressive therapies should be closely monitored for signs of infections, and healthcare providers must strike a balance between controlling psoriasis symptoms and preserving the body’s ability to fight off pathogens.
Injection Site Reactions: Biologics are administered through injections, and patients may experience injection site reactions such as redness, swelling, or pain. While these reactions are generally mild and temporary, they can contribute to discomfort and impact treatment adherence.
Development of Antibodies: In some cases, patients treated with biologics may develop antibodies against the medication. This can reduce the drug’s effectiveness over time, requiring adjustments to the treatment plan. Regular monitoring and, if necessary, switching to an alternative medication may be necessary to address this issue.
Liver and Kidney Function: Certain medications, particularly systemic treatments, may exert stress on the liver or kidneys. Regular monitoring of liver and kidney function is crucial to identify any potential adverse effects early on.

Limitations of Psoriasis Treatments

Partial Response and Treatment Resistance: While many patients experience significant improvement with the latest treatments, not everyone responds equally. Some individuals may only achieve a partial response, requiring combination therapies or alternative approaches. Moreover, a subset of patients may develop resistance to certain medications over time, necessitating a switch to different treatments.
Cost and Accessibility: The high cost of biologics and other advanced therapies can pose a significant barrier to accessibility for some patients. Insurance coverage and financial assistance programs may help, but the overall economic burden of long-term psoriasis treatment can be daunting.
Long-Term Safety Concerns: The long-term safety of newer psoriasis medications is an ongoing area of research. Limited data are available on the extended use of these drugs over several decades, and continuous monitoring is essential to identify any unforeseen complications that may arise with prolonged treatment.

Conclusion

The latest medications and treatments for psoriasis have undoubtedly transformed the landscape of care, offering hope and relief to many patients. However, it is crucial to approach these advancements with a nuanced understanding of their limitations. While these treatments have shown remarkable efficacy, healthcare professionals must carefully weigh the benefits against potential side effects, treatment resistance, and economic considerations.

Ongoing research and vigilant monitoring of patients receiving psoriasis treatments are imperative to refine our understanding of their long-term safety and efficacy. Collaborative efforts between healthcare providers, researchers, and pharmaceutical companies can contribute to the development of even more effective and accessible therapies for psoriasis, ultimately improving the quality of life for individuals living with this chronic condition.

Learn about Natural and Safe Ayurvedic Psoriasis Treatments

References

What are the Latest Medications and Treatments for Psoriasis?

Diagnosis: