If you’ve been suffering from itchy skin, as well as the painful and embarrassing plaques and scales of psoriasis, relief is on the way. Research and drug development for treating psoriasis has escalated over the last few years, leading to a number of promising therapies that could lead to 100% skin clearance in many patients.
This is a major step forward in psoriasis treatment. Less than 20 years ago, 100% clearance wasn’t even considered to be an achievable goal.
What’s changed? For one, a number of new triggers for the disease have been identified, which has given medical researchers more options to create targeted therapies to shut down the cascade that leads to psoriatic plaques.
Understanding the PASI Score and How it Relates to Psoriasis Treatment
Before breaking down the newer psoriasis treatments that may help you control or even totally clear your psoriasis, it’s important to understand the psoriasis area and severity index, commonly known as a “PASI” score. This score is used to determine the severity of psoriasis. A score above 40 is rare, though it can go as high as 72.
When researchers use PASI to discuss a drug’s effectiveness, they give the drug a score based on the percent of improvement between the patient’s PASI after therapy, compared with the PASI before treatment.
Rather than saying “PASI 40 improved to PASI 10,” they use a shorthand term that describes the percent of improvement. In other words, the term “PASI 75” — when it’s applied to drug therapy — means that the drug improved a person’s disease by 75%. Different patients with a PASI 75 may have varying levels of the disease simply because the severity of their symptoms before treatment was different. A PASI of 100 indicates total clearance of psoriasis — that’s what we’re looking for!
Here’s a breakdown of some of the upcoming therapies — along with their PASI scores — that you can discuss during a consultation at Kitagawa Dermatology in Honolulu.
Methotrexate
After a little over 16 weeks of methotrexate treatment, 41% of 120 patients who achieved PASI 75 (meaning that their symptoms improved by 75%). 66% of patients achieved PASI 50.
Status: Currently approved for psoriasis
Certolizumab
In studies involving Certolizumab for psoriasis treatment, 81% of one test group and 82% of the other reduced their psoriasis symptoms by 75% (PASI 75.3). This treatment may also reduce the risk of myocardial infarction in psoriasis patients by 50%.
Status: Currently approved for psoriatic arthritis; expected to be approved soon for psoriasis.
Tildrakizumab
Tidrakizumbab achieved best results with higher doses vs. lower doses. The higher doses resulted in 66% of patients achieving PASI 75. Tidrakuzumab appears to be safe and well-tolerated.
Status: In clinical trials
Guselkumab
After 16 weeks of treatment, 73% of patients who received the guselkumab reached PASI 90, versus just 2.9% of patients on placebo!
Status: Recently FDA-approved under the name “Tremfya.”
Risankizumab
One dose of this inhibitor allowed 87% of patients to reach PASI 75. After 12 weeks, 58% had achieved PASI 90. One third of them remained clear more than 2 months later.
Status: In clinical trials
Secukinumab
Good results with this treatment seem to be maintained even after 4 years of testing. Eighty-eight percent of patients were able to achieve PASI 75, 66.5% went on to achieve PASI 90, with 43.5% ultimately achieving PASI 100 (total clearance)!
Status: Recently FDA-approved under the name “Cosentyx.”
Ixekizumab
With Ixekizumab, 47% of patients achieved total clearance of their psoriasis symptoms over the course of 5 years. Eighty percent were able to achieve PASI 75, with 70% going on to reach PASI 90. Adverse events seemed to be uncommon and unrelated.
Status: Recently FDA-approved under the name “Taltz.”
Other Ways to Control Psoriasis
While you’re waiting for some of these promising new drugs to be approved, there are many other ways to manage your disease. At Kitagawa Dermatology, we can help you find relief for your dry, itchy skin and psoriatic plaques using oral medications, topical creams, biological treatments, light therapy, steroids, and lifestyle recommendations. Contact us today to set up an appointment with Dr. Kitagawa!
Next, read our blog, Maintain Great Skin in your 20s, 30s, and 40s With Treatments Ideal for Every Age Group.
