From medicalnewstoday.com
Although there is no cure for psoriasis, the complete or nearly complete remission of skin lesions is possible. The effectiveness of current treatments hints at the possibility of a cure further down the line.
Psoriasis is a chronic, inflammatory condition that affects more than 7.5 million adults in the United States. Experts consider it an immune-mediated disease, which means that it is related to a dysfunction in the immune system that causes inflammation. However, they do not fully understand what causes it.
Treatments focus on reducing systemic inflammation and addressing the physical manifestations, such as skin lesions. With effective treatment, a person living with psoriasis can almost fully control their symptoms, achieving remission.
This article reviews where psoriasis treatment currently stands and looks at what the future may hold for treating the condition.
Experts have not yet found a cure for psoriasis. However, available treatments can often significantly reduce psoriasis symptoms.
Doctors use several treatments to treat psoriasis. The variety of available treatments gives doctors a range of options and allows them to individualize treatment plans and change medications as necessary. This flexibility is important because not everyone will respond the same way to treatment.
Some potential treatments that doctors may offer include:
- Topical: Topical treatments include creams, ointments, lotions, and other products that a person applies directly to their skin. They can help reduce the appearance of plaques and minimize discomfort. Doctors typically use them to treat mild cases of psoriasis.
- Phototherapy: Phototherapy involves using light exposure under medical supervision to treat psoriasis plaques.
- Systemic medications: These options treat widespread inflammation throughout the body. They include biologics and small molecule medications. Doctors usually prescribe them for moderate to severe cases of psoriasis.
- Complementary therapies: This term refers to a diverse group of therapies, including acupuncture and supplements. These options can help alleviate psoriasis symptoms, but doctors do not currently consider them a part of conventional Western medicine.
A person’s treatment plan may include one or more medications and therapies to address their symptoms and inflammation. A person should talk with their prescribing doctor if they do not achieve favourable results with their current treatment. It might be that other treatment options provide better results.
In 2016, the National Psoriasis Foundation provided the first psoriasis treatment targets for the U.S. The goal of these targets is to help more people living with psoriasis achieve clear skin.
The treatment targets are:
- Within 3 months of starting a new treatment, psoriasis should affect less than 1% of a person’s body surface area (BSA).
- If treatment provides some improvement but does not reduce psoriasis to less than 1% BSA within 3 months, a doctor may take a “wait-and-see” approach.
- An acceptable response to treatment involves a BSA of 3% or less or a 75% reduction in BSA within 3 months of starting a new treatment.
- After 3 months, a person and their doctor may decide to stick with the same treatment or try a different approach if their symptoms do not meet the criteria for an acceptable response.
- At this point, possible treatment changes include altering the dosage of the existing medication or switching to a new therapy altogether.
- Following successful treatment, a doctor should regularly check in with the person every 6 months.
Researchers are continually seeking to improve the quality and quantity of treatments that they can use to treat psoriasis and improve the quality of life for people with the condition.
According to the National Psoriasis Foundation, researchers are examining several new options for psoriasis, including the following.
New topical treatments
A new topical medication, tapinarof, is currently under investigation. This new topical does not contain any steroids, but it may be just as effective as steroidal options. As it does not contain steroids, a person could use it anywhere on their body.
New biologics
Biologics are a type of therapy made of living cells from animals and other organisms. Doctors consider them a type of systemic treatment because they treat not only the skin but also widespread inflammation in the body.
Biologics work by blocking protein receptors on immune cells, which helps prevent or reduce inflammation. They can come in the form of infusions or injections.
Many biologics currently have approval to treat psoriasis. Two new biologics are also under investigation: bimekizumab and mirikizumab. Research suggests that these biologics are generally safe and effective. They may also have the potential to treat psoriatic arthritis.
In a 2022 study, researchers looked at real-world data for another type of biologic called brodalumab. They found that the use of brodalumab was safe in most people and generally effective, even in individuals who previously had not responded to other biologics. The study authors concluded that a Psoriasis Area and Severity Index (PASI) score of 2% or less might be possible with brodalumab.
If the Food and Drug Administration (FDA) approves these new biologics for treating psoriasis, they will give doctors new options to try if other medications are not working.
TYK2 inhibitors
Another new medication under investigation for treating psoriasis is known as BMS-986165. This drug is a type of tyrosine kinase 2 (TYK2) inhibitor, and it works similarly to biologics, blocking off a key molecule involved in psoriasis.
Unlike biologics, a person can take TYK2 inhibitors orally as a pill.
TYK2 inhibitors are closely related to Janus kinase (JAK) inhibitors, a few of which are approved treatments for other chronic inflammatory conditions such as rheumatoid arthritis and psoriatic arthritis.
Researchers believe that BMS-986165 is generally safe and effective. It may even require less monitoring during treatment.
No one knows for certain whether a psoriasis cure will ever be available. However, experts appear hopeful.
With today’s available treatments, a person in remission can go years without a relapse in symptoms. However, most remissions last 1-12 months. After remission, psoriasis may come back worse than before.
Still, future treatment advances may, one day, effectively keep psoriasis under more permanent control or even cure it.
There is currently no cure for psoriasis. However, the current treatment options can help reduce the impact of psoriasis and, in many cases, allow a person to achieve remission.
At this time, there are several psoriasis treatments to choose from, including topicals, phototherapy, and systemic medications. As scientists develop even more treatments, doctors will have additional ways to treat a person’s condition should they stop responding to the current treatment options.
Researchers continue to develop a better understanding of psoriasis, which may mean that a cure for psoriasis is available in the future.
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