In the largest study of its kind, clinician-researchers compared the risk of serious infection -- a side-effect of concern given the immune altering effects of these treatments -- across seven systemic medications used for the treatment of psoriasis. Lead author Erica D. Dommasch, MD, MPH, a dermatologist in the Department of Dermatology at BIDMC, and colleagues found a decreased risk of infection in patients with psoriasis using some of the newer, more targeted medications compared to those taking methotrexate, a drug widely used since the 1960s as a first line treatment for moderate-to-severe psoriasis. The findings were presented today at the Society for Investigative Dermatology meeting in Chicago and published concurrently in JAMA Dermatology.
"In addition to being potentially more effective than methotrexate, some of the newer targeted treatments for psoriasis may also be safer for patients in terms of risk of infection," said Dommasch, who is also Instructor of Dermatology, Harvard Medical School. "Doctors and patients may want to consider the risks of infection when choosing a systemic treatment for patients with moderate to severe psoriasis."
Psoriasis - Cells - Times - Cells - Patches
In psoriasis, skin cells proliferate too quickly -- about ten times faster than normal -- and the excess cells build up into scaly thick patches of itchy dry skin, especially on the scalp, elbows and knees. Methotrexate -- an anti-inflammatory that blocks cells' ability to grow -- has been an effective treatment option for psoriasis patients with more severe disease. But because methotrexate acts on all cells of the body, its use has the potential to result in unwanted side effects, including serious infection.
Certain immune system proteins, called cytokines, are important in causing psoriasis. Newer treatments, such as the biologics, work by inhibiting different types of cytokines. Some of the earliest biologics, including adalimumab, etanercept, and infliximab, work by inhibiting tumor necrosis (TNF)-alpha,...
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