Convincing psoriasis sufferers to seek treatment
Stigma surrounding psoriasis has persisted as long as people have manifested its dry red scaly patches on their skin. Doctors suspect that this includes references in the Bible to "lepers."
Current medication for this chronic skin disease clears the symptoms from only about half of patients, and older treatments such as methotrexate have been shown to cause organ toxicity over time. As a result, just one-third of people with moderate to severe psoriasis seek treatment.
But Dr. Bruce Strober, vice chair of UConn Health's Department of Dermatology, says treatment of this common disease has experienced a "renaissance" in the past decade, with the development of more advanced therapies with minimal side effects.
Strober recently testified before the Food and Drug Administration (FDA) about a new medicine that could dramatically improve the lives of the nearly 7.5 million Americans with psoriasis.
"The reason these new injectable therapies represent a renaissance is that they effectively treat a high percentage of patients," explains Strober, who was recently recognized by the National Psoriasis Foundation for his commitment to cure psoriatic disease. "And more advanced therapies are in the pipeline."
Strober answered questions for the FDA about secukinumab – a novel medication for the treatment of adult moderate to severe psoriasis. In clinical trials, Strober found the drug highly effective – clearing or nearly clearing the skin of 80 percent of patients.
"This has really changed psoriasis therapy," says Strober. "These therapies have widened interest in medical dermatology in general, because the knowledge base that goes into using these medicines creates an environment and interest in all serious skin disease, not just psoriasis."
With psoriasis, it's not just a patient's skin that is inflamed but also often joints, ligaments, tissues, and organs, such as the liver and blood vessels. Unchecked inflammation throughout the body creates sticky blood vessels, which means a greater chance of clotting, and therefore an increased risk for heart attacks or strokes.
That's one reason why people with moderate to severe psoriasis live an average of five years less than people in the general population, Strober says."Patients come in and they're focused on the risks of the medicines, and I tell them they need to focus on the risks of the disease when it's untreated.
"These patients are suffering," Strober adds. "They become reclusive, they have high absenteeism. If they go to work they are not productive, because they're incredibly self-conscious and experience physical discomfort."
Yet, even while psoriasis medications are improving, there is a lack of information about the patients themselves, which is why Strober is also working on the development of a new registry for psoriasis patients.
As scientific director for the project, Strober hopes to enroll thousands of patients in the National Psoriasis Foundation and Corrona Registry. The registry will collect data on patients, following them over many years, chronicling their therapies and any issues that arise.
"A good registry has patients on many different treatments, and you compare them to see how each therapy works in the real world," he says. "Importantly, registries provide information about the safety of each treatment."