WHAT CAUSES PSORIASIS?
RECENT DEVELOPMENTS IN PSORIASIS
It is believed that psoriasis begins in the immune system when T cells are triggered and become overactive, although the exact trigger is still unknown. According to the Psoriasis Association, new research has found that T cells act as if they were fighting an infection or healing a wound. They produce inflammatory chemicals which can lead to rapid skin cell growth causing plaques to form. Psoriasis can, but doesn’t always, run in families, leading some to believe it has its basis in genetics. It is not contagious.
Treatment will depend on the type of psoriasis, the severity of the condition and what works for the individual. It can be a trial and error process to get treatment right, leading to frustration for those living with the condition. Initially individuals should contact their GP to discuss treatments, they may then be referred to a dermatologist in more severe cases. UK charity, the Psoriasis and Psoriatic Arthritis Alliance (papaa) lists the different types of treatments as: • Emollients • Antifungals • Antihistamine • Coal Tar • Steroids • Retinoids • Dithranol • Immunosuppressant therapies • Phosphodiesterase 4 inhibitors • Biologic Agents.
Celltrion Healthcare announced in June that the Committee for Medicinal Products for Human Use of the European Medicines Agency has recommended expanding the existing marketing authorisation for the subcutaneous (SC) formulation of Remsima® (CT-P13) in an additional five indications including for the treatment of patients with psoriatic arthritis and psoriasis. The subcutaneous formulation can be administered by patients giving flexibility and control. In early June, the Janssen Pharmaceutical Companies of Johnson & Johnson announced new data from two Phase 3 clinical trials, DISCOVER-1 and DISCOVER-2, which showed that TREMFYA® (guselkumab) demonstrated improvements in multiple clinical outcomes including joint symptoms, skin symptoms, soft tissue inflammation, physical function and reduction in radiographic progression at week 52 in adult patients with active psoriatic arthritis (PsA). Guselkumab is currently not licensed for the treatment of PsA and is undergoing evaluation for this use by the European Medicines Agency.
Psoriasis flare-ups can be caused by a range of factors from environment to health. Understanding what triggers a flare up can help people to manage their condition. Common triggers are: • Excessive amount of alcohol • Smoking • Stress • Injury to the skin including cuts and scrapes • Sunburn • Hormonal changes, particularly in women • Medication, including some anti-inflammatories, antimalarial medicines, and ACE inhibitors • Throat infection, such as streptococcal throat infection can cause guttate psoriasis to develop, usually in children and young adults • Other immune disorders, including HIV. Source: NHS.UK
The National Institute for Health and Care Excellence recommends topical therapy as first-line treatment with follow-up review to evaluate effectiveness. Vitamin D may also be prescribed in specific circumstances. If topical treatments do not offer adequate control of the condition, a referral to a specialist is recommended where phototherapy or systemic therapy can be considered. Phototherapy involves exposing the skin to specific types of ultraviolet light, either narrowband ultraviolet B or psoralen with local ultraviolet A (PUVA). Systemic therapy is divided into biological and non-biological therapy. Treatments for psoriatic arthritis include: • Topical analgesics • Non-steroidal anti-inflammatory drugs (NSAIDS) • Corticosteroids • Disease modifying anti-rheumatic drugs (DMARD) • Biologics.
The National Institute for Health and Care Excellence recommends topical therapy as first-line treatment with follow-up review to evaluate effectiveness
32 | P H A R M A FI EL D.CO.U K
The key players operating in the psoriasis treatment market are: • Amgen Inc. • Sun Pharmaceutical Industries Ltd. • MSD. • Eli Lilly and Company. • UCB S.A. • Novartis AG. • LEO Pharma A/S. • Celgene. • AbbVie Inc. • Johnson & Johnson Services, Inc. • Pfizer Inc. Source: Fortune Business Insights™
With thanks to the Psoriasis Association.
Sources: Psoriasis Association https://tinyurl.com/yd9eyh5c NHS.UK https://tinyurl.com/yc4o8ln4 | https://tinyurl. com/ya445noq | Leo Pharma https://tinyurl.com/y769nqg9 Capon, F. The Genetic Basis of Psoriasis, International Journal of Molecular Sciences https://tinyurl.com/ y8cxc8m2 | British Skin Foundation https://tinyurl. com/ycmwcwpp The Psoriasis and Psoriatic Arthritis Alliance | https://tinyurl.com/y7ffwu7m | NICE, Psoriasis: Assessment and Management https://tinyurl.com/y97y7krp Fortune Business Insights https://tinyurl.com/ya8wss4z
Pharma on the frontline