Psoriasis

Home » Psoriasis » Other Treatments, Prevention

Questions to Ask Your Doctor about Psoriasis
(Free Handout)

Other Treatments

Oral (systemic) treatment of psoriasis may be used in severe cases. Several therapies are available, including acitretin (Soriatane®), an oral retinoid. This drug can be used alone or in combination with ultraviolet light therapy. Blood tests are performed regularly during treatment to monitor for side effects, which can include elevated levels of cholesterol and blood lipids (fats), and liver irritation. This drug is contraindicated in women who are pregnant and in those who intend to become pregnant within 3 years of discontinuing treatment.

Methotrexate, which inhibits cell proliferation, may be administered weekly to treat severe psoriasis and psoriatic arthritis. During treatment, daily supplementation with vitamins and 1 to 5mg of folic acid is recommended to reduce the risk for anemia and nausea caused by the medication. Regular blood tests are also performed during treatment to detect liver inflammation. After 1–1.5 grams of the drug has been administered, a liver biopsy may be performed to detect abnormalities not apparent in blood tests.

Cyclosporine (Neoral®) also may be used to treat psoriasis. During this treatment, kidney function and cholesterol levels are monitored using blood tests.

Mycophenolate mofetil is an imunosuppressant that may be used. This medication is typically less effective than other drugs, but it is safe for long-term use. Maintaining a daily dosage under 3 grams minimizes side effects such as low white blood cell count (neutropenia). Routine blood tests are performed during treatment.

Alefacept (Amevive®) is an immunosuppressant used to treat moderate to severe psoriasis. This medication is given by injection or administered intravenously (through an IV) once a week, for 12 weeks. In some cases, the course is repeated.

Alefacept inhibits the production of overactive T cells, which can cause psoriasis, without impeding normal immune system function. T cell are a critical component of the immune system, and T cell counts are routinely monitored during the course of treatment.

Patients with compromised immune systems due to disease or medication and those undergoing phototherapy should not take alefacept. This medication should be used with caution in patients with a history of metastatic cancer or chronic infections.

Side effects include the following:

• Chills
• Cough
• Dizziness
• Headache
• Increased risk for infection and cancer
• Muscle pain
• Nausea
• Pain, itching, and inflammation (redness) at the injection site
• Sore throat

There are several ongoing investigations for biologic treatment of severe psoriasis. Initial trials with anti-CD 11a are promising. This medication, given by injection, modulates the immune system's activity, thus resolving psoriasis plaques.

Efalizumab (Raptiva®) is a once-weekly injection approved by the U.S. Food and Drug Administration (FDA) to treat moderate-to-severe psoriasis in people over the age of 18. This medication, which suppresses the immune system, may increase the risk for serious infections (e.g., bacterial sepsis, viral meningitis, fungal infection). Raptiva also may cause a life-threatening infection called progressive multifocal leukoencephalopathy (PML). Patients who are taking this drug and develop symptoms of PML (e.g., confusion, dizziness, loss of balance, vision loss, weakness, excessive bleeding or bruising) should seek immediate medical attention.

Prevention

At this time, not enough is known about psoriasis to prevent its occurrence. Patients who have experienced a psoriasis flare-up with strep throat should be treated using antibiotics at the first sign of infection.

For more information, contact the National Psoriasis Foundation at www.psoriasis.org.

Psoriasis, Other Treatments, Prevention reprinted with permission from dermatologychannel.net
© 1998-2009 Healthcommunities.com, Inc. All Rights Reserved.

Psoriasis Resources

	Join Our Psoriasis Forum Do you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience? The healthchannels forum is a resource for everyone to share and discuss their health and medical needs with others.	Advertising Disclaimer
	Living with...Share your story Do you have a personal health story that you would like to share with others? As a source of free patient education, our goal is to provide our users with trustworthy information and support from others. That's why we've started our "Living with..." sections.
	Our "Living With..." support pages are a place to share experiences about living with a certain condition, disease, disorder, or illness and for loved ones of those dealing with health-related issues. Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Help others by sharing your story. View stories already submitted.
	Stay Updated Sign up for our newsletter and receive important updates on the medical conditions that are most important to you.
To quickly access health information from your website's browser, download Healthcommunities.com's healthchannels toolbar. Advertising Disclaimer