Doctors warn that Poland still lacks comprehensive treatment for patients with psoriasis and psoriatic arthritis. In the drug program for severe plaque psoriasis, the treatment time is only 96 weeks. After their expiration, therapy is interrupted, and the patient must wait for the next exacerbation of the disease, because only then can the drug be resumed. Doctors simply call this situation absurd.
Among the postulates of dermatologists there is also a call for the introduction of the newest drug from the group of interleukin 17 inhibitors into the program of medical treatment of plaque psoriasis. In the case of PsA, there is a shortage of the latest biological drugs directed against IL-23. Another problem is that the population of children diagnosed with psoriasis is growing. Therefore, there is an urgent need to increase the portfolio of biologics for the smallest patients.
“A patient with psoriasis and psoriatic arthritis has a chronic disease. When joints are involved in psoriasis, it is associated with chronic pain. The patient, even with good treatment, there are periods of exacerbation of the disease and a situation may arise when the treatment needs to be changed. However, if the patient is treated too late, the already started changes are often irreversible, even if we start treatment. In the case of psoriatic arthritis, delays in diagnosis are long, and often patients already have irreversible changes in the musculoskeletal system, which causes pain resulting from joint destruction,” explained Prof. doctor hab. Brigida Kwiatkowska, MD, national consultant in the field of rheumatology, head of the Early Arthritis Clinic, deputy clinical director of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw.
Psoriasis and its symptoms
Psoriasis develops as a result of a disordered reaction of the immune system, which, becoming overactive, stimulates the proliferation of skin cells and the growth of the epidermis. Inflammation affects not only the skin, but the entire body. About 2% of people suffer from psoriasis. society. It is initially confused with an allergy or reaction to detergents because its first symptom is often a simple rash. With inflammation, the main symptom is skin changes - most often these are red-brown spots covered with white-gray scales. There is also redness, burning, itching, cracking or bleeding of the skin, accompanied by chronic pain.
The most common variant of the disease is plaque psoriasis, which affects 80 to 85 percent. Patients. It is usually seen on the trunk, elbows, knees, abdomen, scalp, ears, arms, and legs, but can also affect places such as the eyelids, neck, armpits, and genitals.
The disease of shame
Psoriasis is a disease that has a huge impact on the daily life of patients. Skin changes affect their perception at work, at school or in social life, because many people - although this has nothing to do with the truth - are afraid of contracting psoriasis. As a result, patients make a lot of effort to hide the disease, and doctors call them masters of disguise. They wear long-sleeved clothes, do not wear black clothes that show pieces of the epidermis, and if the disease has affected the scalp, they do not go to the hairdresser out of shame. Chronic pain and itching also interfere with everyday life, and if the disease has affected the hands, then they even have problems with daily activities.
- Another aspect is comorbidities, which are the result of an untreated inflammatory process. If the patient is young, just starting to get sick and is well treated, then the number of concomitant diseases is less or the timing of their appearance is much later. However, if a patient develops diabetes or hypertension, that is, coronary heart disease, or depression, this also affects his comfort and proper functioning in society, says prof. Brigid Kwiatkowska.
These medicines relieve the symptoms of psoriasis
As is the case with other immune-mediated diseases, there is still no therapy that would completely cure this disease. However, there are those that reverse the symptoms and allow patients to live without signs of illness. In Poland, there has long been a problem with access to such modern treatment, and the therapeutic portfolio was very different from what was available in other countries.
However, for some time in the drug program for the treatment of severe plaque psoriasis, in addition to TNF-alpha inhibitors, newer biologics have become available: inhibitors of IL-17 and IL-12/23, which improve the treatment of peripheral psoriatic arthritis. Among the available group of drugs, there are no drugs directed against IL-23. Studies show that in these PsA patients, treatment with IL-23 inhibitors improves physical function and slows the rate of disease progression.
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Source: Wprost
