As you probably know, there are quite a few different biologic drugs available for people with psoriatic arthritis (such as myself). These biologics are wonderful as it can put the arthritis into remission, doing a much better job than traditional medications such as methotrexate. Yet there is another wonderful benefit that we all are really grateful for. That is, the biologics also do a great job of clearing up a lot of psoriasis. Yes, there are exceptions, however most of us are amazed at being able to see the lesions clear up.
However I’ve always found this situation to be unfair. To me, psoriasis is just as debilitating as psoriatic arthritis. I find it impossible to describe the humiliation, embarrassment, anger and depression that comes from having moderate to severe psoriasis, i.e. psoriasis that is just about impossible to keep hidden from view. How would you feel having people obviously disgusted when they see your skin, avoiding you or even teasing you. I’m sure you would find it uncomfortable. Now multiply that by every day for a year. How do I explain the agonizing deliberation that every psoriasis warrior goes through before the simple act of taking your shirt off to go for a swim, or even just wearing a short sleeved shirt? It is medically accepted that psoriasis not only causes physical discomfort, but also a serious psychological impact.
Even though moderate psoriasis is so debilitating, for some reason biologics are not targeted at this group. I find it perplexing. Biologics obviously do a wonderful job for a lot of people of clearing up psoriasis (as those of us with psoriatic arthritis can see), so why isn’t it approved for plain old psoriasis? I think maybe it could be because of the cost. Biologics are very expensive and if they were suddenly approved as a treatment for psoriasis (without arthritis), then the insurance companies would all be looking at a big bill from the millions of people who have moderate to severe psoriasis. I’d love for someone to prove that cost isn’t the reason why. Maybe there is another reason I’m just not aware of.
While I’m on this subject of drug approval for conditions, why is it that psoriatic arthritis sufferers are always typically the last on the list to get approved for a new arthritis treatment? Aren’t the pathways the same? When Enbrel first came out, it was only approved for rheumatoid arthritis, and only after another couple of years did it get approved for psoriatic arthritis too. Insurance companies influence? Am I paranoid about big business putting profits ahead of patient well being? Probably.
Anyway, today Novartis announced that a new drug AIN457 (or secukinumab) has passed Phase II trials with great success. AIN457 is an exclusive treatment for psoriasis – NOT psoriatic arthritis! You can read the complete press release with all the data from Novartis here, and in summary the trials showed “rapid and significant relief of symptoms in up to 81% of patients with psoriasis”!
This is really great news. I’m not sure what the next step is, whether they have to go to Phase III trials or can immediately make an application to the FDA. My fingers are crossed that this will get approved and out to all the psoriasis warriors as soon as possible. There are so many people with psoriasis but without psoriatic arthritis, who do not qualify for biologics, but who really need something to clear up the debilitating psoriasis.
I also have my fingers crossed that the price will be reasonable. If it is as expensive as the biologics, then I will be disappointed, as many people without insurance just can’t afford to pay those prices. The studies had different types and doses of administration, however the most effective (81%) came from a 150mg subcutaneous injection once per month (compare that to Enbrel which is a once / twice weekly subcutaneous injection)! So my hopes are high that if AIN457 gets approved, it won’t be prohibitively expensive.