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Patient Experience With Psoriasis Therapies

Posted Aug 24 2008 1:49pm
BRIAN BALLESIO: People look at you a little bit different, and they'd start talking about you. Even though they don't know what it is, they'd say, "Hey, look at that guy. He's got that stuff all over his body, all over his hands."

ANNOUNCER: For Brian Ballesio, "that stuff" was psoriasis, an unsightly and even painful skin condition brought on by a disease of the immune system.

PAUL YAMAUCHI, MD: It's not simply a cosmetic disease of the skin, but it impacts the quality of their lives tremendously, interferes with their activities of daily living, things that we take for granted: going to the gym, going to the beach, swimming. It also affects interpersonal relationships with their significant other or families. In addition, it affects their schooling or their job performance because of the fact that they're covered with psoriasis, and it lowers their self-confidence and their self-esteem.

ANNOUNCER: There have been a variety of treatment options including topical creams, light therapy and oral medications. For people with widespread disease, the use of creams can be problematic.

NANCY BERNSTEIN: I found that I had to apply them to large areas of my body, and they usually come in a very small tube, so you wind up spending a lot of money and time trying to get, you know, enough medication to put over a large area.

PAUL YAMAUCHI, MD: For people with extensive psoriasis, it can be cumbersome to put topical creams all over their body. Patients tell me that it takes them like an hour a day just to put the creams on if they've had extensive psoriasis.

ANNOUNCER: Light therapy can serve as serve as an effective alternative. There are various forms of light therapy such as laser therapy, narrow band UVB, broad band UVB, and PUVA. PUVA is the most widely used. Although effective, it is still not without complications.

JERRY BAGEL, MD: You have to take pills before you come in for the light treatments and there's an increased frequency of skin cancer after 150 PUVA treatments. So the risks are greater, although you do get an average of six months of clearing after 30 treatments of PUVA, you still have to come in three times a week for PUVA treatments.

NANCY BERNSTEIN: I used to go two or three times a week before work, so I would have to get dressed in the morning, go in there, get undressed, do the treatment, get dressed again, go in to work.

ANNOUNCER: Systemic medications are another line of defense.

PAUL YAMAUCHI, MD: The systemic therapies are a good treatment for severe psoriasis, things like methotrexate, cyclosporine and acitretin. The downside to that, it can induce organ toxicity. The remission for these systemic agents is not long enough. The methotrexate, the patients can be in remission for several weeks to a few months. With the cyclosporine, the remission period is shorter, for a few weeks, and then the patient's psoriasis will start to flare up again.

ANNOUNCER: For some people with psoriasis, nothing seemed to work.

BRIAN BALLESIO: Some of them work for a short period of time, some of them don't work at all, but again, the psoriasis comes back and tells you that, "Hey, you're trying to get rid of me, and you're not going to get rid of me. I'm going to come back and get you twice as bad."

ANNOUNCER: But recently a new form of therapy called biologics has been giving renewed hope to people like Nancy and Brian. One biologic is taken for a set amount of time and stopped till needed.

JERRY BAGEL, MD: Amevive is administered intramuscularly once a week for 12 weeks.

NANCY BERNSTEIN: I went in, and it took about five minutes for them to do the medication administration on me, and it was done, and I just would go back the next week. It was quick and easy and not a problem.

ANNOUNCER: Two other biologics are self-injected at home and must be taken continuously to be effective. For some long time psoriasis sufferers, biologics seems to have made a big impact on their lives.

NANCY BERNSTEIN: I started going for pedicures, and I was able to wear dresses again and summer clothing. I started to try to lose weight and go to the gym. Prior to that, I felt that it really didn't matter, because I had this, this ugly condition, so I just didn't care anymore, and I felt a lot better about myself once the psoriasis was gone.

ANNOUNCER: As with most new treatments, long-term side effects are yet to be determined. However at present side effects appear to be minimal.

PAUL YAMAUCHI, MD: The most common side effects, which were few, were flulike symptoms, headaches and runny nose, which are temporary.

ANNOUNCER: Many patients can now look forward to months and even years without scaly skin.

PAUL YAMAUCHI, MD: The clinical studies have shown that for those people who attain a very good reduction of their psoriasis, that these patients were able to maintain a remission of their psoriasis for at least seven months. I've had patients who have been disease-free for two years after their last course of Amevive.

ANNOUNCER: For people like Brian, who's been clear of psoriasis for two years, the use of biologics has meant that life can change.

BRIAN BALLESIO: I believe I can do anything now. There's no stopping me. I'm not shy in talking to anybody. I will wear whatever I want. I will go wherever I want. It's like this big weight has been lifted off my shoulders.

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