What Drugs Are Used To Treat Psoriasis

How Should This Medicine Be Used

Ixekizumab injection comes as a solution in a prefilled syringe and as a prefilled autoinjector to inject subcutaneously . To treat plaque psoriasis in adults, it is usually given as two injections for the first dose, followed by one injection every 2 weeks for the next 6 doses, and then one injection every 4 weeks. To treat plaque psoriasis in children, it is usually given as one or two injections for the first dose, depending on the weight of the child, followed by one injection every 4 weeks. To treat psoriatic arthritis or ankylosing spondylitis, it is usually given as two injections for the first dose, followed by one injection every 4 weeks. To treat non-radiographic axial spondyloarthritis, it is usually given as one injection every 4 weeks.

You may receive your first dose of ixekizumab injection in your doctor’s office. If you are an adult, your doctor may allow you or a caregiver to perform the ixekizumab injections at home after your first dose. If you have vision or hearing problems, you will need a caregiver to give you injections. If your child weighs 110 pounds or less, ixekizumab injection must be given in a doctor’s office. If your child weighs more than 110 pounds, your doctor may allow a caregiver to perform the injections at home. Ask your doctor or pharmacist to show you or the person who will be injecting the medication how to inject and prepare it.

Do not shake a syringe or autoinjector that contains ixekizumab.

Other Risks Of Methotrexate

Methotrexate can cause other problems as well. These include:

• Drug interactions. You shouldnt combine this drug with certain other drugs due to the risk of serious side effects. These may include anti-inflammatory drugs that are available over the counter. Talk to your doctor about other serious interactions that could occur if you take certain medications.
• Liver damage. If this drug is taken for a long time, it can cause liver damage. You shouldnt take methotrexate if you have liver damage or a history of alcohol abuse or alcoholic liver disease. Your doctor may recommend a liver biopsy to check for liver damage.
• Effects with kidney disease. Talk to your doctor before taking this drug if you have kidney disease. You may need a different dosage.
• Harm to pregnancy. Women who are pregnant, breastfeeding, or planning to become pregnant shouldnt use this drug. Men should not get a woman pregnant during treatment and for three months after stopping this drug. Men should use condoms throughout this time.

In 2014, the U.S. Food and Drug Administration approved to treat psoriasis and psoriatic arthritis in adults. Apremilast is thought to work within your immune system and decrease your bodys response to inflammation.

What Is The Best Medication For Psoriasis

Because psoriasis can vary in symptoms and triggers, finding the best medication can be hard to do. Many patients will have to try a few different medications before finding the one that works best. Your psoriasis treatment may be completely different than the one that works for another person. Consult a healthcare professional when selecting a medication for your psoriasis.

Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

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What Are Psoriasis Types

The exact cause remains unknown. A combination of elements, including genetic predisposition and environmental factors are involved. It is common for psoriasis to be found in members of the same family. Defects in immune regulation are thought to play a major role. Despite research over the past 30 years, the “master switch” that turns on psoriasis is still a mystery.

Plaque psoriasis is the most common form of psoriasis and about 80% of people with psoriasis have this type. Symptoms of plaque psoriasis include red, raised and inflamed skin lesions, covered in thick silver-white scales. The areas of the body typically affected by plaque psoriasis include the elbows, knees, scalp, and lower back. The plaque may also appear on the ears, around the belly button, on the palms of the hands and soles of the feet, or on the fingernails and toenails.

Guttate psoriasis usually occurs in children or younger adults and is the second-most common type of psoriasis. This type of psoriasis is called guttate beacause of the spontaneous appearance of small, individual, pink, scaly spots. These spots are usually not as thick as the plaque lesions seen in plaque psoriasis. Guttate psoriasis general affects the skin on the trunk, and the arms and legs. Strep throat is a common trigger for this type of psoriasis.

Which Medicines Taken By Mouth Or Injected Work Best To Treat A Skin Condition Called Plaque Psoriasis

Key messages

– After six months of treatment, medicines called ‘biologics’ seem to work best to clear patches of psoriasis on the skin.

– Longer studies are needed to assess the benefits and potential harms of longer treatment with medicines that are injected or taken by mouth to treat psoriasis.

– More studies are needed that compare these types of medicines directly against each other.

What is psoriasis?

Psoriasis is an immune condition that affects the skin, and sometimes the joints. Psoriasis speeds up the production of new skin cells, which build up to form raised patches on the skin known as ‘plaques’. Plaques can also be flaky, scaly, itchy, and appear red on white skin, and as darker patches on darker skin tones. Plaque psoriasis is the most common form of psoriasis.

How is psoriasis treated?

Treatments for psoriasis depend on how bad the symptoms are. Around 10% to 20% of people with moderate or severe psoriasis will need to take medicines that affect their immune system, to help control the psoriasis. These medicines are called systemic treatments, because they affect the whole body. These are usually taken by mouth or injected.

Why did we do this Cochrane Review?

There are three different types of systemic medicines to treat psoriasis:

We wanted to find out about the benefits and potential harms of taking systemic medicines to treat psoriasis, and to see if some medicines work better than others.

What did we do?

How up to date is this review?

What did we find?

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What Should I Know About Storage And Disposal Of This Medication

Keep this medication in the container it came in to protect it from light, tightly closed, and out of reach of children. Store ixekizumab injection in the refrigerator, but do not freeze it. If needed, you may store ixekizumab injection at room temperature for up to 5 days in the original carton to protect it from light. Once stored at room temperature, do not return ixekizumab injection to the refrigerator. Discard ixekizumab injection if it is not used within 5 days at room temperature.

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

What Is The Best Oral Medication For Psoriasis

The best medication for you will depend on your medical history, other medications, and information your doctor can provide you with. Each person is different and each medication that is the best for someone will also differ. Consult your healthcare professional to find the best oral medication for your psoriasis.

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Other Risks Of Cyclosporine

Cyclosporine can cause other problems as well. These include:

• Drug interactions. Some versions of cyclosporine cant be used at the same time or after other psoriasis treatments. Tell your doctor about every drug or treatment youve ever taken and are currently taking. This includes medications to treat psoriasis, as well as treatments for other conditions. If you have trouble remembering which drugs youve taken, which many people do, ask your pharmacist for a list of those medications.
• Kidney damage. Your doctor will check your blood pressure before and during your treatment with this drug. Youll likely also need to have regular urine tests. This is so your doctor can check for possible kidney damage. Your doctor may pause or stop your treatment with cyclosporine to protect your kidneys.
• Infections. Cyclosporine raises your risk of infections. You should avoid being around sick people so you dont pick up their germs. Wash your hands often. If you have signs of an infection, call your doctor right away.
• Nervous system problems. This drug can also cause nervous system problems. Tell your doctor right away if you have any of these symptoms:
• mental changes

• loss of appetite
• infections

Your doctor may recommend a folic acid supplement to help protect against some of these side effects.

Communicate With Your Doctor

Its important to keep the lines of communication open with your physician if you decide to use herbs to help you manage your psoriasis. Herbal supplements can carry risks and may cause side effects, just like prescribed treatments for psoriasis. Also, be a smart consumer. Herbal medicine is not regulated in the United States. Make certain you read the label for warnings, expiration date, details of potential interactions, and information as to where it was manufactured.

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Development Of The Actual Recommendations For Treatment Of Psoriasis

There has been considerable debate in the literature regarding the most appropriate method to determine the initial treatment in psoriasis. The general observation of the psoriasis guideline therapy reveals that the basic decisions are based on psoriasis intensity and its form of clinical manifestation. Body Surface Area and Psoriasis Area and Severity Index are the main criteria to decide therapeutic strategy in psoriasis.

It is well accepted that a BSA higher than 10% and/ or a PASI higher than 10 is the limit that determines the use of systemic medication . This elementary principle is found on the balance between risk and benefits of any therapy. The use of this guideline generally results in a ration and effective therapy for psoriatic patients however, it is not an absolute rule. These therapy guideline suggestions are best paired with a recommended route of administration and should always be mediated by the good judgement of an analytical physician.

Figure 2.

PASI and BSA scales. The putative limit between the use of topical and systemic treatment for psoriasis are demonstrated in both ribbons.

Other Risks Of Apremilast

Other possible concerns related to the use of apremilast include:

• Weight loss. Apremilast can also cause unexplained weight loss. Your doctor should monitor your weight for unexplained weight loss during treatment.
• Effects with kidney disease. Talk to your doctor before taking this drug if you have kidney disease. You may need a different dosage.
• Drug interactions. You shouldnt combine apremilast with some other drugs, because they make apremilast less effective. Examples of these drugs include the seizure medications carbamazepine, phenytoin, and phenobarbital. Talk to your doctor about other medications youre taking before you start apremilast.

Systemic treatments also include injected prescription drugs. As with oral drugs, injected drugs called biologics work throughout your entire body to slow the diseases progress. Still other treatments include light therapy and topical medications.

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Treatments That Can Work For Both Psoriasis And Psoriatic Arthritis

If you have psoriasis and psoriatic arthritis, you need an individualized treatment plan based on the severity of each condition and your response to medication. According to Luk, there are a number of different drug options:

• Nonbiologic Disease-Modifying Anti-Rheumatic Drugs Restasis , Arava , Trexall , and Azulfidine can be used to suppress the immune system and slow down the processes that result in psoriatic arthritis and psoriasis. If the psoriatic arthritis is severe, your doctor may prescribe two DMARDs.
• Biologic DMARDs These drugs made from living cells treat psoriasis and psoriatic arthritis by targeting key parts of the immune system involved in the inflammation process, such as the protein tumor necrosis factor alpha , and interleukins 12 and 23. These medications include Stelara , an IL-12 and IL-23 inhibitor, and Cosyntyx , an IL-17 inhibitor.
• JAK Inhibitors Xeljanz and Xeljanz XR can reduce inflammation from psoriatic arthritis by targeting a specific part of the immune system. Although JAK inhibitors have shown some success as a treatment for psoriasis in studies, they are not approved by the U.S. Food and Drug Administration for this use.
• Phosphodiesterase Inhibitors Otezla blocks the action of certain naturally occurring substances in the body that cause inflammation.

Whats The Best Way To Control Psoriasis

Everyones case of psoriasis is different, which means treatment will be different for every person. However, some of the best treatments for psoriasis seem to include a combination of lifestyle changes, home remedies, and prescription medications. This article contains information on treatments and medications. Using this article in combination with a consultation from your doctor can help you find the best way to control psoriasis.

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Drugs Commonly Prescribed For Psoriasis

Psoriasis is a chronic skin condition that can occur anywhere, but tends to affect the elbows, knees and scalp. If you are one of the 7.5 million Americans who have it, you know how uncomfortable it can be. Symptoms typically include red patches with silvery scales and small scaly spots that can bleed and crust. Skin can itch and become sore. Some people also notice changes in their nails.

Psoriasis is an autoimmune disease, meaning your immune system mistakenly attacks healthy tissue. In the most common form of psoriasis, your immune system causes skin cells to grow faster than your body can shed them. This leads to an accumulation of skin cells into plaques or patches.

In most cases, psoriasis cycles through periods when symptoms worsen and then resolve. These flares can last for weeks to months. Between flares, your disease may go into remission. Medications can help manage symptoms when they occur and decrease the frequency of flares.

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Topical Treatments For Psoriasis

These are drugs you rub directly on your skin. Along with a good moisturizer, theyâre usually the first thing your doctor will suggest, especially for mild to moderate psoriasis. There are over-the-counter and prescription options.

Topical treatments for psoriasis come as ointments, creams, or foam and include:

Steroid creams. These slow down immune cells in your skin. They can ease swelling and redness. Mild steroid creams are available over the counter. Youâll need a prescription from your doctor for something stronger. Steroids come with side effects and shouldnât be used on sensitive areas like your face or genitals. They can burn or thin the skin. Use them exactly the way your doctor tells you.

Salicylic acid. This can soften and thin scaly skin. But it can also irritate your skin if you leave it on too long. It might weaken your hair follicles and cause temporary hair loss, too. The body can absorb salicylic acid if you put it on large patches of skin.

Calcipotriol . This is a strong form of synthetic vitamin D. Itâs known to control overactive skin cells. Your doctor might pair it with a steroid cream.

Tazorac is available gel or cream and applied one and twice daily. it is ot recommended for those who are pregnant or breast-feeding or intending to become pregnant.

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How Do You Pick The Best Treatment Option

Once you are diagnosed with psoriasis, your healthcare provider will help you decide the best treatment for you. Your primary care provider can usually treat mild psoriasis. In some cases, you might need to see a specialist called a dermatologist.

Psoriasis is different for everyone, but treatment generally proceeds as follows:

• If you have mild psoriasis involving a small area of your body, you can try a topical treatment or targeted phototherapy first. If that doesnt work, systemic treatment with an oral medication or biologic is the next step.

• If you have moderate or severe psoriasis involving a larger area of the body or a sensitive area like the palms or soles a systemic treatment with or without phototherapy is recommended as first-line treatment.

• Systemic treatment is also needed if you have both psoriasis and psoriatic arthritis.

Finding the right treatment isnt always easy. Its not easy to predict how someone will respond to treatment, and sometimes you have to try a few medications before you find one that works for you. You may even need more than one medication, too. This process can be frustrating, but your healthcare provider can guide you through the process.

If you have already been diagnosed with psoriasis and need prescription refills, it may help to know that there are several services that can provide a consultation and prescription online.