Psoriasis, an autoimmune disorder that triggers inflammation and overgrowth of skin cells, affects about 7.5 million Americans. Its symptoms include red, raised patches of skin that may itch, burn, and crack.

Having the chronic condition also increases the risk of developing heart disease, according to experts who explain that both are inflammatory conditions.

Fitness expert Jackie Warner remembers her grandmother’s struggle with psoriasis.

“My grandmother lived with psoriasis for many years,” Warner tells the Post, “and she was very embarrassed by it—especially during flare-ups. This led to a sedentary lifestyle, and resulted in significant weight gain. Her struggle motivated me to become a part of a comprehensive wellness program designed with psoriasis sufferers in mind.”

Warner developed a new fitenss program to help psoriasis sufferers.

The new online program and DVD, Fit in Your Skin http://www.fitinyourskin.com/, offers tips on fitness, nutrition, and reducing stress.

People without the skin disease can also benefit from the wellness plan.

“Fit in Your Skin offers fitness and nutrition guidance to help people get healthy and enjoy a more active lifestyle—whether or not they have the disease,” explains Warner.

Psoriasis, Exercise, and Heart Health The Saturday Evening Post

Joan,

Fort Worth, Texas

Psoriasis, an autoimmune disorder that occurs when skin cells grow too quickly, affects about 6 million Americans. Its symptoms include red, raised patches of skin that may itch, burn, and crack. Although the cure is not yet known, many cases are controlled with lotions, light therapy, and prescription medicines such as methotrexate, cyclosporine, and Soriatane (acitretin) to reduce inflammation and smooth the skin. When psoriasis covers large areas of the body, frequent (sometimes weekly) injections of immune-suppressing drugs, such as Amevive, Enbrel, Humira, or Remicade may be recommended.

Adults suffering from moderate to severe psoriasis might be candidates for Stelara, a new drug that received FDA approval in the fall of 2009. Stelara (ustekinumab), targets specific components of the immune system to block overproduction of skin cells and reduce inflammation.

“It is the first drug therapy that requires just four shots a year,” says Dr. Mark Lebwohl, chairman of the Department of Dermatology at the Mount Sinai School of Medicine in New York and Stelara study investigator. “The approved treatment schedule is two injections four weeks apart, followed by injections every 12 weeks. Four weeks after the first injection, most patients improve dramatically. Three months later, they are clear or close to clear.”

For more from Dr. Lebwohl about Stelara, visit saturdayeveningpost.com/stelara.

New Psoriasis Solution? The Saturday Evening Post

Psoriasis, an autoimmune disorder that occurs when skin cells grow too quickly, affects about 6 million Americans. And nearly 1 million adults might be candidates for the new treatment, which is not indicated for children. Stelara disables proteins released by the immune system that play a role in the overproduction of skin cells and inflammation.

At the close of a busy afternoon at his dermatology practice, Dr. Lebwohl, who was involved in the clinical testing of the new drug, discussed with us the promise (and potential drawbacks) of Stelara and other drugs that treat disease by targeting the immune system.

Q: What sets Stelara apart from conventional therapies for moderate-to-severe psoriasis?

Dr. Mark LebwohlCourtesy of Dr. Mark Lebwohl

Dr. Lebwohl: We have never had anything that works precisely this way. It is the first drug therapy that requires just four shots a year, and the overwhelming majority of patients improve dramatically. The approved treatment schedule is two injections four weeks apart, followed by maintenance injections every 12 weeks. Other injectable therapies are given weekly, twice a week, or every other week.

Q: What type of benefit have you observed with Stelara in your patients or study participants?

Dr. Lebwohl: We have seen benefit in many patients. In fact, it would be unusual for it not to work. On day one, people get the first injection. Four weeks later, there is a dramatic benefit. They get the second injection at that time and then return three months later for a third shot. At that visit, most patients are clear or close to clear.

Q: Has Stelara been tested for the type of psoriasis that affects people’s joints?

Dr. Lebwohl: It has been studied for joint disease, and it was beneficial. The study dose was higher than the one used for skin disease, and given once a week for four weeks.

Q: Do people inject themselves with Stelara or come to the doctor’s office?

Dr. Lebwohl: It is approved for administration in the doctor’s office. If you review the FDA deliberations on this approval, it seems their conclusion is based on the fact that Stelara is a systemic drug, it affects the immune system, and patients ought to be seen by doctors at least four times a year.

Q: Any word yet on insurance coverage?

Dr. Lebwohl: We expect approval from federal insurers, and the drugmaker, Centocor Ortho Biotech, has set up a phone line for physicians to check with the other insurances. However, the insurers have not yet had time to respond.

Q: What do people considering treatment with Stelara need to know?

Dr. Lebwohl: Clinical trials of Stelara were conducted in more than 2,000 patients. Some have taken the drug for longer than three years, and many for a shorter period of time. No clear side effect that emerged.

Stelara is an antibody that blocks a component of two chemicals: IL (interleukin) 12 and IL 23. It turns out that some people are born without that target component. In other words, they are born as though they had Stelara on board. Research on 41 of these people shows that their main problem has been susceptibility to Salmonella infections and also mycobacterial infections, such as tuberculosis.

In the studies of Stelara, there were no cases of either kind of infection–perhaps because we are giving the drug intermittently as opposed to having a lifelong genetic abnormality.

Nonetheless, people should be tested for tuberculosis prior to initiating Stelara therapy. In addition, they should never receive BCG (bacille Calmette-Guérin) vaccines, a type of vaccine used in other countries (but not in the United States) that contains mycobacteria. The usually harmless bacteria caused serious infections in those 41 people; that’s how their genetic abnormality was discovered. People on Stelara should get flu vaccines, but not one containing the live virus. For example, patients on this treatment should not get the seasonal flu vaccine in the inhaled form that has a live virus. They should instead get the shot that contains inactive virus and has no chance of infecting them.

Q: Are you involved in clinical trials of other dermatologic treatments or promising research projects?

Dr. Lebwohl: Yes. At least two experimental biologic agents for psoriasis act upon newly identified molecular targets and appear to be effective. We will be seeing more biologics as time goes on.

Highly targeted biologic therapies are very effective and safe. The drawback, however, is they are very expensive to make. The same is true for biologics to treat diseases other than psoriasis. For example, some cancer drugs target the tumor and spare normal cells that are nearby. Biologics are very costly but have the potential of significantly changing our lives for the better. It’s important that we figure out better ways to develop and manufacture these promising therapies.

Dr. Mark Lebwohl is president of the New York State Society of Dermatology and has served as chairman of the Section on Dermatology of the New York Academy of Medicine. Dr. Lebwohl is a member of the medical advisory board of the National Psoriasis Foundation and editor of Psoriasis Forum as well as medical editor of The Bulletin of the National Psoriasis Foundation.

New & Effective Psoriasis Drug The Saturday Evening Post

The product is called Aquaphilic, manufactured by a small company in Iowa called Medco Labs. It was originally sold as a professional beautician product but is now sold by major pharmacies as well as to professional beauticians. Some pharmacies do not stock Aquaphilic, but all can obtain it within a few days. It only costs about $10 for a one-pound jar. Read about it on their website medcolab.com. I have no connection with Medco Lab, but this product has changed my life. I hope this information is of help to your many readers.

Gary

Shawnee, Kansas

Psoriasis Relief The Saturday Evening Post