Insights into Changing Psoriasis Treatment Options
Psoriasis is a chronic inflammatory disease that affects adults in the United States. While there are many available treatments for psoriasis, the right medication for each individual may change over time.
Common reasons for switching psoriasis medications, particularly biologics, include reduced effectiveness over time, side effects, high treatment costs, and the development of antibodies that reduce drug efficacy.
When the current medication fails to achieve satisfactory disease control, especially if symptoms worsen or do not improve adequately, it may be time to consider a switch. Similarly, if side effects are significant or harmful, or treatment costs become prohibitive, a change may be necessary.
In some cases, switching between different classes of biologics can lead to faster and more stable improvements in psoriasis. However, it's important to note that this may increase infection risk in some cases.
Decreased effectiveness or loss of response can occur when the immune system develops antibodies against a biologic, a phenomenon sometimes called biologic fatigue.
Patients should consult their dermatologist or healthcare provider to decide if switching is appropriate, considering the benefits and risks, including the potential for increased infection risk with some biologic switches.
In clinical practice, switching is often guided by measurement of disease severity (like the Psoriasis Area and Severity Index - PASI), patient-reported outcomes, and safety monitoring.
For instance, a person may consider switching if they still have an unacceptable number of plaques after 180 days or more. A doctor may recommend switching to a different medication for reasons such as the current medication not working, bothersome side effects, cost, or development of resistance.
New treatments for psoriasis are continually being developed. Bimekizumab (Bimzelx), an IL-17A and IL-17F inhibitor, is a recent addition to the list of approved treatments for moderate to severe plaque psoriasis in adults. Deucravacitinib (Sotyktu), a tyrosine kinase 2 inhibitor, was approved by the FDA in 2022 for the same indication.
When starting a new medication, it's crucial to talk with the doctor to help set expectations and review the side effects. Taking the medication as prescribed, continuing close follow-up with the doctor, letting the doctor know about any new side effects, and noting any new medical concerns are important steps after making a medication change.
While psoriasis might be uncomfortable, painful, or distressing, there are many available treatments that can help. A doctor or specialist such as a dermatologist can help a person find the treatment that best fits their treatment goals. The right medication for psoriasis might change over time, and a doctor can make recommendations to meet a person's needs.
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