Between 6:58 and 7 p.m. each night, between the end of the evening news and Jeopardy, television viewers see multiple commercials on the major networks that carry direct-to-consumer marketing messages for new psoriasis treatments. They go something like this:
“I have suffered from psoriasis for many years, with raised red unsightly patches all over my body. They impair the quality of my life. I don’t want to socialize or go to the pool. I cover up, even in the summer, so no one can see what I have. People might think I’m contagious. But now there is treatment …” But then, the images of happy patients are offset by an announcer reciting fearsome warnings of medication side effects.
The decision to seek treatment for severe psoriasis — accepting its benefits and its risks — is a serious one that requires expert physician consultation. It is a decision that cannot be made from a television ad alone.
Modern psoriasis medicines were developed based on new understandings of the immune system. With them,
• 40 percent of patients will be 100 percent clear in 12 weeks, and 80 percent will maintain that response
• 70 percent of patients will improve by 90 percent
• 90 percent of patients will improve by 75 percent
These medicines work by reducing the activity of the immune system that drives psoriasis. With this reduced immune function, there may be an increased risk for infections, though overall the risk remains low. An average person has a 1/100 risk per year to develop a serious infection. Persons who use these medications have a 2/100 risk. Looking at it differently, 98/100 people who use them will not have a serious infection in any given year. There may be increased risk for tuberculosis with the medicines, but with proper physician monitoring the risk for real harm is very low.
The TV ads for psoriasis medications recite government-mandated warnings of this risk for cancer, and hearing messages these causes many patients to avoid treatment. These warnings do not tell the full story.
First, the underlying data is derived from studies on the use of these drugs to treat rheumatoid arthritis. This population of patients often uses the medicines in cocktails of multiple immunosuppressive drugs. It is these multi-drug cocktails that create the cited risk — yet such multi drug regimens are relatively uncommon in psoriasis treatment.
Second, the incidence of cancers observed in single-use regimens mirrors the expected background rate otherwise expected in the general population as seen in large population registries. In summary, the gloomy cancer warnings that accompany TV ads for psoriasis treatments may drive patients from receiving safe and effective treatment and a better quality of life.
Windsor Dermatology, 59 One Mile Road Extension, East Windsor. 609-443-0424. www.windsordermatology.com.