From the Oakland Tribune 18th Dec 2003
Editorial wary of psoriasis drugs
AMA recommends non-primary use of treatments
By Michelle Cortez, Bloomberg News
New psoriasis medicines from Johnson & Johnson, Genentech Inc. and other drugmakers should be used only as a backup to existing therapies, according to the lead editorial in the Journal of the American Medical Association.
The drugs are less effective, more expensive and unproven for long-term use compared with standard treatments, wrote Robert S. Stern, chief of dermatology at Beth Israel Deaconess Medical Center and professor at Harvard University, in the Dec. 17 issue.
Johnson & Johnson's Remicade, South San Francisco-based Genentech's Raptiva and drugs made by Amgen Inc. and Biogen Inc. work in different ways to calm an overactive immune system in psoriasis patients that causes rough patches on the skin that crack, bleed and itch. About 4.5 million Americans have the disfiguring condition, and analysts expect the new medicines to eventually top $7 billion in sales. Still, opinions such as Stern's may slow acceptance of the drugs.
"These new agents are best reserved for patients with severe disease unresponsive to, intolerant of, or lacking access" to other treatments, Stern said in the editorial.
While the drugs are promising, they shouldn't be used as a first-line treatment until long-term studies show they are safer than older medicines such as methotrexate and as effective as traditional treatments like ultraviolet light therapy, he wrote.
A study of Genentech's Raptiva, which appears in the same issue, showed 27 percent of patients getting the drug had at least a 75 percent improvement in the area and severity of the disease, compared with 4 percent of those on a placebo.
Doctors should consider early treatment with drugs such as Raptiva for most patients with moderate to severe forms of the disease, said Kenneth B. Gordon, lead researcher for Genentech's trial.
"This is a disease that occurs in young people and they can have it for 50 years," Gordon said in an interview. "It's important to have multiple options."
