Experimental Psoriasis Drug Produces Impressive Results

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There is a widely recognized need for new treatments.

The new study, published in the Feb. 8 issue of the New England Journal of Medicine, involved 320 people with moderate-to-severe psoriasis who were randomly chosen to receive the interleukin-12/23 monoclonal antibody at different doses and schedules, or a placebo. The study was sponsored by pharmaceutical company Centocor, which makes the drug.

There was a 75 percent or more improvement in 52 percent of participants who received one 45-milligram (mg) dose of the monoclonal antibody, in 59 percent of those receiving one 90 mg dose, in 67 percent of those receiving a 45 mg dose four times weekly, and in 81 percent of those receiving four weekly 90-mg doses.

There was at least a 90 percent improvement in 23 percent, 30 percent, 44 percent and 52 percent, respectively, of patients receiving the monoclonal antibody.

Only 2 percent of those receiving the placebo experienced this type of recovery.

Some 79 percent of the interleukin-12/23 group experienced side effects, compared with 72 percent of the placebo group. The difference was not considered statistically significant.

The high response rate to the drug supports the idea that psoriasis is a disease with an immune basis, researchers said.

"The number one thing this article does is give us further evidence of the immune-mediated nature of psoriasis," said Dr. Daniel Bennett, an assistant professor of internal medicine at Texas A&M Health Science Center College of Medicine and a dermatologist with Scott & White Hospital. "The argument in the past was that the problem was primarily in the skin vs. being immune-mediated. But the more we tinker with the actual signaling molecules in the immune response, the more evidence that it seems to be immune-mediated."

The drug falls into the class of medications called biologics, which have specific mechanisms of action. This compound works on signaling molecules in the immune response that have not been targeted before. "It's an expansion of the biologics," Bennett said.