New Biologic For Psoriasis Launched In Malaysia

Article From The Star 08 April 2012

A ‘new’ drug for moderate-to-severe plaque psoriasis is now available in Malaysia.

OFTEN mistaken as a mere cosmetic nuisance, psoriasis has a considerable impact on both the mental and physical well-being of patients.

In most cases, psoriasis sufferers spend a lot of time hiding, literally, beneath clothing, and avoiding social situations due to discomfort and embarrassment.

It is a long-lasting, non-contagious, and often misunderstood disease. Many who endure this condition are unaware of what it is and how it is caused. Here’s a definition for clarification.

Dr Chow explaining how ustekinumab works at the recent launch of the drug in Malaysia.

Psoriasis is a common skin disease that affects the lifecycle of skin cells. It causes cells to build up rapidly on the surface of the skin, forming thick silvery scales, and itchy, dry red patches that are sometimes painful.

Normal skin cells mature and shed in an ongoing cycle of 28 to 30 days. In psoriasis, skin cells mature in just three or four days. When psoriasis is severe, it can grow over large areas of the body.

Generally, the severity of psoriasis can be evaluated by body coverage:

·Severe psoriasis – more than 10% of the body

·Moderate psoriasis – from 3% to 10%

·Mild psoriasis – less than 3%

The degree of severity can also be measured by a tool called The Psoriasis Area & Severity Index, also known as PASI. This tool is a measure of the average redness, thickness and scaliness of lesions weighted by the area of involvement.

“I have been working with patients who suffer from moderate-to-severe psoriasis for many years, and I’ve seen how the disease affects patients’ relationships and their sense of self-esteem. Psoriasis patients are also at increased risk for other diseases such as obesity, diabetes, hypertension and myocardial infarction,” said Dr Steven Chow Kim Weng, honorary medical adviser for the Psoriasis Association of Malaysia.

For those who believe psoriasis is genetically induced, you are not entirely wrong. As with many genetically influenced diseases, psoriasis tends to run in families.

Contrary to popular belief, hygiene is not a trigger for the onset of psoriasis. However, there are certain lifestyle factors that are often involved in the prevalence of psoriasis. These include heavy smoking, alcohol consumption, dietary preferences and excessive weight gain.

Managing psoriasis starts with accepting and acknowledging it as a chronic condition. Patients sometimes may not realise the severity of their condition and may mistake the issue as an allergic reaction, dry skin or a passing phase.

Especially for patients who suffer from moderate to severe plaque psoriasis, it is important to seek professional help from a doctor who can diagnose the condition and advise the most suitable treatment option to alleviate the condition.

Diagnosis is usually made after careful examination of the skin, followed by a biopsy. It is crucial for the patient to discuss treatment options with their doctor or dermatologist to determine which would be the optimal treatment for him/her.

Some of the treatment options include:

1. Topical treatment: creams, gels, lotions, sprays and shampoos.

2. Phototherapy: sunlight, UVB phototherapy, pulsed dye laser, combination light therapy.

3. Conventional systemic treatment: methotrexate, cyclosporine, hydroxyurea and retinoids pills.

It is important to remember that treatment options are personalised – they depend on the patients’ age, health, and also, the severity of the disease.

In moderate to severe psoriasis, the above options may not be as effective, and some patients may be contra-indicated or intolerated to these treatments. For such cases, the use of biologics is increasingly becoming a viable treatment option.

Biologics are derived from natural proteins found in living cells. Currently, all biologics used for the treatment of psoriasis must be injected. Biologics work by targeting the underlying cause of psoriasis – excessive skin cell growth due to an overactive immune system.

Pharmaceutical company Janssen, a division of Johnson & Johnson Sdn Bhd, recently launched ustekinumab – a prescription-based biologics drug to manage moderate-to-severe plaque psoriasis. It is the only biologics treatment for psoriasis available with a quarterly dosage (every 12 weeks), or as few as four injections per year, following two starter doses.

The drug has received approval in 57 countries for moderate to severe plaque psoriasis patients above 18 years of age. Administered by subcutaneous injection, ustekinumab is indicated to treat moderate to severe plaque psoriasis patients who have failed to respond to, or who have a contraindication to, or are intolerant to conventional systemic therapy.

According to two large phase 3 studies (PHOENIX 1 and PHOENIX 2), which involved a total of approximately 2,000 patients, at least two thirds of patients showed at least 75% clearer skin, as measured by PASI, at 12 weeks, after two injections of ustekinumab. Findings from these studies also showed that every 12-week dosing with the drug effectively maintains substantial skin clearance in most patients.

Ustekinumab is a prescription medicine that may affect activities of the immune system, and like all medicines, it can result in side effects, although not every patient will experience them. The most common side effects reported include upper respiratory tract infections and nasopharyngitis.

“Before receiving ustekinumab, it is imperative that patients visit their dermatologists for a thorough medical check-up. The medicine is not for everyone, and only a doctor can decide whether it’s right for an individual,” said Dr Chow.

> This educational article is contributed by Janssen. Janssen provides this information for educational and communication purposes only. It should not be construed as medical advice. Information in this article is not intended to replace, supplant or augment a consultation with a health professional regarding individual medical care.
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6 thoughts on “New Biologic For Psoriasis Launched In Malaysia

  1. Hi.
    I had just found out I had psoriasis which a dermatology had confirmed that.
    It was mistaken for the past 5 years as eczema and been given all types of steroid medicine.

    I have it on my face, sometimes its visible, red scaly patches.

    I need advice on what I should do to avoid it triggers more.
    I am currently avoiding detergent, bleach and seafood.
    I notice my hands skin starts to get scaly and peeling after washing the dishes and moments later I feel itchy on my face.
    I feel its hard to educate people around me about psoriasis and how severe it is.
    The dermatologist said the the place I have it (on my face) is very rare, he just touch it and scratch it and said its psoriasis.
    There was no test done not even biopsis etc.
    please help.

    • psoriasismalaysia

      Hi Jiji,

      Thanks for visiting the association website. Here are some inputs and comments in reply:

      a) Psoriaisis patients have the option to use steroids as part of our psoriasis treatment. Some chose to use it and others may opt for other topical treatments. As for psoriasis on the face, many do use the mild steroid in order for the psoriasis to clear fast.

      B) should you be concerned about the diagnosis – another option is to see another dermatologist and get a second opinion to confirm if it is psoriasis. Usually if skin flakes off and is white or silver and shiny, this is an indication of psoriasis due to the layer of skin that is piling up and being manufactured by our body at the increasing speed. From out experience, not many doctors will conduct biopsies to determine psoriasis. Experienced dermatologist usually can diagnose by examination.

      C)triggers – we all have our own individual triggers and you need to find out by observation. Common triggers are food that cause you to itch and when you scratch the skin (even sometimes unconsciously while asleep) Psoriaisis could appear due to the Koebner phenomenon. Others are stress, exposure to certain chemicals, etc. go to which is the America site for more comprehensive information

      d)Cure & Treatments – there is currently no know medical cure for psoriasis. Having said that, There are very effective drugs that are being introduced (in our lifetime) to manage psoriasis and the biologics are promising. However most people know that the biologic’s cost are prohibitive for majority of people. Everyone is waiting for the prices to drop.

      In order to manage your psoriasis effectively, psoriasis patients need to work with their dermatologist or doctor to find a combination therapy that works. For example: This could be a combination of topical (medicine applied on top of skin), systemic (taken orally) and even complimentary therapy (safe alternative medicine or alternative therapy).

      Should you have any immediate question, please email us (email address found on the front page of website). We will do our best to help you with information.

  2. Please research on family planning pills, maybe its the main cause of psoriasis to your childrens.

  3. Hi.
    I got a moderate psoriasis for 20 years to date. I tried different type of medications from traditional one to modern drug, but none seems effective for my case. I also have some patches on my face, thigh and stomach, but most of them are on lower back and the skin at the back of the neck. I also got them on the scalp.

    Is this ustekinumab expensive?How much would it approximately cost? I might deal with my dermatologist if it is a better solution.
    Thank you.

  4. Can I get it cosentyx in hospital?

    • Psoriasis Association Of Malaysia

      Hi yes it is available at Private Hospitals in Malaysia. Not sure the full list, you might need to call the Pharmacy Department of the hospital nearest to you to enquire. Based on other patients’ feedback, Sunway Medical stocks Cosentyx.

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