Jab ends scaly skin misery for 60% of psoriasis patients
PEOPLE blighted by psoriasis could soon find relief from a drug that completely eradicated the itchy skin disease in nearly twothirds of users during trials. Doctors say bimekizumab ‘beats all other treatments’ and are hopeful it could be available across the NHS in a year.
Psoriasis causes red, flaky, itchy patches of skin, and at its most extreme can cover every part of the body, with many sufferers scratching to the point of bleeding.
It affects more than two per cent of Britons and typically develops in early adulthood. While the cause is not fully understood, it occurs when the body over-produces skin cells, which build up, and is thought to be due to problems with the immune system. Many patients manage their symptoms with creams containing anti-inflammatory steroids, but it currently cannot be cured and returns throughout a lifetime.
The patches, which are often described as scales, typically form on the arms and legs, but for those with severe psoriasis they can cover up to 90 per cent of the body.
Professor Richard Warren, consultant dermatologist at Salford Royal NHS Foundation Trust and lead investigator on the bimekizumab trial, says that life for those worst affected can be unbearable.
He adds: ‘There’s a big misconception that skin diseases don’t have a big impact on life. Psoriasis is a disfiguring disease – it impacts every part of your life, from relationships to work. Severe sufferers will often avoid situations where they have to remove clothing, such as swimming pools. Many of them can’t hold down relationships because the psoriasis affects their genitals.’
Those unable to control psoriasis with steroid creams will usually be offered drugs such as secukinumab and adalimumab. These work by limiting the immune system’s production of proteins which are thought to cause inflammation.
Bimekizumab is the first treatment of its kind to target specific immune-system proteins – called Interleukin 17A and Interleukin 17F. Results from one the most recent trials, published by the University of Manchester last week, are said to have exceeded all expectations.
Patients were given the drug as an i njection once every f our weeks. By week four, nearly threequarters of patients had begun to see their condition improve. Astonishingly, by week 16, more than 60 per cent reached ‘complete skin clearance’, meaning they had no patches anywhere on the body.
In a separate trial, also published last week, more than 86 per cent of patients on the new drug achieved near-total skin clearance compared with just under 50 per cent on adalimumab. Prof Warren, also of The University of Manchester, says: ‘ It’s the fastest- acting psoriasis drug we’ve ever seen.’
Bimekizumab is expected to be offered to patients suffering from moderate-to-severe psoriasis who have not responded to other treatments. This means more than 200,000 Britons could stand to gain from its approval by regulators.
But the drug is not without its side effects – ten per cent of patients developed thrush infections, particularly in the mouth.
However, Prof Warren says the majority of these were easily treated with other medication.
One patient to benefit from the treatment is Libby Quayle, a 24-yearold trainee solicitor from Manchester. Libby first developed psoriasis when she began her solicitor apprenticeship aged 18.
She says: ‘I started to get itchy patches on my scalp. Then it spread down my neck. A year later, it was covering my entire body.’
LIBBY says the psoriasis was ‘incredibly painful’ but i t also affected her confidence. None of the usual treatments worked, but in February 2018 Libby was placed on the bimekizumab trial and the results started to show within weeks. She adds: ‘By week three the scales were going down, and by about week eight it was just the redness that was left. Having lived with this for so long, I almost couldn’t comprehend it was gone.
‘For the first time since I was 18, I could wear make- up and nice skin products without worrying they’ll cause a flare-up. You don’t realise at that time how much of a physical and mental burden it is.’
Libby is part of a five-year trial looking at its long- term effects. Prof Warren says: ‘We haven’t quite realised how to switch off psoriasis permanently, so this isn’t a cure. But for now, this is the best treatment we have. Hopefully, this can get NHS approval within the next 12 to 24 months.’