January 13, 2003
BIRMINGHAM, AL - UAB is expanding services for patients who seek relief from the itching, cracking and bleeding skin caused by psoriasis.
Long-suffering patients are heralding the drug infliximab (Remicade), given as an infusion in special clinics, as a major advance in treatment, according to Dr. Boni S. Elewski, professor of dermatology at UAB. Elewski participated in clinical testing of infliximab, which was approved by the U.S. Federal Drug Administration last year for treatment of rheumatoid arthritis. It also is used to help with inflammatory bowel disorders.
"Infliximab was noticed to help with skin-based symptoms of psoriasis," she said. "We started offering the two-hour infusions of this immune-based treatment in a once-a-week clinic, but demand is necessitating a second clinic and we are planning to expand even more in coming months," she said. "We're seeing patients from Alabama and adjoining states that tell us this drug is really improving their quality of life. Many people with psoriasis tend to be reclusive, depressed and prone to more thoughts of suicide due to the skin manifestations of the disease."
The treatments are given at UAB's Kirklin Clinic. Only a few medical clinics offer the infliximab treatment, primarily due to the start-up costs involved, she said.
People wishing to inquire about UAB's psoriasis treatment program may call (205) 934-5188. For information on other such treatment sites in the United States, they may call Centocor, Inc., at (800) 858-2585.
After an initial treatment, patients receive additional infusions two and six weeks later, then return every two or three months for treatments. "They generally begin to see their psoriasis start to clear after the second treatment, and minimal side effects generally occur," Elewski said.
That's great news for patients such as Brenda Bass of Opp. "I've tried many treatments, gone to every doctor I can find in south Alabama and in north Florida," she said. "Most of the time nothing works, and the ones that do help, like methotrexate, made me throw up frequently."
Like most psoriatics, Bass wears light clothing when possible to minimize the appearance of dandruff-like flakes of skin that are a hallmark of the autoimmune disease. "I try not to let psoriasis keep me from going out and living my life, but a lot of people with it just stay hidden because of the embarrassment."
The flaking skin is unsightly, she said, but even worse is the constant itching. "The skin is dry and cracked, and it oozes and bleeds when you scratch it. I've tried every cream and emollient available, and nothing helps much."
For decades, the nation's seven million psoriatics have been a rich marketing ground for numerous nostrums and treatments with tars, lights, and more recently topical corticosteroids in a variety of forms. Medications that suppress the immune system are currently used, but can cause serious side effects.
"With infliximab, said Elewski, "three-fourths of our patients are getting 75 percent improvement in six months, and this improvement holds up several months more for half our patients."