PHILADELPHIA — More expensive biologic treatments for psoriasis were only marginally more effective than standard treatments, according to a new study led by researchers in the Perelman School of Medicine at the University of Pennsylvania. Researchers found that previously reported response rates from randomized controlled trials were higher than results in a clinical, real-world setting. The research was published in the Archives of Dermatology, one of the JAMA/Archives Journals.
The researchers found that biologics were slightly more effective than a standard drug treatment for psoriasis, methotrexate, but that their impact was less then what has been reported in clinical trials which study efficacy of a medication under idealized circumstances and only for a short period of treatment.
"When one looks at the outcome as being clear, or almost clear [skin], the biologics appear to be more effective than methotrexate," said study author Joel Gelfand, MD, assistant professor of Dermatology and Epidemiology. But, when total body surface area affected by the disease is added in that difference diminishes, he said. More importantly, patients noted no differences in health related quality of life with the newer biologic medications compared to methotrexate which has been used for psoriasis for over 40 years.
Gelfand noted that while the newer biologics are generally tolerated better by patients, with fewer side effects that lead to stopping the medication, their effectiveness diminishes with time. Traditional treatments may cause nausea and other potential side effects. Since psoriasis is a life-long disease, patients on biologics are often left with only a relatively short period of optimum control of their psoriasis.
Biologics can cost $10,000 to $20,000 a year, compared to a couple of thousand dollars for older drugs or phototherapy, said Gelfand.
The study was funded by the National Institutes of Health's National Institute of Arthritis and Musculoskeletal and Skin Diseases (5RC1AR058204-02) as part of the American Recovery and Reinvestment Act (ARRA), commonly referred to as the stimulus program.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $5.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 18 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $373 million awarded in the 2015 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2015, Penn Medicine provided $253.3 million to benefit our community.