By Dr. Maria Simbra

PITTSBURGH (KDKA) – There’s a new treatment that’s really targeting the cause of psoriasis. For many people, it’s clearing up their skin completely.

The patchy, flaky, red and scaly rash of psoriasis. This autoimmune disease comes with arthritis, too.

It’s typically treated with creams and pills and in severe cases, injections to stop the excess inflammation that worsens the condition.

“Over the last 15 years, newer and newer injections have come out. They started off targeting really broad parts of the immune system, now they’re targeting more and more specific parts, specific to just psoriasis,” Dr. Brian Horvath, of Horvath Dermatology, said.

The existing shots clear the skin to a large extent, but some red spots may persist.

“So 75 percent improvement is nice, but maybe not as much as people want,” Dr. Horvath said.

A newer option, called Siliq, was approved by the FDA a couple months ago.

“These newer medications sometimes have a 100 percent improvement. So some of these people on this medication, as much as 40 percent, have no visible psoriasis whatsoever,” Dr. Horvath said. “Which is really unheard of for prior psoriasis treatments.”

The more targeted approach means less immune system suppression altogether, and better treatment of the psoriasis.

But, there are costs.

“It will definitely be tens of thousands of dollars a year,” Dr. Horvath said.

There’s also the cost of potential side effects: aches and pains, fatigue, nausea and diarrhea, low blood counts, and another concern.

“In a trial of about 4,000 people, four people in the trial actually committed suicide while taking the medicine. It’s not clear whether the medication contributed to that or not, but this medicine does have a specific warning on it that you have to watch for suicidal thoughts or behavior,” Dr. Horvath said.

For these reasons, it will be used only when other choices haven’t worked.

There’s no biological explanation as to why the medication would have the small suicide risk. Time will tell whether this is a true risk or just a coincidence that showed up in the studies.

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Dr. Maria Simbra