Psoriasis treatments: Drug vs. botanical
Tunnel Ahead
Here’s a classic bit of tunnel vision health care…
In psoriasis, an immune system dysfunction causes skin cells to multiply too rapidly. Blood flow increases in spots where the epidermis thickens, prompting itchy, unsightly rashes.
So if you’re a drug maker, what do you do? Why it’s simple – you develop a drug that suppresses the immune system.
Now what could possibly go wrong with that idea?
Highlights and lowlights
FDA officials recently announced that the psoriasis drug Raptiva will get a new boxed warning. According to FDA News, the warning will “highlight the risks of life-threatening infections,” including:
- Bacterial sepsis
- Viral meningitis
- Invasive fungal disease
- Progressive multifocal leukoencephalopathy
- Other opportunistic infections
Serious infections, hospitalizations, and deaths have been linked to Raptiva use, but, you know, once they get that “boxed warning” in place everything will be okay, as long as the warning reads something like: “For the love of Pete! PLEASE don’t use this drug!”
But the name alone might scare off a few patients. Raptiva sort of sounds a rare species of poisonous reptile. You have to wonder if executives at Genentech Inc. (the maker of Raptiva) were actually trying to send consumers a subtle warning when they chose the name.
Out of the blue
Raptiva is designed to be taken once each week by injection, and is approved for adults with moderate to severe plaque psoriasis – the most common type of the disease.
But if you’d like to try something else before risking your life with Raptiva, you might talk with your doctor about a botanical called indigo naturalis – long used in traditional Chinese medicine to treat infections and skin disorders, such as eczema.
Last month, an indigo naturalis study from Taiwan appeared in the Archives of Dermatology. The Taiwanese team recruited 42 patients with chronic plaque psoriasis that had been resistant to treatment. Every day for 12 weeks, each subject applied indigo naturalis in ointment form to a plaque lesion on one side of their body, and a placebo ointment to a lesion on the other side of their body.
The authors write: “Approximately 31 of 42 patients (74%) experienced clearance or near
clearance of their psoriasis in the indigo ointment-treated lesion.”
Some patients reported mild allergic reactions to the indigo naturalis treatment, but none experienced serious adverse effects. Reuters Health reports, however, that long-term use of the botanical has been linked to liver and gastrointestinal problems, so ideally this treatment should be used under the guidance of an experienced herbalist.
You can read about other non-drug treatments for psoriasis in the e-alert “Surface Protectors” (10/9/06).
Sources:
“FDA Approves Updated Labeling for Psoriasis Drug Raptiva” FDA News, 10/16/08, fda.gov
“Clinical Assessment of Patients With Recalcitrant Psoriasis in a Randomized, Observer-Blind, Vehicle-Controlled Trial Using Indigo Naturalis” Archives of Dermatology, Vol. 144, No. 11, November 2008, archderm.ama-assn.org
“Indigo Plant May Treat Chronic Skin Disease” Reuters, 11/17/08, reuters.com
