From the Guidelines
Psoriasis treatment options include topical therapies, phototherapy, and systemic medications based on disease severity, with the most recent guidelines recommending a tailored approach to individual patient needs 1.
Treatment Options
- For mild to moderate cases, topical corticosteroids (like betamethasone or clobetasol) are first-line treatments, applied once or twice daily for 2-4 weeks.
- Vitamin D analogs such as calcipotriene can be used alone or combined with steroids.
- Calcineurin inhibitors (tacrolimus, pimecrolimus) work well for sensitive areas.
Phototherapy and Systemic Options
- For moderate to severe psoriasis, phototherapy using UVB light 2-3 times weekly for 10-12 weeks is effective.
- Systemic options include oral medications like methotrexate (starting at 7.5-15mg weekly), cyclosporine (2.5-5mg/kg/day), and apremilast (30mg twice daily).
Biologics and Lifestyle Modifications
- Biologics targeting specific immune pathways include TNF inhibitors (adalimumab, etanercept), IL-17 inhibitors (secukinumab, ixekizumab), IL-23 inhibitors (guselkumab, risankizumab), and IL-12/23 inhibitors (ustekinumab) 1.
- Lifestyle modifications like stress reduction, maintaining healthy weight, and avoiding triggers like alcohol can complement medical treatment, as supported by guidelines from 2009 and 2011 1.
Key Considerations
- Treatment should be tailored to meet individual patients’ needs, taking into account body location, characteristics of the psoriasis being treated, and patient preferences 1.
- The choice of vehicle can significantly alter the use and penetration of the medication, and therefore alter the efficacy 1.
From the FDA Drug Label
HUMIRA is a tumor necrosis factor (TNF) blocker indicated for: Plaque Psoriasis (Ps) (1. 7): treatment of adult patients with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy, and when other systemic therapies are medically less appropriate. Plaque Psoriasis or Adult Uveitis (2.5): Adults: 80 mg initial dose, followed by 40 mg every other week starting one week after initial dose.
Treatment Options for Psoriasis:
- Adalimumab (HUMIRA) is indicated for the treatment of adult patients with moderate to severe chronic plaque psoriasis.
- The recommended dosage for plaque psoriasis is an initial dose of 80 mg, followed by 40 mg every other week starting one week after the initial dose. 2
From the Research
Treatment Options for Psoriasis
- Topical corticosteroids and vitamin D analogs are well-established as safe and effective first-line treatments for mild to moderate plaque psoriasis 3
- Topical therapy includes corticosteroids, vitamin D3 analogs, retinoids, tars, anthralin, keratolytics, and topical immunomodulators, which can be used alone or in combination with other treatments 4
- Combining a vitamin D derivative and a strong glucocorticoid is considered the most efficient way to treat psoriasis when topical agents are indicated 5
Traditional Therapies
- Topical therapies such as corticosteroids, vitamin D analogues, and retinoids are used for localized disease 6
- Phototherapy, including broadband ultraviolet B (UVB), narrowband UVB, PUVA, and climatotherapy, are effective for more extensive disease 6
- Systemic therapies such as methotrexate, retinoids, and ciclosporin are effective for patients with refractory or extensive cutaneous disease 6
Topical Therapies
- Emollients are useful adjuncts to the treatment of psoriasis 7
- Salicylic acid can be used in combination with other topical therapies to increase absorption into psoriatic plaques 7
- Low- to mid-potent topical corticosteroids (TCS) are used in facial/flexural psoriasis, while high-potent TCS are used over palmoplantar/thick psoriasis lesions 7
- Vitamin D analogs alone or in combination with TCS are useful in stable plaques over limbs and palmoplantar psoriasis 7