Claim: New psoriasis drug is more effective than current treatment
Verdict: REFUTES

Retrieved passages:
title: Psoriasis
text: and ustekinumab were the most effective biologics for treating psoriasis. In general, anti-IL17, anti-IL12/23, anti-IL23, and anti-TNF alpha biologics were found to be more effective than traditional systemic treatments. The immunologic pathways of psoriasis involve TH-9, TH-22, TH-17 and TH-1 lymphocytes, and the above biologics hinder different aspects of these pathways. Another treatment for moderate to severe psoriasis is fumaric acid esters (FAE) which may be similar in effectiveness to methotrexate. Limited evidence suggests removal of the tonsils may benefit people with chronic plaque psoriasis, guttate psoriasis, and palmoplantar pustulosis. Uncontrolled studies have suggested that individuals with psoriasis or psoriatic

title: Psoriasis
text: to use outside of research settings, which has led to attempts to simplify the index for clinical use. While no cure is available for psoriasis, many treatment options exist. Topical agents are typically used for mild disease, phototherapy for moderate disease, and systemic agents for severe disease. Topical corticosteroid preparations are the most effective agents when used continuously for 8 weeks; retinoids and coal tar were found to be of limited benefit and may be no better than placebo. Greater benefit has been observed with very potent corticosteroids when compared to potent corticosteroids. Vitamin D analogues such as paricalcitol were

title: Psoriatic arthritis
text: sulfasalazine. These immunosuppressant drugs can also reduce psoriasis skin symptoms but can lead to liver and kidney problems and an increased risk of serious infection. The most recent class of treatment is called biological response modifiers or biologics has been developed using recombinant DNA technology. Biologic medications are derived from living cells cultured in a laboratory. Unlike traditional DMARDS that affect the entire immune system, biologics target specific parts of the immune system. They are given by injection or intravenous (IV) infusion. Biologics prescribed for psoriatic arthritis are TNF-α inhibitors, including infliximab, etanercept, golimumab, certolizumab pegol and adalimumab, as well

title: Tofacitinib
text: investigational drug in psoriasis. Tofacitinib has demonstrated its effectiveness for plaque psoriasis in Phase 3 randomized, controlled trials in comparison to placebo and to etanercept. In particular, a 10 mg twice-daily dose of tofacitinib was shown to be noninferior to etanercept 50 mg subcutaneously twice weekly. Based on preclinical studies in a mouse model of the disease, tofacitinib has been investigated for the treatment of alopecia areata. Early case reports suggested potential efficacy, as did a phase II open-label clinical trial, published in tandem with a phase II clinical trial showing the same for ruxolitinib. In a June 2015 case

title: Ponesimod
text: Ponesimod Ponesimod (INN, codenamed ACT-128800) is an experimental drug for the treatment of multiple sclerosis (MS) and psoriasis. It is being developed by Actelion. In a 2009–2011 Phase II clinical trial including 464 MS patients, ponesimod treatment resulted in fewer new active brain lesions than placebo, measured during the course of 24 weeks. In a 2010–2012 Phase II clinical trial including 326 patients with psoriasis, 46 or 48% of patients (depending on dosage) had a reduction of at least 75% Psoriasis Area and Severity Index (PASI) score compared to placebo in 16 weeks. Common adverse effects in studies were temporary

title: Psoriasis
text: found to be superior to placebo. Combination therapy with vitamin D and a corticosteroid was superior to either treatment alone and vitamin D was found to be superior to coal tar for chronic plaque psoriasis. For psoriasis of the scalp, a 2016 review found dual therapy (vitamin D analogues and topical corticosteroids) or corticosteroid monotherapy to be more effective and safer than topical vitamin D analogues alone. Due to their similar safety profiles and minimal benefit of dual therapy over monotherapy, corticosteroid monotherapy appears to be an acceptable treatment for short-term treatment. Moisturizers and emollients such as mineral oil, petroleum

title: TNF inhibitor
text: guidelines for the treatment of severe psoriasis using the anti-TNF drugs etanercept (Enbrel) and adalimumab (Humira) as well as the anti-IL12/23 biological treatment ustekinumab (Stelara). In cases where more conventional systemic treatments such as psoralen combined with ultraviolet A treatment (PUVA), methotrexate, and ciclosporin have failed or can not be tolerated, these newer biological agents may be prescribed. Infliximab (Remicade) may be used to treat severe plaque psoriasis if aforementioned treatments fail or can not be tolerated. In 2010 The National Institute of Clinical Excellence (NICE) in the UK issued guidelines for the treatment of severe Crohn's Disease with Infliximab

title: Calcipotriol/betamethasone dipropionate
text: of plaque-type psoriasis vulgaris amenable to topical therapy. The foam formulation was approved by the FDA in 2015 and is indicated for the topical treatment of plaque psoriasis in patients 18 years of age and older. In all pivotal trials of Cal/BD ointment, topical suspension, or foam, treatment success or achievement of 'clear' or 'almost clear' disease was defined by Investigator's Global Assessment, an alternative to the Psoriasis Area and Severity Index (PASI) score. In an international, double-blind, parallel group study of 1603 patients with psoriasis (affecting at least 10% of one or more body regions), more patients on once-daily

title: Ixekizumab
text: months of treatment (depending on the dosing scheme), and 40% of patients experienced a complete absence of psoriasis symptoms (PASI100). In the placebo group, PASI75 was reached in 4% of patients, and PASI100 in none; in the group of patients receiving etanercept, an older anti-psoriasis drug, PASI75 was reached in 48%. Until the 60th study week, 11–44% of ixekizumab treated patients relapsed (again, depending on the dosing scheme), as compared to 84% under placebo. In December 2017 the US FDA approved it for active psoriatic arthritis. The drug is contraindicated for patients with certain infections such as active tuberculosis. In

title: Psoriasis
text: a different point than the anti-TNF-α antibodies. IL-12 and IL-23 share a common domain, p40, which is the target of the recently FDA-approved ustekinumab. In 2017 the US FDA approved guselkumab for plaque psoriasis. There have been few studies of the efficacy of anti-TNF drugs for psoriasis in children. One randomized control study suggested that 12 weeks of etanercept treatment reduced the extent of psoriasis in children with no lasting adverse effects. Two drugs that target T cells are efalizumab and alefacept. Efalizumab is a monoclonal antibody that specifically targets the CD11a subunit of LFA-1. It also blocks the adhesion

title: Psoriatic arthritis
text: tablet form and taken by mouth. Side effects include headaches, back pain, nausea, diarrhea, fatigue, nasopharyngitis and upper respiratory tract infections, as well as depression and weight loss. Patented in 2014 and manufactured by Celgene, there is no current generic equivalent available on the market. A review found tentative evidence of benefit of low level laser therapy and concluded that it could be considered for relief of pain and stiffness associated RA. Retinoid etretinate is effective for both arthritis and skin lesions. Photochemotherapy with methoxy psoralen and long-wave ultraviolet light (PUVA) are used for severe skin lesions. Doctors may use

title: Psoriasis
text: applied directly to psoriatic plaques can help reduce inflammation, remove built-up scale, reduce skin turnover, and clear affected skin of plaques. Ointment and creams containing coal tar, dithranol, corticosteroids (i.e. desoximetasone), fluocinonide, vitamin D analogs (for example, calcipotriol), and retinoids are routinely used. (The use of the finger tip unit may be helpful in guiding how much topical treatment to use.) Vitamin D analogues may be useful with steroids; however, alone have a higher rate of side effects. They may allow less steroids to be used. Another topical therapy used to treat psoriasis is a form of balneotherapy, which involves

title: Psoriatic onychodystrophy
text: but there is little information concerning their effectiveness and safety. Treatments include topical, intralesional, radiation, systemic, and combination therapies. Available studies lack sufficient power to extrapolate a standardized therapeutic regimen. As of April 2009, an assessment of the evidence for the efficacy and safety of the treatments for nail psoriasis is in progress. A 2013 meta-analysis showed improvement of nail psoriasis with infliximab, golimumab, superficial radiotherapy, electron beam, and grenz rays compared to placebo. Although systemic therapies have been shown to be beneficial, they may have serious adverse effects. Topical treatments have not been well studied but may be beneficial.

title: Psoriasis
text: the immune process involved in psoriasis. Unlike generalised immunosuppressive drug therapies such as methotrexate, biologics target specific aspects of the immune system contributing to psoriasis. These medications are generally well-tolerated and limited long-term outcome data have demonstrated biologics to be safe for long-term use in moderate to severe plaque psoriasis. However, due to their immunosuppressive actions, biologics have been associated with a small increase in the risk for infection. Guidelines regard biologics as third-line treatment for plaque psoriasis following inadequate response to topical treatment, phototherapy, and non-biologic systemic treatments. The safety of biologics during pregnancy has not been assessed. European

title: Ustekinumab
text: The etanercept group received subcutaneous injections of the drug twice weekly for 12 weeks while the ustekinumab group received two injections, one month apart, of either 90 or 45 milligrams. At twelve weeks, psoriatic plaques were reduced by at least three-quarters in 68% of the low-dose ustekinumab group and 74% of the high-dose group. Both groups fared better than the etanercept group, 57% of whom saw such improvement. Dr. Alan Menter, chairman of psoriasis research at Baylor Research Institute said of the results, "now we have a drug that will be used less frequently ... with a significant increase in

title: Psoriasis
text: present in increased concentrations in psoriasis skin lesions while contributing less to protection against opportunistic infections. Other cytokines such as IL-17 and IL-22 also have been targets for inhibition as they play important roles in the pathogenesis of psoriasis. Another avenue of research has focused on the use of vascular endothelial growth factor inhibitors to treat psoriasis. Oral agents being investigated as alternatives to medications administered by injection include Janus kinase inhibitors, protein kinase C inhibitors, mitogen-activated protein kinase inhibitors, and phosphodiesterase 4 inhibitors, all of which have proven effective in various phase 2 and 3 clinical trials. However, these

title: Psoriasis
text: direct costs. Pharmacy costs are the main source of direct expense, with biologic therapy the most prevalent. These costs increase significantly when co-morbid conditions such as heart disease, hypertension, diabetes, lung disease and psychiatric disorders are factored in. Expenses linked to co-morbidities are estimated at an additional $23,000 per patient per year. The role of insulin resistance in the pathogenesis of psoriasis is currently under investigation. Preliminary research has suggested that antioxidants such as polyphenols may have beneficial effects on the inflammation characteristic of psoriasis. Many novel medications being researched target the Th17/IL-23 axis, particularly IL-23p19 inhibitors, as IL-23p19 is

title: IL17A
text: evaluated in psoriasis and the first report showing Secukinumab is effective when compared with placebo was published in 2010. In 2015, the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approved anti-IL-17 for the treatment of psoriasis. Other than the monoclonal antibodies, highly specific and potent inhibitors targeting Th17 specific transcription factor RORγt have been identified and found to be highly effective. Vitamin D, a potent immunomodulator, has also been shown to suppress Th17 cell differentiation and function by several research groups. The active form of vitamin D has been found to 'severely impair' production of the

title: Psoriatic arthritis
text: as the IL-12/IL-23 inhibitor ustekinumab. Biologics may increase the risk of minor and serious infections. More rarely, they may be associated with nervous system disorders, blood disorders or certain types of cancer. A first-in-class treatment option for the management of psoriatic arthritis, apremilast is a small molecule phosphodiesterase-4 inhibitor approved for use by the FDA in 2014. By inhibiting PDE4, an enzyme which breaks down cyclic adenosine monophosphate, cAMP levels rise, resulting in the down-regulation of various pro-inflammatory factors including TNF-α, interleukin 17 and interleukin 23, as well as the up-regulation of anti-inflammatory factor interleukin 10. It is given in

title: Goeckerman therapy
text: shift away from Goeckerman therapy. A 2007 comparative study of psoriasis treatment found Goeckerman therapy to be more efficacious at 12-weeks than biologics. It has also been successfully used in patients who have failed some biologic therapies. Goeckerman therapy Goeckerman therapy is a regimen for treatment of moderate to severe plaque psoriasis using a combination of crude coal tar and artificial ultraviolet radiation. It is a specialized form of light therapy. First formulated in 1925 by American dermatologist William H. Goeckerman (1884–1954), Goeckerman therapy continues to be used due to its efficacy and safety profile. Individual institutions have modified the