Characterized by painful red patches on the skin covered with thick silvery scales, psoriasis is a chronic autoimmune skin condition that afflicts roughly 125 million people worldwide. Newly released data from a clinical study shows that Cosentyx, a psoriasis treatment manufactured by Novartis, is 21 percent more effective than the widely administered treatment Stelara.
Researchers do not understand the exact cause of psoriasis. However, certain genes predispose individuals to the condition. Known triggers of psoriasis include various infections, skin injuries or side effects of certain medications. This is not merely a cosmetic problem. While the intensity and frequency of psoriasis relapses vary, most patients report that the condition adversely affects their everyday lives. Aside from feeling unattractive and depressed, many psoriasis patients develop psoriatic arthritis in their joints.
Mild psoriasis can be curbed by applying creams or shining special lights to clear blemishes, but more severe cases require oral or injected medications. Treatments against severe psoriasis focuses on reducing inflammation, an immune response that induces chemical signals called cytokines. Various skin pathologies are caused by these signals. Up to 50 percent of patients report that they are dissatisfied with existing treatments.
Cosentyx binds and blocks cytokine IL-17A, which signals skin cells to grow in number and form thick, scaly plaques. Skin with psoriasis contains up to six times more IL-17A than skin without psoriasis. Classified as a biologic, Cosentyx is distinct from traditional drugs. Made by living cells in labs, biologics target specific immune cells or proteins instead of the entire immune system. Directly targeting IL-17A does not compromise the immune system.
Earlier this year, the Food and Drug Administration (FDA) and the European Union approved Cosentyx as a first-line treatment for psoriasis. This makes Cosentyx the first and only IL-17A inhibitor approved for the condition. Clinical studies show that nearly 80 percent of Cosentyx patients achieved clear skin at the 16th week of usage.
On March 20, Novartis announced new clinical study results showing that Cosentyx is significantly superior to Stelara in clearing skin. Not only is Cosentyx an improvement, but it provides patients with a new treatment option. Before Cosentyx was available for first-line therapy, biologics against psoriasis such as Stelara and Enbrel were only recommended as second-line therapies.
Novartis’s news release coincides with a booming time for drug development. Forecasted to generate over $1 billion in sales for 2019 alone, Cosentyx is one of the “2015 Drugs to Watch” mentioned in the Thomson Reuters Market Insight Report published last month. The increasing number of FDA-approved drugs means that competition between pharmaceutical companies is growing. Not surprisingly, pharmaceutical companies respond by engaging in price wars and diversifying the uses of their drugs. Novartis is currently in Phase III development for ankylosing spondylitis, a disease that involves IL-17A in the spine.
Despite the success of Cosentyx, Dr. Matthew Hayden, an assistant professor of dermatology at Columbia College of Physicians and Surgeons, believes in continued psoriasis research.
“Blocking cytokines is effective, but it has limitations,” Hayden said. “These therapies are not curative and must be taken indefinitely.”
Psoriasis increases the risk of diseases in other parts of the body, such as cardiovascular disease, diabetes and inflammatory bowel disease.
“There is a need for both curative therapies as well as therapeutic approaches that are more selective to the disease process, rather than blocking all of the functions of a cytokine,” Hayden said.
