Sreedhar Krishna (Faculty of Medicine, University of London Imperial College)

Published in medi.philica.com

Observation
Psoriasis is a common, chronic, disfiguring inflammatory condition of the skin involving both genetic and environmental factors in its pathophsyiology. Up until recently, treatment of this condition has centred around topical treatments, phototherapy and generalised immunosuppression. However, with the advent of new immunobiologics, targeting either Tumor Necrosis Factor (TNF) or T-cells/Antigen presenting cells (APC), there is new hope for sufferers.

Unfortunately, these treatments are prohibitively expensive, starting at around $10,000 per annum. Currently, rationalising the use of such expensive agents falls upon two indices: The PASI (Psoriasis Area Surface Index) and DLQI (Dermatology Life Quality Index). While it can be agreed that both the PASI and DLQI are useful indicators of treatment response, they are in my opinion, quite severely lacking. As many sufferers will attest, psoriasis has terrible psychological, social and emotional consequences.

The busy dermatologist of today is time-constrained to use any index to use at all – let alone both of these clumsy, unwieldy measures. However, it is only by robust, uniformly periodic monitoring that we can assess the value of these novel agents.

An alternative, simplified version incorporating all facets of this pervasive disease needs urgent consideration - only then will we know how truly effective these treatments are.

Information about this Observation
Peer-review ratings (from 1 review, where a score of 100 represents the ‘average’ level):
Originality = 125.00, importance = 150.00, overall quality = 150.00
This Observation was published on 23rd August, 2008 at 21:08:12 and has been viewed 2308 times.

This work is licensed under a Creative Commons Attribution 2.5 License.

The full citation for this Observation is: Krishna, S. (2008). Monitoring of the efficacy of immunobiologics in psoriasis. PHILICA.COM Observation number 48.