Up to three percent of the world’s population – or more than 125 million people globally – live with psoriasis, a chronic autoimmune disease that causes red, scaly patches to appear on the skin. Psoriasis occurs when the immune system erroneously sends signals that advance the growth cycle of skin cells. Approximately 30 percent of psoriasis patients also develop psoriatic arthritis, a form of arthritis that causes joint pain, swelling and stiffness, according to the National Psoriasis Foundation in Portland, Oregon, USA.
Although there are several forms of the disease, the most common type is plaque psoriasis, affecting more than 80 percent of psoriasis patients. It causes the signature raised, red patches and silvery white colored dead skin cells visible on skin. The patches are often itchy and painful, and cracking and bleeding is not uncommon. More than a third of people with plaque psoriasis have a moderate to severe form, meaning that more than 10 percent of their body surface is affected, often including sensitive parts like the hands or feet. For many psoriasis patients, the road to diagnosis is long and arduous, and involves trying various therapies to manage their symptoms. Some studies have suggested that patients with the more severe forms of psoriasis have a significantly reduced life expectancy due to the fact that they are more likely to suffer from comorbidities including cardiovascular disease and diabetes.
One of the more troubling aspects of the disease is that many psoriasis patients feel that their medical needs are not being met. Approximately 40 to 50 percent of people with plaque psoriasis report dissatisfaction with existing treatments, indicating the need for new, more efficacious therapies that are safe, fast-acting and long-lasting. “There is a wide range of treatments available for management of plaque psoriasis,” says Christopher Griffiths, Professor of Dermatology at the University of Manchester in the United Kingdom. “In the vast majority of patients who have limited extent disease, topical therapies are utilized, though they are not wholly effective.”
Novartis is committed to developing innovative therapies for severe skin diseases. This is why the company has enhanced its research efforts on interleukin 17-A (IL-17A), a messenger protein that acts directly on the keratinocyte, and plays a key role in psoriasis and other autoimmune diseases. IL-17A levels are up to six times higher in psoriatic skin than in normal skin. In psoriasis, increased levels of IL-17A signal to skin cells, or keratinocytes, which grow in number at a faster rate than normal, causing a build-up of cells on the skin’s surface, resulting in thickened skin and plaques visible on patients. IL-17A also signals to infection-fighting cells to go to the infection site, which triggers inflammation, bringing about the itching and redness that psoriasis patients experience. The infection-fighting cells also create more and more IL-17A, which in turn creates a feedback loop that continues to signal that more skin cells and infection-fighting cells are needed. By developing treatments that target IL-17A, Novartis scientists hope there is the potential to provide patients with sustained clear or nearly clear skin. Research has shown that directly inhibiting IL-17A does not compromise other parts of the immune system and allows the body to continue to fight infections.
Having clear or almost clear skin could greatly improve the quality of life of psoriasis patients who suffer more than just physical effects from the disease. Seventy-five percent of psoriasis patients feel unattractive, 54 percent feel depressed and 8 percent are restricted to working at home.
Educating people around the world about this disease is crucial for the well-being of psoriasis patients, some who may feel socially shunned, particularly in traditional societies where information about the disease is lacking. The International Federation of Psoriasis Associations (IFPA), a non-profit organization that is comprised of psoriasis foundations from around the world, launched World Psoriasis Day in 2004 to bring attention to the devastating impact of psoriasis and psoriatic arthritis, and to raise the profile of these diseases as a condition that must be taken more seriously by national and international authorities and made a priority on healthcare agendas worldwide.