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Plaque Psoriasis

Understanding Psoriasis

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What is plaque psoriasis?

Plaque psoriasis is the most common form of psoriasis. It can appear anywhere on the body, but it is most commonly found on the elbows, knees, scalp, and lower back. With plaque psoriasis, the skin typically becomes red and inflamed and may form white scaly patches. It can be quite painful and may itch, crack, and bleed. While psoriasis may look like just a skin disease, it is in fact a disease of the immune system.

Up to 42% of people with psoriasis actually have psoriatic arthritis. This is a condition that affects both the skin and the joints. If you ever experience joint pain, swelling, and morning stiffness in addition to your psoriasis symptoms, you may actually have psoriatic arthritis. Untreated, psoriatic arthritis may result in permanent joint damage. Find out more about psoriatic arthritis.

Dr. Craig Leonardi on psoriasis and the immune system

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The knowledge that psoriasis is a disease of the immune system has led to the development of newer treatment options, like ENBREL, that work at the level of the immune system. These treatment options reduce inflammation and help keep skin clearer. Because ENBREL suppresses your immune system, it may lower your ability to fight infections.

    
Hear from dermatologist Dr. Craig Leonardi as he describes the science of ENBREL and explains how it works to help treat the symptoms of moderate to severe plaque psoriasis.
   

Craig Leonardi, MD, Clinical Associate Professor of Dermatology, St. Louis University School of Medicine.

How ENBREL treats plaque psoriasis

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In patients with plaque psoriasis, there is an overproduction of skin cells. Normally, skin cells are formed underneath the surface of the skin and move up to the surface over a period of about 30 days. These cells are eventually shed, revealing new skin cells. In people with plaque psoriasis, however, this skin cell cycle is sped up so that the skin cells multiply in just 3 to 4 days. The body has no way to shed the skin cells fast enough, and they accumulate on the surface, forming raised, red patches or lesions.

ENBREL works in a targeted way inside your body, on the immune system, to help slow the rapid growth of skin cells and reduce the inflammation associated with moderate severe plaque psoriasis. In other words, ENBREL works from the inside out. Because ENBREL works on the immune system it may lower your ability to fight infection.

Talk to a dermatologist about treatment with ENBREL

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Only a qualified health care professional can determine whether or not you have plaque psoriasis. Although your family doctor may be able to diagnose your symptoms, it's a good idea to see a dermatologist if you suspect you have psoriasis. Dermatologists specialize in treating skin diseases and can work with, or as a consultant to, your physician. Because dermatologists treat a range of skin conditions, it may be helpful to find out if yours treats psoriasis before you make an appointment.

To find a dermatologist who has experience prescribing biologic therapies like ENBREL to treat moderate to severe plaque psoriasis, visit the Dermatologist Directory Service.

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IMPORTANT SAFETY INFORMATION

What is the most important information I should know about ENBREL?

ENBREL is a medicine that affects your immune system. ENBREL can lower the ability of your immune system to fight infections. Serious infections have happened in patients taking ENBREL. These infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some patients have died from these infections. Your doctor should test you for TB before you take ENBREL and monitor you closely for TB while on ENBREL.

Before starting ENBREL, tell your doctor if you:
  • Think you have, are being treated for, have signs of, or are prone to infection. You should not start taking ENBREL if you have any kind of infection.
  • Have any open cuts or sores
  • Have diabetes or an immune system problem
  • Have TB or have been in close contact with someone who has had TB
  • Were born in, lived in, or traveled to countries where there is more risk for getting TB. Ask your doctor if you are not sure.
  • Live or have lived in certain parts of the country (such as, the Ohio and Mississippi River valleys, or the Southwest) where there is a greater risk for certain kinds of fungal infections, such as histoplasmosis. These infections may develop or become more severe if you take ENBREL. If you don't know if histoplasmosis or other fungal infections are common in the areas where you live or have lived, ask your doctor.
  • Have or have had hepatitis B
  • Have heart failure
  • Develop symptoms such as persistent fever, bruising, bleeding, or paleness while taking ENBREL
  • Use the medicine Kineret® (anakinra)
  • Have or develop a serious nervous disorder, seizures, any numbness or tingling, or a disease that affects your nervous system such as multiple sclerosis
  • Are scheduled to have surgery
  • Are scheduled for any vaccines. All vaccines should be brought up-to-date before starting ENBREL. Patients taking ENBREL should not receive live vaccines.
  • Are allergic to rubber or latex
  • Are pregnant, planning to become pregnant, or breastfeeding

After starting ENBREL, call your doctor right away if you have any sign of infection, including a fever, cough, flu-like symptoms, or have any open sores on your body. ENBREL can make you more likely to get infections or make any infection you have worse.

Possible side effects of ENBREL

Serious side effects include: serious infections including TB; nervous system problems, such as multiple sclerosis, seizures, or inflammation of the nerves of the eyes; rare reports of serious blood problems (some fatal); heart failure, including new heart failure or worsening of heart failure you already have; allergic reactions; immune reactions, including a lupus-like syndrome and lymphoma (a type of cancer). People with rheumatoid arthritis and psoriasis may have a higher chance for getting lymphoma.

Common side effects include: Injection site reaction, upper respiratory infections (including sinus infection), and headaches.

In a medical study of patients with JIA, infection, headache, abdominal pain, vomiting, and nausea occurred more frequently than in adults. The kinds of infections reported were generally mild and similar to those usually seen in children. Other serious adverse reactions were reported, including serious infection and depression/personality disorder.

If you have any questions about this information, be sure to discuss them with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see Prescribing Information and Medication Guide.

INDICATIONS
Moderate to Severe Rheumatoid Arthritis (RA)
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with moderate to severe rheumatoid arthritis. ENBREL can be taken with methotrexate or used alone.

  • In medical studies, ENBREL was shown to be effective in about 2 out of 3 adults with RA who used it, and has been shown to begin working in as few as 2 weeks, with most patients receiving benefit within 3 months. In an RA medical study, 55% of patients had no progression of joint damage.

Moderate to Severe Polyarticular Juvenile Idiopathic Arthritis (JIA)
ENBREL is indicated for reducing signs and symptoms of moderately to severely active polyarticular juvenile idiopathic arthritis (JIA) in children ages 2 years and older.

  • In a medical study, ENBREL was shown to be effective in about 3 out of 4 children with JIA who used it. For these JIA patients, ENBREL has been shown to begin working in approximately 2 to 4 weeks.

Psoriatic Arthritis
ENBREL is indicated for reducing signs and symptoms, keeping joint damage from getting worse, and improving physical function in patients with psoriatic arthritis. ENBREL can be used in combination with methotrexate in patients who do not respond adequately to methotrexate alone.

  • In a medical study, ENBREL was shown to be effective in about 50% of psoriatic arthritis patients who used it. Clinical responses were apparent at the time of the first visit (4 weeks) and were maintained through 6 months of therapy.

Ankylosing Spondylitis (AS)
ENBREL is indicated for reducing signs and symptoms in patients with active ankylosing spondylitis.

  • In a medical study, ENBREL was shown to be effective in about 3 out of 5 adults with AS who used it. Clinical responses were seen at 2 weeks in 46% of patients, with 59% of patients receiving benefit within 8 weeks.

Moderate to Severe Plaque Psoriasis
ENBREL is indicated for the treatment of adult patients (18 years or older) with chronic moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

  • In medical studies, nearly half of patients saw a significant improvement in their plaque psoriasis within 3 months of using ENBREL. Overall, 3 out of 4 patients saw improvement. ENBREL can work fast; many patients saw improvement within 2 months. ENBREL has been shown to be effective through 12 months of therapy.
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