Making specific changes to your lifestyle can control, ease and drastically reduce your psoriasis and psoriatic arthritis. These changes need your commitment to improving what you eat, the way you deal with anxiety and your external environment that is within your control. The upcoming Psoriasislife posts will aim to encourage and guide you. They are free and fabulous!
To get you motivated towards improvements in your lifestyle that will control your psoriasis, let’s first look at why modern medicine is not yet able to offer a long-term solution, and why medical researchers warn that a strategy for the safe and effective long-term use of treatments for psoriasis is urgently needed. Psoriasis treatments are known for their unfortunate side effects. This is why:
- Treatment with methotrexate or ustekinumab for longer than 12 months is associated with increased malignancy risk. 1
- PUVA light therapy treatment poses an increased risk of squamous cell carcinoma for Caucasians. 2
- Methotrexate heightens the risk of progression to bridging fibrosis or cirrhosis in patients with pre-existing liver disease 3
- Acitretin increases the risk of hypercholesterolemia, hypertriglyceridemia 4. 5; and risk of birth defects
- Cyclosporine may increase triglyceride levels and risks of hypercholesterolemia and diabetes. Increased risk of renal dysfunction in patients with pre-existing kidney disease. Associated with hepatotoxicity and liver injury in some cases. 6
- Etanercept is a potential risk of worsening or induction of ulcerative colitis and Crohn’s disease. 7
- Certolizumab pegol has a risk of major adverse cardiovascular effects. 8
- Secukinumab has a risk of hypercholesterolemia. 9
- Brodalumab increases risk of suicide in patients with history of depression or suicidality 10 and may exacerbated Crohn’s disease 11
You may be as familiar with these medications as I am and understand they have a place in stabilising severe psoriasis. I am not a medical professional and will never advise you to cease medication as this is a long way outside of my scope. In fact, by ceasing to use some of these medications there is a risk that your condition may worsen. These risks are why we need a more sustainable approach to healing psoriasis.
No healing journey is complete without a journal, just like no change in lifestyle will immediately change your psoriasis. A journal will record your commitment to change and improvement, monitor your psoriasis size and severity, and months later allow you to measure the results. I truly wish that what I will be sharing with you will heal you just like it did for me.
Till soon, take care and get ready with your A3 notebook!
Reference
1 Fiorentino, D. et al. (2017) ‘Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry’, Journal of the American Academy of Dermatology, Volume 77, Issue 5, November 2017, Pages 845-854.e5
2 Wang, E. et al. (2015) ‘Cutaneous Carcinogenic Risk of Phototherapy: An Updated Comprehensive Review’, Journal of Psoriasis and Psoriatic Arthritis, 1(1), pp. 44–51. doi: 10.1177/247553031500100107.
3 Malatjalian DA, Ross JB, Williams CN et al. Methotrexate hepatotoxicity in psoriatics: report of 104 patients from Nova Scotia, with analysis of risks from obesity, diabetes and alcohol consumption during long term follow-up. Can J Gastroenterol. 1996;10(6):369–375.
4 Roenigk HHJ, Callen JP, Guzzo CA et al. Effects of acitretin on the liver. J Am Acad Dermatol. 1999;41(4):584–588.
5 Gisondi P, Cazzaniga S, Chimenti S et al. Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry. J Eur Acad Dermatol Venereol. 2013;27(1):e30–e41.
6 Mikhaylov, Daniela et al. “Systemic Psoriasis Therapies and Comorbid Disease in Patients with Psoriasis: A Review of Potential Risks and Benefits.” The Journal of clinical and aesthetic dermatology vol. 12,6 (2019): 46-54.
7 O’Toole A, Lucci M, Korzenik J. Inflammatory bowel disease provoked by etanercept: report of 443 possible cases combined from an IBD referral center and the FDA. Dig Dis Sci. 2016;61(6):1772–1774.
8 Bykerk VP, Cush J, Winthrop K et al. Update on the safety profile of certolizumab pegol in rheumatoid arthritis: an integrated analysis from clinical trials. Ann Rheum Dis. 2015;74(1):96–103.
9 Novartis Pharmaceuticals Corporation; East Hanover, NJ: 2018. COSENTYX® (secukinumab) [package insert]
10 Valeant Pharmaceuticals International, Inc.; Bridgewater, NJ: 2017. SILIQTM (brodalumab) [package insert] 11 Targan SR, Feagan B, Vermeire S et al. A randomized, double-blind, placebo-controlled phase 2 study of brodalumab in patients with moderate-to-severe Crohn’s disease. Am J Gastroenterol. 2016;111(11):1599–1607.
