I heard that psoriasis can be cured with injections, is that true?

This is the 3829th article of Da Yi Xiao Hu

Mr. Wang has suffered from psoriasis for more than ten years. He has been to various hospitals in Shanghai, but the treatment effect is sometimes good and sometimes bad. It gets worse in winter, and he can't stand it day and night. Recently, I heard that there is a new treatment for psoriasis, which is said to be cured by injection. Is it so magical?

Introduction: Psoriasis is a chronic inflammatory skin disease, which is commonly manifested by flaky erythema covered with white scales, which may be accompanied by itching and dryness. It tends to worsen in winter and is relatively mild in summer.

Question 1: What are psoriasis injections?

"Injection" is what ordinary people call it. In fact, it is a biological agent treatment, and the way of taking the medicine is what everyone calls "injection".

Question 2: Is the treatment effective?

Judging from current usage, biological agents have a good therapeutic effect, which is much more effective than previous medications and ointments. Some patients can even achieve complete clearing of the rash.

Question 3: The effect is so good, I want to try it, is it okay?

Not suitable for all patients!

If conventional medications and ointments can alleviate the condition and do not bring a major impact on your life, we usually recommend that you do not use biologics. After all, biologics also have side effects and disadvantages.

However, if previous treatments cannot effectively control the disease, or if there are many rashes in exposed areas such as the face, neck, and hands, which seriously affects social interaction, it is recommended to use biological agents.

Q4: What are the side effects and disadvantages?

The most common side effects are rhinitis, pharyngitis, headache, pain at the injection site, and conjunctivitis. The incidence of upper respiratory tract infection and urinary tract infection will also increase. A small number of patients also experience worsening of tinea pedis.

Patients with a history of hepatitis, tuberculosis, immune system diseases, and tumors may experience worsening symptoms after using biologics. Even if you do not have the above diseases, the possibility of developing hepatitis, tuberculosis, immune system diseases, and tumors will increase after using biologics.

The disadvantages are that some examination items need to be reviewed after a period of use, and the treatment cannot be stopped at will. Moreover, the price is more expensive than oral medications and ointments. We will talk about this at the end.

Question 5: I can accept the above side effects. Can I receive treatment now?

No, further inspection is needed.

Before using biological agents, you need to check: blood routine, CRP, heart, liver and kidney function, tumor indicators, autoimmune indicators, hepatitis C antibody, hepatitis B two-to-a-half, HIV, syphilis, T-spot, chest CT, etc. After the test results come out and there are no serious problems, biological agent treatment can be carried out. After a period of use, some examination items need to be reviewed.

Question 6: How often do I get the injection? How long does it take?

When using different biological agents, the dosage and time interval of injections are also different.

Compare several currently used biological agents:

① Sikuchiu: 2 injections per week for 5 weeks, then 2 injections per month

② Iqizhu: 2 injections for the first time, 1 injection every 2 weeks thereafter, and 1 injection every month after 3 months

③ Ushino: 1 injection per month for 2 consecutive months, then 1 injection every 3 months

④Adamulin: 2 injections for the first time, and 1 injection every 2 weeks thereafter

It is usually required that once biological treatment is started, it cannot be stopped at will. After the condition stabilizes, the treatment interval can be appropriately extended or the dosage can be reduced, but the decision needs to be made after evaluation by a clinical physician. Do not stop using the drug on your own!

Question 7: Do I need to go to the hospital for injections every time?

Not necessarily. Today’s biologics are available for patients to use at home, and they all come with automatic injection needles.

But if you really can’t bring yourself to poke yourself, you can come to the hospital and we can help you!

Question 8: After the injection, do I no longer need to take other medications?

uncertain.

Although biological agents can significantly improve the rash, they do not necessarily reduce itching. Many patients still complain of severe itching. The use of antiallergic and antipruritic drugs in combination can alleviate this problem.

Most patients cannot achieve 100% clearance of the rash. For a small number of residual rashes, the use of topical ointments can achieve better therapeutic effects.

Some patients may experience mild liver function abnormalities after using biological agents. The combined use of liver-protecting drugs can reduce possible side effects of the drugs.

For patients who already have hepatitis or tuberculosis (inactive stage) before using biological agents, antiviral and anti-tuberculosis drugs cannot be discontinued after using biological agents, and strict regular review is required.

In addition, in order to extend the medication interval, reduce recurrence, and stabilize the condition as quickly and better as possible, we recommend the use of traditional Chinese medicine or Chinese patent medicine to alleviate the condition from the perspective of regulating the physical condition.

Finally, I would like to remind psoriasis patients not to rush to seek medical treatment, but to go to a regular medical institution and choose appropriate medication under the guidance of a doctor. Pay attention to a light diet and abandon bad living habits, such as staying up late, smoking, and drinking.

Author: Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

Dongjie GuoAttending Physician