One of the biggest questions psoriasis sufferers have concerns new research and treatments. Because of the chronic nature of psoriasis, this is quite understandable. Genetic progress through the Human Genome Project has shown us that a key player in the disease is the immune system. Because of this, biologic research has received much media attention, but there are still many other treatments being studied in current medical research of psoriasis.

These include topical medications (applied to the skin) and systemic medications (internal by injection or by mouth).

Corticosteroids are the most prescribed treatment for mild psoriasis. Although these have the potential to nearly eliminate symptoms, long-term use can lead to irreversible thinning of the skin. These cannot be used near the eyes, making them impossible for patients with psoriasis near the eyes to use without risk of glaucoma. Researchers have developed two possible alternatives to corticosteroids:

1. Calcitriol - A form of vitamin D which is used in some countries for psoriasis treatment, this topical medicine not only seems to effectively treat psoriasis, it can be used on sensitive areas (face, hairline, and body folds). One study showed that patients experienced longer remission than with other corticosteroids and swelling, stinging, and burning were also shown to be better than with current coritcosteroids.

This medication has yet to be approved in the U.S. due to increased levels of calcium in the blood which can lead to, among other serious conditions, kidney disease. Synthetic forms of this are currently being developed and tested.

2. Tacrolimus - An ointment developed for treating inverse psoriasis and inverse psoriasis, this has yet to be approved by the FDA. Exploratory study is being conducted to see if this ointment will help psoriasis on other body parts when used with 6% salicylic acid gel. In a very short-term study of only 24 adults during 12 weeks, it was found that the combination worked much better than salicylic acid alone. Due to the few participants and the length of time, this will need more study before approval.

Systemic medications are injected or taken orally and offer more powerful relief of psoriasis than topical treatments. The con to this is that these psoriasis medications carry side effects, much like any other medication which is taken into the body. These side effects may force patients to take the medication over short periods or alternate it with other therapies.

Researchers are still attempting to develop systemic medications that do not have the side effects that make this necessary for psoriasis sufferers. While most of this research is focused on the biologics, one medication is gaining headway outside the biologic area.

Fumaric Acid Esters - Since its 1959 introduction in Germany as a psoriasis treatment, this medication has grown in following with several other European countries now using it as a means to relieve psoriasis sufferers. Most patients show marked improvement. However, common side effects cause many to discontinue its use. These side effects include flushing, diarrhea, nausea, and abdominal pain.

More severe is the rare possibility of kidney damage. Close monitoring of patients is necessary and it is usually not given unless the patient doesn't respond to other treatments. Even though these effects exist, there are many other patients who have used this psoriasis treatment for as long as 14 years.

Researchers in Europe have been conducting clinical studies on a new formulation (BG00012) of this drug. This new formulation has reduced incidents of the minor side effects, making it easier for the patients to remain on the medication.

This Phase II study (human volunteers who have had the condition at least one year are the subjects of this study) held 144 total patients with various forms of psoriasis including: plaque, guttate, erythrodermic, palmoplantar, or pustular psoriasis. The earliest that improvement was seen was two weeks and by the twelfth week, 64% (with a 240mg dosage) achieved a 50% improvement and 42% achieved a 75% improvement. Measurement was taken by the psoriasis area on the skin and the amount of severity.

Participants reported flushing and inflammation of nasal passages and pharynx as common side effects. These were mild and did not require any treatment; they disappeared on their own. The common side effects of the original formulation were only reported by one patient

The new formulation, BG00012, is shown to be more effective and less toxic than other systemic medications being used to treat psoriasis and Phase III studies are in process. One of these studies is to study the effects of BG00012 in patients with chronic plaque psoriasis.