There are more than 6 million psoriasis patients in China, experts: scientific cognition reduces misunderstandings, and innovative treatments bring greater benefits

Psoriasis is commonly known as "psoriasis", and surveys show that there are more than 6 million psoriasis patients in China. Since psoriasis is a long-term or even life-long chronic disease, it has high requirements for the patient's own disease management. However, most Chinese patients have relatively low awareness of psoriasis disease and long-term treatment. In addition, due to the recent impact of the epidemic, many patients cannot seek medical treatment in time, and this part of the demand is even more important.

Recently, Professor Zheng Jie, former chairman of the Dermatology and Venereology Branch of the Chinese Medical Association and Professor of Dermatology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, said that during the two sessions this year, relevant departments have been called on to establish a skin care treatment system between tertiary hospitals and primary hospitals. The proposal of psoriasis appeared, hoping to attract national attention to the field of psoriasis treatment.

There are many misunderstandings in psoriasis, and correct identification is very important

Psoriasis is an immune-mediated chronic, relapsing, inflammatory, systemic disease induced by a combination of genetics and the environment, with typical clinical manifestations of scaly erythema or plaques, limited or widespread distribution, non-infectious, disease It is easy to repeat and difficult to cure, and the course of the disease is long, usually about 17-25 years.

According to Professor Zheng Jie, psoriasis is mainly divided into four types, vulgar (also known as plaque type), joint type, erythrodermic type, and dense blister type, of which the first two types are the most common. Its etiology is more complex, and it is the result of the combined effect of genetic factors and acquired environmental factors. There is no scientific basis for the claims that a certain food can cause psoriasis on the market. I hope the public and patients can correctly identify it.

In addition, many patients do not understand that psoriasis is a chronic disease that requires long-term treatment, and believe in "ancestral cures", which eventually leads to aggravation of the disease or even death, which makes clinicians very distressed. Professor Zheng Jie said that with the continuous in-depth research on the pathological mechanism of psoriasis and the emergence of biological agents, curable and preventable recurrence has been achieved, but patients still need long-term or even life-long treatment, which cannot be completely cured. It is appealed to patients with psoriasis to pass standardized diagnosis and treatment and follow the doctor's orders for scientific treatment.

Many clinical needs of patients with psoriasis are not met, and the dual pressures of body and mind cannot be ignored

According to the "Global Report on Psoriasis" released by the World Health Organization (WHO) in 2016, 93% of patients expected to achieve complete clearance of skin lesions, 94% expected to achieve rapid improvement of skin lesions, and 83% expected stable disease without deterioration.

Before the emergence of biological agents, traditional treatment methods of topical medication and systemic therapy were mostly used in clinical practice for psoriasis, with poor safety and unstable effects. Patients faced repeated attacks and incomplete removal of skin lesions, especially for moderate to severe For psoriasis patients, the treatment options are limited and they cannot achieve good results. They not only suffer from physical pain and discrimination from others, but also bear long-term financial pressure.

The long course of disease and the tortuous treatment experience also cause patients to lose confidence in treatment. According to the "Report on Disease Burden and Quality of Life of Psoriasis in China" released by the International Research Center for Pharmaceutical Management of Peking University, 34% of psoriasis patients had suicidal thoughts, and 5% of the patients had committed suicide in the past year. In order to reduce psychological pressure, 51.5% of the patients chose to close themselves and avoid contact with society, friends, and even family members. These effects have brought a heavy burden to patients, families and society.

Professor Zheng Jie said: "Psychological problems will also aggravate the condition of psoriasis, which is a vicious circle, so improving the remission rate of psoriasis is helpful to the patient's body and mind."

Interleukin biologics take the stage to help patients achieve higher treatment goals

Treatment targets for psoriasis are constantly being refreshed as biologics take the stage. Professor Zheng Jie introduced that the application of biological agents in psoriasis has gone through three stages.

The first stage is the anti-tumor factor necrosis factor antagonist TNF-α. The remission rate of skin lesions is acceptable in most patients, but it is easy to relapse after drug withdrawal.

The second biologic, interleukin 23 (IL-23) and 12 (IL-12), treats patients who do not respond well to TNF-α inhibitor therapy.

In 2018, a monoclonal antibody specifically targeting the key pathogenic cytokine interleukin 17A? (IL-17A) in psoriasis appeared. Professor Zheng Jie said that IL-17A inhibitors are currently effective in the field of psoriasis treatment It is fast, safe and stable, and is expected to help some patients achieve PASI 100 (PASI refers to Psoriasis Area and Severity Index).

At the same time, Professor Zheng Jie said that for psoriasis patients who need long-term or even lifelong treatment, the economic burden of biological agents is still very heavy. If they can enter the medical insurance, more patients will truly enjoy the achievements of modern medicine.

As a clinician, he also advocates the establishment of a skin care treatment system between tertiary hospitals and primary hospitals, and guides psoriasis patients to do skin self-care at home, which is not only beneficial to the health of the patients, but also helps reduce the medical expenses of the patients. It can also reduce the medical burden on the government and benefit more patients in the future.

Editor: Gu Jun

Responsible editor: Fan Liping

*Wenhui's exclusive manuscript, please indicate the source for reprinting. Figure | pexels