Psoriasis and Enbrel

[Vladek]

I am on Enbrel for moderate plaque psoriasis for about 3 months now. My psoriasis cleared out (99.5%). My dermatologist is gradually decreasing the dose of Enbrel (started with 50mg twice a week then 50mg once a week and now 25mg once a week). The doctor said if I stop taking Enbrel my psoriasis most likely reappear to the same or maybe even bigger extent. Does that meen that in order to keep  a good skin condition I have to stay on Enbrel for a lifetime? If I quit what are the chances for a long remission? And the last question: are there any known possible serious side effects from taking the Enbrel for long period of time?

thank you in advance.

Vlad

[lizziecee]

I have had psoriasis for some 35 yrs, serious enough to be hospitalised for 3 weeks in an isolation ward. Then, the medication was dithronal and PUVA treatment, which brought me out in a whole body rash.The dithronal treatment was awesome, had to be wrapped like a mummy twice a day. I discharged myself as the food was so awful I lost some 14 lbs when in there.  I live in England where we have socialised medicine and it would have taken 6 months to see a dermatologist on the National Health Service so I went privately last year and the Dermatologist prescribed a new medication to me - Silkis (calcitriol,100g twice a day)- it took about 3 months for all the plaques on my legs, arms, trunk and even my face and hands to disappear, but I only have one plaque now, on my left elbow, which I can live with. Don't know if this medication is used in the US, but you may wish to ask your Dermatologist about it.
Take care,
Liz.

[Alan Rockoff, MD]

Enbrel hasn't been around that many years, but its safety record so far is excellent.  It's hard to be absolutely sure, but your dermatologist is no doubt correct that if you stop the Enbrel, the psoriasis is likely to come back full force sooner or later, not necessarily worse than before, but no better either.  All else being equal, I'd stay on it.

Take care.

Dr. Rockoff