39 and taking soriatane yes/no

[sgm-co]

39 year old healthy male with some plaque on both legs, head, ears, arms, back and my rear end. If you asked percentage covered I would say 5% tops. Had P now for 15 years and some spots come and go. Taken all the topicals from A to Z and no real long term gain. Sometimes they work for a bit then the treatment wears off.

Doc put me on Soriatane last week and wanted some opinions regarding the serverity of P people have when taking Soriatane?

Thanks for your input

SGM-CO

[cordiod]

I could be wrong, but I thought Soriatane was only Rx'd for moderate to severe cases of psoriasis.

I personally had never been put on it because I am "of child bearing age" so that ruled it out as an option for me because it takes 3 years--I believe--before you can "safely" conceive after having taken it.

[RichJ]

hi sgm-co,
sorry i can't help much but welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you,

have a good weekend all

richard

[nodak]

My DH tried soriatane shortly after the holidays this past year. He didn't have good luck with it. The side effects were worse than the P before he started the med. He is e-dermic with about 50%, plus he has a skin condition called pitariasis rubra pilaris--not as serious as P, but still not a picnic. The other thing neither one of us was thrilled about was the cost of soriatane. In the end, it was too expensive to just make him feel worse. His side effects included very chapped lips, increased scalp flaking, dry mouth, tiredness, depression, and _intense_ itching.

However, it DID clear up his hands and feet. He walked without pain for the first time in four months. Those effects have remained even though he has been off the soriatane for about a month.

Hope this is helpful! Good luck--I hope it is successful for you!

Leah

[MikeK]

Hi SGM-CO,

Welcome to the Board! :cool: Nice to meet you.

Given your description that your psoriasis is very mild, I surprised that your derm prescribed Soritatane for you. As Diana said, it's usually prescribed for someone with moderate to severe psoriasis.

(Since Soritane can cause birth defects, a woman can't become pregnant for a minimum of three years after she comes off of Soritane. (As Diana already mentioned.) A man can't donate blood for a minimum of three years after he comes off of Soritane because the donated blood can cause birth defects if it's given to a woman who is is pregnant or who subsequently becomes pregnant within three years after receiving the donated blood.)

I hope this helps.

Good luck. Keep us posted. Let us know if you have any questions and please don't be a stranger.

Mike

[Resist]

Read all the warnings info for Soriatane! My doctor failed to tell me about them all. Like not drinking alcohol while on it and not for several months after stopping it. And not to give blood for 3 years after using it.

I didn't have much gains and side effects were to much for me, like peeling toes and finger tips. It hurt to pick up a coin.

[hkowalczyk]

I had great success with Soriatane, but given the amount of coverage you have and the fact that it's plaque, I'd say that some of the potential side effects of Soriatane would outweight any benefits. especially because one of the side effects on almost all P drugs is that they can increase it, before making it better.

Soriatane is not as effective on plaque as it is on e-derm and pustular. But if you want to stay on it I would suggest you stay at a low dose (10 mg/day) and combine it with UVB (careful though because it makes you more likely to burn). When combined with UV it is much more effective on plaque. and since its side effects are dose dependent you are in a better position at the lowest dose that is working.

Look up my posts and you'll find out a lot of info on what I did when using soriatane to try to avoid the side effects.


oops almost forgot, to answer your question... I was 100% erythrodermic when I started taking soriatane.

Good luck,
Henri

[Jopperm2]

Change the patient to 24 years old, with Plaque, Guttate, and Inverse, 15-25% coverage. How does that change your positions?

[chaimFL]

I never used soriatane, but it was a toss up between that and UVB. I went with UVB and was able to clear so soriatane is on the back burner in case UVB decides to stop working at some time in the future.

I do know that side effects very from person to person and they are mostly dose dependent. If you start off at the lowest dose (10mgs/day) for two weeks or so before moving to 20 mgs/day for another two weeks..etc you can find the highest dose that you can tolerate with no or few side effects.

Soriatane is also good because it is not an immunosuppressant. Many people are nervous to take medications that compromise the immune system and soriatane does not do that at all.

[hkowalczyk]

Jopperm,

I don't really think age matters in this case, it only matters for women of child bearing age since it changes the equation quite a bit. Perhaps if anything, the younger you are the "better" soriatane becomes as an option because it can be a long term maintenance solution.

I guess only you can say how "bad" 15-25% actually is. Heck even if it was 5% and it's on your palms and feet that could be reason enough to use it.

My personal opinion is that if you're at the point of using a systemic, then soriatane deserves a hard look, since like Chaim said, it's not immunosupressive.

-Henri

[Jopperm2]

I've been thinking a lot about what to try because I need to get under control and topicals do basically nothing for me anymore.

My P is starting to spread more and more and I think(along with some doctors i have seen) that I might be getting PA. I really don't need that.

I've looked at the side effects and I think they are the easiest for me to bear compared to other drugs(basically I hate needles and I should be watching my lipids anyway).

[hkowalczyk]

The funny thing is that I also hate needles that's another plus in soriatane's corner, except..... you need blood work monthly! so every month I went to faint er... get blood drawn!

It sounds like it's worth a shot for you then, except it wont do anything for the PA (but maybe if you stop the P, then you may avoid the PA?)

-Henri

[Jopperm2]

Yeah, i know you have to have blood work, but that's better than injections, espescially daily injections. And it's a lot better than biopsy. :(

My hope is that if I can eliminate the P and get clear, the PA will be slowed or stopped.

[SandraJean]

Hi,

Sorry to hear that you may have pa as well. Have you asked your dermatologist about a reference to a good rheumatologist yet? When you are dealing with pa along with p it's really helpful to get treated fo pa as soon as you can to cut down on the progession of pa.

I hope things work out well for you and check into seeing a rheummie too. Take care,

Sandy

[MichaelaCFP]

My experience with Soriatane was not very pleasent. I also agree with the other members on this board that Soriatane should be used for individuals with more serious skin coverage (greater than 25%.)

If you decide to try the soriatane dosage keep a watchful eye on how you psychologically feel over time. I found that Soriatane led me to feeling "jet-legged" and lethargic with a touch of depression.

I must say though - Soriatane (in a very low dosage) + PUVA was extremely helpful.

5%-10% is mild (and fairly easy to treat.) I would ask your derm to write an RX for a compund (to be mixed at your local pharmacy) of Aquaphor w/Coal Tar and Salicylic (sp) acid. Its sort of gooey and you put it on after you shower but it relieves the itchiness and with summer coming, a few days in the sun will improve your skin.

Michael

[Resist]

it only matters for women of child bearing age since it changes the equation quite a bit
And for Males, do NOT give blood until 3 years after stopping Soriatane. You wouldn't want a female to get the blood if they are or want to become pregnant.

[chaimFL]

5%-10% is mild (and fairly easy to treat.) I would ask your derm to write an RX for a compund.....

Michael

I'm a firm believer that severity can only be determined by the patient and not solely based on his or her body coverage. I have spoken to people that were aroud 5% covered that were more severe than me at my worst (40%+) based on their emotional and social reactions to the disease.

Creams are tedious and very discouraging since you have to apply them twice a day every day. Then once you stop you only have a week or two of rest before it all starts again.

Soriatane is a pretty mild systemic treatment. Most of the side effects are uncomfortable, but not dangerous (hair loss, peeling feet, hands, and lips, itchy/sticky feeling). The side effects are also very dose dependent.

Here is a great comparison of PUVA, methotrexate, soriatane, and cyclosporine. It mentions the risks that are associated with each one.

Comparative tolerability of systemic treatments for plaque-type psoriasis.

McClure SL, Valentine J, Gordon KB.

Department of Dermatology, Northwestern University Medical School, Chicago, Illinois 60611, USA.

Psoriasis is a chronic, debilitating skin condition that affects millions of people and is attributed to both genetic and environmental factors. Topical therapy is generally considered to be the first-line treatment of psoriasis. However, many patients do not respond to topical therapy or have disease so extensive that topical therapy is not practical. For these patients, systemic therapy is indicated. Presently, there are four available systemic treatments, psoralen with ultraviolet A (PUVA), methotrexate, oral retinoids (acitretin), and cyclosporin. Unfortunately, all of these treatments have significant potential adverse effects. PUVA may acutely cause nausea, pruritis and sunburn. More chronic and concerning is the development of PUVA lentigines, ocular complications and skin cancer. Non-melanoma skin cancer has been directly linked to PUVA; however, the association with melonoma is more elusive. Methotrexate use most notably carries the risk of hepatic fibrosis and cirrhosis, which is not always evident on liver function tests. Other more rare, but potentially life-threatening adverse effects include pancytopenia, lymphoproliferative disorders and acute pneumonitis. The addition of folic acid may help to reduce the risk of increasing liver enzymes and haematological toxicity seen in those taking methotrexate. Both methotrexate and oral retinoids are teratogenic and should never be used in pregnancy. Oral retinoids are probably the least effective available systemic medication for the treatment of plaque psoriasis. The effects are improved with the addition of other systemic therapies. Acitretin has replaced the formerly used etretinate primarily because of the significantly shorter half-life. The adverse effects are generally mild and reversible, making the drug fairly safe for long-term use. The most commonly seen adverse effects include elevated serum lipids, generalised xerosis and alopecia. Bony abnormalities, while somewhat controversial, have also been described and include diffuse idiopathic skeletal hyperostosis, skeletal calcifications and osteoporosis. Cyclosporin is the most recently approved systemic medication for plaque psoriasis. The nephrotoxicity associated with the use of cyclosporin can be minimised when used in lower doses and for a limited duration. Hypertension is usually mild and can be seen in up to about one-third of patients receiving long-term therapy. Cutaneous and internal malignancies have also been reported with cyclosporin and tend to be correlated with duration of treatment. In this review, we will examine the potential adverse effects with these US Food and Drug Administration-approved treatments in adults, with specific emphasis on the controversies that surround long-term therapy with these agents and their cumulative adverse effects.

Publication Types:
Review

PMID: 12381213 [PubMed - indexed for MEDLINE]

[MichaelaCFP]

I'm a firm believer that severity can only be determined by the patient and not solely based on his or her body coverage. I have spoken to people that were aroud 5% covered that were more severe than me at my worst (40%+) based on their emotional and social reactions to the disease.

In most instances I would agree with you, except for the fact that I have an acquaintance in Asheville who has (now had) one small patch of P on his elbows. When he found out that I was having success with Enbrel (me 60% P w/ PA,) he demanded that his Physician put him on Enbrel. Well, he is clear - but at what price to his insurance company. His P has been long gone and he still gives himself an injection once a week.



M

[MichaelaCFP]

[QUOTE=ChaimFL]I'm a firm believer that severity can only be determined by the patient and not solely based on his or her body coverage. I have spoken to people that were aroud 5% covered that were more severe than me at my worst (40%+) based on their emotional and social reactions to the disease.


In most instances I would agree with you, except for the fact that I have an acquaintance in Asheville who has (now had) one small patch of P on his elbows. When he found out that I was having success with Enbrel (me 60% P w/ PA,) he demanded that his Physician put him on Enbrel. Well, he is clear - but at what price to his insurance company. His P has been long gone and he still gives himself an injection once a week.

Aggressive treatments from the onset is not the right way to treat this disease.

[sgm-co]

well it has been three weeks and much more scaling, chapped lips, dry skin and some sunburn. I'm told it should take at least another three weeks to see some change.

What are the side effect of drinking?

SGM-CO

[grannyfranny]

well it has been three weeks and much more scaling, chapped lips, dry skin and some sunburn. I'm told it should take at least another three weeks to see some change.

What are the side effect of drinking?

SGM-CO

Other commonly used names are 13-cis acitretin , etretin , and isoetretin.

Alcoholic beverages-Drinking alcohol may convert acitretin to a much longer-acting product that can stay in the body 60 times longer than acitretin does. This may result in a greater chance of developing side effects for months or years, depending on how much and how often one drinks. This unusual effect can occur even after you stop taking acitretin, especially for the first 2 months after you stop taking this medicine
Read all about it here,,,,,,
http://www.drugs.com/cons/soriatane_systemic.html

[tay323]

I've been taking Soriatane for a year. In the beginning the side effects were worse. I don't notice the dry mouth, lips, peeling hands, feet, lethargy feeling so much anymore. The one side effect I can't get rid of is that it turned my hair curly.... I mean.... really curly! People think I've gotten a perm curly. I don't mind going and getting my blood work done every 4 weeks.

When I started it I was about 85%. Now, I'm about 35%. I'm going to start Enbrel soon.

I still get nasty flare ups that come and go in cycles. Everytime he's upped my dose, I'd get a flare up. (that eventually subside)

[RichJ]

hi tay323,
welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you,

have a good night all

richard

[jlfinkels]

39 year old healthy male with some plaque on both legs, head, ears, arms, back and my rear end. If you asked percentage covered I would say 5% tops. Had P now for 15 years and some spots come and go. Taken all the topicals from A to Z and no real long term gain. Sometimes they work for a bit then the treatment wears off.

Doc put me on Soriatane last week and wanted some opinions regarding the serverity of P people have when taking Soriatane?

Thanks for your input

SGM-CO

I was put on Soriatane at 30% coverage and it worked well for me. The down side was the side effects. Along with the usual chapped lips and hands, I had enough problems with depression that I had to stop taking the drug after about a year.

I don't understand your derm putting you on such a potent drug for 5% coverage, but they must have their reasons. My advice would be read all the information on Soriatane that you can so you can make an intelligent decision. Don't be afraid to ask your derm if you are at all uncomfortable about anything.

Best of luck,
-jeff