The results indicate higher doses of ISA247, which is a calcineurin inhibitor, significantly improve symptoms of psoriasis. Calcineurin is a protein that helps regulate inflammation.

"This is the first oral medication in 20 years to show promise for the treatment of moderate to severe plaque psoriasis," said lead researcher Dr. Kim Papp, from Probity Medical Research in Waterloo, Ontario.

The new drug is safer and easier to use than current treatments for psoriasis, the researchers said.

Psoriasis is an autoimmune skin disease. The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells. As many as 7.5 million Americans have psoriasis, according to the U.S. National Institutes of Health.

Currently, one of the most effective treatments for psoriasis is the calcineurin inhibitor drug ciclosporin. However, the drug's toxic effects on the kidneys prevent it from being used for long-term treatment, which is often needed because psoriasis tends to reappear once treatment is stopped.

Other drugs such as infliximab (Remicade) are safe and effective but are expensive and inconvenient to use. In addition, the long-term safety of the drug isn't known.

The report is published in the April 19 issue of The Lancet.

In the study, Papp's team randomly selected 451 patients with plaque psoriasis that affected at least 10 percent of the body, to receive the new drug or placebo. There were three groups of patients who received ISA247, but at different doses.

The researchers looked for a 75 percent reduction in what is called the psoriasis area and severity index score (PASI 75).

Papp's group found that after 12 weeks of treatment, 47 percent of patients who received the highest dose of ISA247 achieved PASI 75. Patients receiving lower doses achieved a 25 percent or a 16 percent improvement in their PASI score. Among patients in the placebo group, only four of 115 achieved PASI 75, the researchers reported.

"ISA247 is a reasonable oral medication for the treatment of psoriasis," Papp said. "It is reasonable because of reasonable efficacy, high tolerability and minimal metabolic effects."

In addition, because the effect of the drug correlates with its dose, it "can be titrated to suit patients response and tolerance without undue risk of adverse effects," Papp said.

One expert thinks the result of this trial needs to be duplicated in longer-term studies, and it needs to put in a head-to-head comparison with other psoriasis drugs.

"ISA247 may offer advantages compared with ciclosporin," said Dr. Luigi Naldi, from the Unit of Dermatology and GISED Study Centre at Ospedali Riuniti di Bergamo, Italy, and author of an accompanying editorial. "However, its efficacy and safety profile needs to be further evaluated in the context of longer-term comparative studies."

Naldi noted that these trials need to be done in real-life situations. In addition, the trial done by Papp is too short to really tell whether or not the drug is safe, since most patients taking the drug would have to use it for a long time to control their psoriasis, he said.

"The risk of chronic kidney toxicity induced by calcineurin inhibitors increases with treatment duration and cannot be reliably predicted with short-term data," Naldi said." An obvious comparator in the ISA247 trial would have been ciclosporin. Without such an internal comparison, the claim that ISA247 is safer than ciclosporin should be viewed cautiously, because it is based on external comparisons," he said.

More information

For more on psoriasis, visit the U.S. National Library of Medicine.

The findings, published April 4 in the open-access journal PLoS Genetics, may help define some of biological pathways that cause psoriasis and aid in the development of treatments that target these specific avenues.

"Common diseases like psoriasis are incredibly complex at the genetic level," lead investigator Anne Bowcock, a professor of genetics at the Washington University School of Medicine in St. Louis, said in a prepared statement. "Our research shows that small but common DNA differences are important in the development of psoriasis. Although each variation makes only a small contribution to the disease, patients usually have a number of different genetic variations that increases their risk of psoriasis and psoriatic arthritis."

Psoriasis, in which the body's immune cells mistakenly attack the skin, is characterized by red, scaly patches that can be itchy, painful or both. The autoimmune disease affects an estimated 7 million Americans. Up to 30 percent of sufferers may also develop psoriatic arthritis, an often excruciatingly painful and debilitating condition.

For the study, the researchers looked at common variations in the DNA genome called single nucleotide polymorphisms (SNPs). About 10 million SNPs affect the genome to make each individual unique. Some SNPs also affects a person's predisposition to disease or good health.

The investigators scanned more than 300,000 SNPs in the genomes of 223 psoriasis patients, including 91 who had psoriatic arthritis, and compared them to those found in 519 healthy control patients.

Researchers found seven unique DNA variations linked to psoriasis. Several found on chromosome 4 were strongly linked to psoriatic arthritis. These same variations were also associated with psoriasis and had been previously linked to type 1 diabetes, rheumatoid arthritis, Grave's disease (caused by an overactive thyroid gland) and celiac disease (caused by the inability to digest gluten).

A larger genome-wide association study of psoriasis patients is under way, and Bowcock said she expects it to find more genetic variations linked to the condition.

More information

The U.S. National Library of Medicine has more about psoriasis.

The study, published online in the Journal of the American Academy of Dermatology, states that people with more severe cases of psoriasis have an increased incidence of psoriatic arthritis, cardiovascular disease, hypertension, diabetes, cancer, depression, obesity and even other immune-related conditions such as Crohn's disease.

As a result, the study authors recommended that psoriasis patients get regular, comprehensive exams from their doctors and work to improve their physical and mental health while avoiding high-risk behaviors, such as smoking, overeating and excessive sun exposure.

Psoriasis has long been associated with increased cardiovascular disease risk factors, such as obesity and smoking, but these were thought to be linked to the psychosocial burden of psoriasis. Two recent studies have changed that thinking because they show an increased risk of heart and circulation issues in psoriasis patients even when controlling for major cardiovascular risk factors.

"Taken together, these studies suggest that psoriasis itself may be a risk factor for developing atherosclerosis and myocardial infarction," study leader and dermatologist Alexa B. Kimball, an associate professor of dermatology at Harvard Medical School, said in a prepared statement.

Psoriasis has long been known to cause considerable emotional stress for patients, including an increased incidence of mood disorders. One study estimates that 24 percent of psoriasis patients suffer from depression.

"Depression in patients with psoriasis is a serious concern that should be addressed, as it may significantly impact a patient's overall emotional and physical well-being," Kimball said. "Another concern is that depression may be a contributing factor to an increased risk of cardiovascular disease, which as we know is already an increased risk in psoriasis patients."

Several studies have found an increased risk of certain cancers in psoriasis patients, such as lymphoma and a form of skin cancer known as squamous cell carcinoma. Some of these cancers have been associated with specific psoriasis treatments that suppress the immune system.

"Following the recommended routine health screenings for cancers and avoiding high-risk behaviors that increase the risk of developing some cancers, such as smoking, alcohol abuse, and intentional sun exposure, must be a high priority for psoriasis patients who may be at an increased risk for these potentially life-threatening diseases," Kimball said.

Kimball and the task force urged psoriasis patients to work with their dermatologists and physicians to outline an appropriate preventive program based on their individual medical history and known risk factors.

More information

The National Psoriasis Foundation has more about psoriasis.

A team at Wyeth Research, in Cambridge, Mass., found that antibodies that neutralized the IL-22 molecule in mice prevented the development of psoriasis-like lesions. The researchers also found injecting IL-22 into the skin of normal mice activated genes associated with the development of psoriasis-like skin lesions.

These findings, published in the Jan. 17 issue of the Journal of Clinical Investigation, suggest that targeting IL-22 may provide a new approach to treating people with psoriasis, the study authors said.

Psoriasis, which causes red, scaly, raised skin lesions, affects up to 3 percent of the world's population and more than 7.5 million Americans, according to the National Psoriasis Association.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about psoriasis.

The study found that 57 percent of the children and teens enrolled in the study had at least a 75 percent improvement in their symptoms, and their quality of life also improved.

"Psoriasis is not just some benign skin disease but can be truly life-altering for patients," said the study's lead author, Dr. Amy Paller, chairwoman of dermatology at Northwestern University's Feinberg School of Medicine.

"In our study, etanercept positively impacted quality of life," added Paller, who's also a pediatric dermatologist at Children's Memorial Hospital in Chicago.

Psoriasis is a common skin condition that causes the skin to grow at an accelerated rate. Because the skin cells are growing faster than they can be shed, scaly patches develop on the skin. The disorder tends to run in families, and doctors suspect it's an autoimmune disease, in which the body is mistakenly sensing that healthy cells are foreign substances. Nearly one-third of those with psoriasis also have what's known as psoriatic arthritis, according to the U.S. National Institutes of Health.

Mild cases of the disorder may respond to over-the-counter and prescription creams and ointments. But, for people with moderate to severe disease, stronger medications -- such as immune suppressants -- are often needed.

Newer medications, such as etanercept (Enbrel) and infliximab (Remicade), have been approved for treating psoriasis in adults. These medications, called biologics, specifically target the immune response, rather than dampen the entire immune system.

None of these medications has yet been approved for the treatment of children, however.

"This is the first trial that's been done in children and adolescents in this whole category of biologics for psoriasis," Paller said.

Etanercept is a tumor necrosis factor receptor (TNF). People with psoriasis have too much TNF, and entaercept reduces the amount of TNF. But, it can also lower the immune system's ability to fight infections.

To assess whether or not the drug was as safe and effective in children under 17 as it is in adults, Paller and her colleagues recruited 211 children and adolescents with moderate to severe psoriasis to participate in the trial.

Paller said the researchers chose etanercept, because it's already being used to treat children with juvenile rheumatoid arthritis and appears to be safe in that population.

The study volunteers, all between the ages of 4 and 17, were randomly assigned to receive 12 weeks of once-weekly injections of 0.8 milligrams (mg) of etanercept or a placebo. After the initial 12-week phase of the study, everyone was put on once-weekly etanercept for 24 weeks. Finally, at 36 weeks, 138 study volunteers were randomly chosen again to receive either etanercept or a placebo.

After 12 weeks, 57 percent of those on etanercept showed a 75 percent or greater improvement in their symptoms, compared with 11 percent on a placebo. During the 24 weeks when everyone received etanercept, 68 percent of those who had initially been on etanercept and 65 percent of those who started on a placebo showed a 75 percent or greater response.

During the second "randomized" portion of the trial, 42 percent of those placed on a placebo began having symptoms again.

Several children experienced infections while on etanercept, but all recovered without complications, according to the study.

"This is an incredible result," Paller said. "What's really exciting is we were worried because we were using a pretty low amount of etanercept. In adults who achieved the same blood levels of etanercept, there was a 30 to 34 percent response [of 75 percent or more]. Kids clearly are showing a better response than adults," she added.

The study was funded by Immunex, the manufacturer of Enbrel.

"This study was not a surprise. Etanercept has been approved for several years for psoriasis. It's very effective in adults and has a reasonably good safety record," said Dr. Mark Lebwohl, chairman of the medical advisory board of the National Psoriasis Foundation, and chairman of the department of dermatology at Mt. Sinai School of Medicine in New York City.

"Children with psoriasis grow up with a stigma; they get made fun of. Psoriasis has a profound psychological impact as well as a physical impact. Effective treatment really changes the lives of these kids in a very beneficial way," Lebwohl said.

More information

To learn more about psoriasis, visit the U.S. National Library of Medicine.