"An experimental drug called briakinumab appears to be more effective than a standard medication https for treating psoriasis https a new study shows. The study is published in the New England Journal of Medicine. It included psoriasis https patients who were assigned to get monthly injections of briakinumab or to take methotrexate https pills weekly. The result The thick red flaking skin https lesions that are characteristic of psoriasis https cleared up in about three times as many patients who got briakinumab as those who got methotrexate. This drug has had in this trial the highest efficacy we have ever seen with any biologic in psoriasis https before says study researcher Kristian Reich MD. Biologics are genetically engineered proteins derived from human genes. Reich a partner at Dermatologikum Hamburg and professor of dermatology venerology and allergology at GeorgAugustUniversity in Gottingen Germany says that after a year of therapy roughly  of the  patients in the briakinumab group had near or complete clearance of their skin lesions. Those same results were achieved by about  to  of  patients in the methotrexate group. This is unheard of Reich tells WebMD. We in dermatology have never spoken about remission before. But with this drug the word remission is on the table. But as successful as the drug appears to be for some patients it may come with a significant risk. Patients taking briakinumab had more serious infections and more cancers than those taking methotrexate. We had amazing responses Reich says. Obviously the price that this comes with is the increased rate of serious infections and cancers. Abbott the company that makes briakinumab announced in January that it was withdrawing its bid to get the drug approved in the U.S. and Europe after regulators asked to see more robust proof that the medication was safe. At that time the company said it wanted to evaluate the next steps for briakinumab and might try for approval again at a later date. This is the single most effective drug weve had in psoriasis ever says Kenneth B. Gordon MD a dermatologist and clinical associate professor at the University of Chicagos Pritzker School of Medicine. Many of us were disappointed it was withdrawn because there would be a subset of patients who wouldnt respond to anything else and it would have been nice to have for them. Gordon was not involved in the current study but he has been involved in research of the drug and has been a paid consultant and investigator for Abbott. Causes of Psoriasis Psoriasis is caused by an overactive immune system that speeds up the growth cycle of the skin. In normal skin new cells surface about once a month. In psoriasis new cells surface in just three to four days. These cells build up into thick patches that have a silvery flaking crust. Psoriasis is thought to affect about  of the population and its misery may go deeper than skin. Psoriasis is a systemic disease Gordon says. People with psoriasis also have higher risks of cardiovascular disease https diabetes https depression https and alcoholism https he says. So when people think of psoriasis as limited to the skin it really isnt laying credence to the severity of the disease and the overall health of the individual. Its very debilitating as well. Briakinumab helps stem the bodys overactive immune system by blocking two proteins that drive inflammation https A similar drug Stelara which also blocks the same two proteins was approved by the FDA in . In studies Stelara did not appear to be associated with as many adverse events Reich says perhaps because it is not as complete an inhibitor of the two proteins as briakinumab or because it is given at lower doses. Even if the drug is never approved Reich says the study is still important because it proves that highly effective treatment of psoriasis is possible. I take this briakinumab as ... a shining example of how far we can get with efficacy. On the other hand I hear the warning signal that is contained in the study that we need to make sure that the big benefit contained in the study is not putting the patient at risk he says. Other experts say the study is important because it provides some of the first information about how well methotrexate works. After six months the study showed about  of patients who were taking weekly doses of methotrexate had at least a  improvement in their skin symptoms. That number dropped to  after a full year of treatment. Still fewer achieved complete clearance of their skin lesions. Serious adverse events occurred in . of patients on briakinumab compared to . of patients taking methotrexate group. There were a lot of people who thought methotrexate would work better than it does Gordon says. But because its a drug thats available cheaply as a generic he says methotrexate is an important treatment option."