More than 60% women with psoriasis did not engage in a discussion with their dermatologist about maternity plans and choosing safe therapy - according to the survey 'Parenting and procreation in the context of psoriasis' conducted by the AMICUS Psoriasis and Psoriasis Foundation as part of the Plan a New Life campaign.
There are two periods of developing psoriasis. The first, when psoriasis appears between 20 and 40 years of age. This type affects approximately 80% patients. 20% of patients are older people, after the age of 60 is the second type.
Prof. Dr. med. Irena Walecka, head of the Department of Dermatology CMKP/CSK MSWiA in Warsaw comments on the current situation - As far as women with mild psoriasis are concerned, we have therapeutic options for them also for the period of pregnancy and breastfeeding. There is a bigger problem with patients with moderate or severe psoriasis, because most of the drugs for these patients are not recommended and cannot be used because they have various side effects, including teratogenic effects. In such patients, but only during pregnancy, we can only use, in the absence of contraindications, cyclosporine, which is also not inert. On the other hand, biologic drugs, which seem to be best tolerated and are the best option for young patients with moderate to severe psoriasis, cannot be given to pregnant women in Poland. In the drug programmes of the NFZ, these patients absolutely have to use effective contraception for the entire period of drug use and (depending on the type of drug) from several weeks to several months after the end of therapy. In contrast, biologic treatment is administered to pregnant women worldwide. Recent recommendations from the American Academy of Dermatology allow anti-TNF-alpha drugs and these are recommended for pregnant women. I hope that this issue will be dealt with positively and women who are planning a pregnancy will be able to get such drugs. - Prof Walecka says.
A joint guideline from the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) on the treatment of psoriasis in adults with biologics and comorbidities, issued in early 2019, makes it clear that biologic drugs such as TNF-α Inhibitors are safe during pregnancy and lactation and in men planning to have children. The organisation also sets out specific conditions for the use of such therapy. (1)
Webinar on pregnancy planning and breastfeeding in the context of psoriasis
- Many women, but also men, come to our organisation with questions about the impact of treatment on the health of the planned child, on fertility, on but also on the possibility of conceiving a child. - says Dagmara Samselska, President of the AMICUS Foundation. - Taking into account the huge number of young people with psoriasis who are potential parents and the lack of education in this area, we decided to organise a The educational webinar "Planning a family. How to prepare for it while suffering from psoriasis".. The webinar will be hosted by Prof. Dr. med. Irena Walecka.
Thanks to the possibility of accessing the webinar via the Internet, people living in any corner of our country will be able to take part in the meeting. To take advantage of this opportunity, all you have to do is go to the website on 12 December at 7.30 p.m. http://luszczyca.edu.pl/2019/11/29/webinar-planujemy-rodzine-jak-sie-do-tego-przygotowac-chorujac-na-luszczyce/ There will also be an opportunity to ask the presenter questions via chat.
People with psoriasis fear becoming parents
When asked about psoriasis-related concerns surrounding parenting plans in the 'Parenting and procreation in the context of psoriasis' survey, the majority of respondents (women and men) answered that they felt a fear of burdening their child with psoriasis, due to its hereditary nature; some women feared psoriasis exacerbation during pregnancy; some feared that psoriasis would take away the ability to breastfeed. It is also sometimes the case that psoriasis sufferers give up on their parenting plans or having another offspring.
Workshop with a psychologist as part of the Plan a New Life campaign
Psoriasis is one of those chronic diseases that significantly affects the quality of life of patients. Approx. 62% of patients manifest symptoms of depression. Psychological support should be one of the elements that guarantee the effectiveness of therapy, says Samselska.
To support sick people, the AMICUS Foundation carries out psychological workshopswhich take place in various cities in Poland. The next ones, as part of the Plan a New Life campaign, will take place 14 December in Warsaw and will address fears and concerns about parenting, emotions and coping with a child's chronic illness. The workshop will be led by Agnieszka Bartczak, a psychologist who works with the Foundation.
The workshop is free of charge. More information and registration is available at https://evenea.pl/event/rodzicielstwo/
Psoriasis, a chronic, non-communicable inflammatory disease, affects more than 1 million Poles, about 80% are young people - planning to start a family or parents living in fear for their children's health. It is therefore very important to emphasise the importance of psychological support for patients. The mental state of a chronic disease patient translates into successful treatment. Education of the patients themselves, but also of GPs and specialists in many fields related to the treatment of comorbidities with psoriasis, also plays a key role.
More information on the Plan a New Life campaign can be found at www.luszczyca.edu.pl in the PROJECTS tab and on the campaign's dedicated Fanpage www.facebook.com/luszczycaPlanujemyNoweZycie #PplanningNewLife
(1) Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics Menter, Alan et al. Journal of the American Academy of Dermatology, Volume 80, Issue 4, 1029 - 1072. DOI: https://doi.org/10.1016/j.jaad.2018.11.057 (accessed 29.11.2019)
(press release)