This study evaluated the diagnostic accuracy of multiphoton microscopy (MPM) in psoriasis and its potential application in therapeutic monitoring.

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Background and Objectives:
Psoriasis is a chronic inflammatory skin disease, and noninvasive diagnostic tools are essential for accurate diagnosis and treatment monitoring. Multiphoton microscopy (MPM) enables real-time, noninvasive skin imaging with submicron resolution. This study evaluated the diagnostic accuracy of MPM in psoriasis and its potential application in therapeutic monitoring.

Patients and Methods:
This prospective observational study enrolled 34 patients with psoriasis. It comprised three parts: (1) analysis of imaging features of lesional and nonlesional skin using multiphoton microscopy (MPM; Transcend Vivoscope); (2) evaluation of the diagnostic performance of MPM parameters compared with reflectance confocal microscopy (RCM); and (3) prospective monitoring of 24 patients treated with Benvitimod (Tapinarof) cream for 8 weeks (T0/T1/T2).

Results:
MPM detected psoriasis characteristics (including hyperkeratosis, parakeratosis, an absent stratum granulosum, enlarged nucleus diameter, and absent bright rimming) with comparable diagnostic efficiency to RCM (AUC = 0.838, p < 0.001 vs. 0.824, p < 0.001). Psoriatic lesions showed significant perinuclear fluorescence accumulation compared to healthy skin (p < 0.001). All imaging features improved significantly after 8 weeks of treatment (p < 0.001). PASI/TLS scores showed correlations with the epidermal thickness (r = 0.403/0.492, p < 0.001), nuclear diameter (r = 0.4/0.375, p < 0.001), and fluorescence intensity (r = –0.419/–0.492, p < 0.001).

Conclusions:
MPM is a novel and non-invasive imaging technique for psoriasis evaluation and treatment monitoring.

If you are using injections for psoriasis which type do you prefer, pen type (auto injector) or prefilled syringe ?

Members and guests can vote in the poll above, and our members are welcome to post in this thread too if they wish.

Efficacy and safety of Rinvoq (upadacitinib) in palmoplantar pustulosis study highlights the complex immune response patterns.

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Background and objectives: 
Palmoplantar pustulosis (PPP) is a chronic and refractory inflammatory skin disorder with unclear pathogenesis.

Patients and methods: 
Ten PPP patients treated with upadacitinib were monitored to assess efficacy and safety. Immunofluorescence and immunohistochemistry were employed to evaluate Th1, Th2, and Th17 cell expressions, along with their associated cytokines in lesions on palms or soles from 16 PPP patients, 10 chronic eczema (CE) patients, 10 psoriasis vulgaris (PV) patients, and 7 healthy controls (HC).

Results:
 In PPP patients receiving upadacitinib, the shortest time to achieve PPPASI75 and PPPASI90 was 4 weeks and 8 weeks, respectively. The rates of patients achieving PPPASI90 at week 16, week 24, and week 52 was 70 %, 100 %, and100 %, respectively. Th1 cells and IFN-γ levels in PPP were comparable to CE and PV, and higher than HC. Th2 cells, IL-4, and IL-13 levels in PPP were similar to CE, and greater than HC and PV. Th17 cells, IL-17, and IL-36γ levels in PPP were comparable to PV, and more abundant than HC and CE.

Conclusions: 
Upadacitinib is a safe and effective option for PPP patients, which may be attributed to the complex Th1, Th2, and Th17 inflammatory responses associated with PPP.

This study suggests TYK2 inhibitors for psoriasis show improvements in both skin and mood symptoms and enhanced patient adherence to treatment regimens.

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Background:
Psoriasis and depression frequently coexist, creating a complex, bidirectional relationship that complicates treatment. This study, integrating clinical assessments with transcriptomic and metabolomic analyses, hypothesizes that TYK2 (tyrosine kinase 2) inhibitors possess a dual therapeutic potential to simultaneously address both dermatological manifestations of psoriasis and the frequently accompanied depressive symptoms.

Methods:
In a cohort of 298 psoriasis patients evaluated using the Hospital Anxiety and Depression Scale (HADS), participants were categorized into a TYK2 inhibitor group, a Janus kinase (JAK) inhibitor group, and a non-JAK pool (comprising interleukin [IL]-23 biologics, IL-17 biologics, and other treatments) to avoid overlapping JAK pathway inhibition. Statistical analysis was conducted using generalized linear models (GENMOD), with adjustments for the following covariates: age, sex, Psoriasis Area and Severity Index (PASI), body surface area (BSA), prior systemic or biologic therapy within 12 months, disease duration, and phototherapy history.

Results:
For HADS-D scores, the TYK2 inhibitor group showed significantly lower values compared with the non-JAK pool (β = 1.23, 95% confidence interval [CI]: 0.37–2.10). However, no significant differences were observed when compared with the IL-23 biologics group (β = 0.67, 95% CI: −0.76–2.10) or the JAK inhibitor group (β = 0.84, 95% CI: −1.54–3.21). Transcriptomic analysis of peripheral blood revealed significant downregulation of genes related to the IL-6 receptor, long-term depression pathways, and Th17 cell differentiation, while pathways associated with neuronal activity were upregulated. Metabolomic profiling highlighted a decrease in kynurenic acid, which is known for its pro-inflammatory and depressive effects, and an increase in 1H-indole-3-propanoic acid, an anti-inflammatory metabolite with neuroprotective properties. It is important to note that these findings are based on exploratory omics analyses, for which false discovery rate (FDR) control was applied.

Conclusions:
These findings provide a hypothesis that TYK2 inhibitors disrupt the persistent “peripheral inflammation–central depression” cycle by targeting the IL-23/Th17 axis and modulating the IL-6/tryptophan metabolic hub. This innovative, multi-targeted approach represents a possibility for treating psoriasis with comorbid depression, offering not only clinical improvements in both skin and mood symptoms but also enhanced patient adherence to treatment regimens.

Could cobalt phosphide nanoparticles deposited on carbon polyhedral framework help psoriasis ? This study suggests it could.

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Psoriasis, a chronic inflammatory skin disease characterized by oxidative stress and dysregulated immunity, necessitates innovative therapies to overcome the limitations of conventional treatments. This study introduces cobalt phosphide nanoparticles deposited on carbon polyhedral frameworks (CoP-C PFs) as a multifunctional nanoplatform integrating enzyme-mimicking catalysis and photothermal activity for synergistic psoriasis management.

CoP-C PFs exhibit superior catalytic efficiency, with low Michaelis-Menten constants (e.g., Km = 0.26 mM for H2O2 decomposition), enabling potent reactive oxygen species (ROS) scavenging to alleviate oxidative damage in RAW264.7 macrophages and HaCaT keratinocytes. Under 808 nm near-infrared irradiation, CoP-C PFs exhibit a high photothermal conversion efficiency of 68.6%, enabling precise control of the local temperature to generate localized hyperthermia to enhance catalytic ROS elimination and antibacterial activity.

In an imiquimod-induced psoriatic murine model, CoP-C PFs alleviated inflammation by restoring redox balance, suppressing CD3+ T cell/F4/80+ macrophage infiltration, modulating IL-17A/IL-23 and TNF-α/NF-κB pathways, and promoting M2 macrophage polarization (increased CD206+/CD68+ ratio), resulting in epidermal normalization and reduced abnormal keratinization without organ toxicity, underscoring effectiveness and biosafety.

By integrating photothermal enhancement with multienzyme catalysis, this “all-in-one” nanozyme platform enables dual regulation of oxidative stress and immune microenvironment, offering a promising therapeutic strategy for psoriasis and other inflammatory skin disorders.

This study aimed to evaluate the expression of Enhancer of Zeste Homologue 2 (EZH2) across immune cell subsets in the peripheral blood of patients with psoriasis.

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Enhancer of Zeste Homologue 2 (EZH2) is an epigenetic regulator involved in immune cell differentiation and function; however, its role in psoriasis remains unknown.

This study aimed to evaluate EZH2 expression in peripheral blood mononuclear cells from patients with psoriasis and explore its potential functional relevance to disease pathogenesis. Peripheral blood samples were obtained from 40 psoriasis patients and 18 healthy controls, and EZH2 expression in T cell and monocyte subsets was analysed by flow cytometry. EZH2 expression was significantly reduced in circulating CD8+ naïve and memory T cells, as well as in monocyte subsets from psoriasis patients compared to healthy controls. EZH2 levels in CD8+ naïve T cells showed a significant inverse correlation with disease severity scores.

Functional analyses revealed that pharmacological EZH2 inhibition suppressed IL-17A expression in peripheral blood mononuclear cells under IL-23/IL-1β stimulation. In addition, immunofluorescence staining identified EZH2-positive T cells and monocytes within psoriatic skin lesions.

Collectively, these findings suggest that EZH2 may be involved in the regulation of type 3 inflammatory responses and may therefore represent an epigenetic regulator contributing to psoriasis pathogenesis.

This was passed to me by Waine

Taltz (ixekizumab) and Zepbound (tirzepatide) used together delivered superior efficacy in first-of-its-kind Phase 3b trial for adults with active psoriatic arthritis and obesity or overweight.

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Eli Lilly and Company announced positive topline results from the novel TOGETHER-PsA open-label Phase 3b trial evaluating the concomitant use of Taltz (ixekizumab) and Zepbound (tirzepatide) compared to Taltz alone in adults with active psoriatic arthritis (PsA) and obesity or overweight with at least one weight-related condition. At 36 weeks, treatment with concomitant Taltz and Zepbound met the primary and all key secondary endpoints for superiority to Taltz monotherapy. TOGETHER-PsA is the first controlled study to evaluate an incretin therapy used with a PsA biologic. An estimated 65% of adults with PsA in the U.S. also have obesity (BMI ≥30 kg/m²) or overweight (BMI 27-29.9 kg/m²) with at least one additional weight-related comorbidity, highlighting a need for integrated treatment approaches that address the full burden of their diseases.

In the study, 31.7% of patients in the Taltz plus Zepbound treatment arm achieved a 50% improvement in PsA activity, based on American College of Rheumatology 50 (ACR50), and weight reduction of at least 10%, compared to 0.8% of patients on Taltz monotherapy, meeting the primary endpoint (p<.001). In a key secondary endpoint, Taltz plus Zepbound delivered a 64% relative increase over Taltz monotherapy in the proportion of patients who achieved ACR50 (33.5% of patients vs. 20.4%, respectively, p<.05), demonstrating that treatment of obesity or overweight with Zepbound reduced the burden of PsA. The study population included patients with a high disease burden at baseline and an average BMI of 37.6 kg/m2 across both arms. Patients had high disease activity and meaningful functional impairment. More than 60% had prior experience with one or more advanced therapies, reflecting a difficult-to-treat patient population.

"TOGETHER-PsA represents a pioneering first step leveraging Lilly's leadership in incretin science to deliver a major advance in disease outcomes for people living with the cumulative burden of psoriatic arthritis and obesity or overweight," said Mark Genovese, M.D., senior vice president of Lilly Immunology development. "This is the first controlled pharmacologic study to demonstrate that treatment of obesity improved PsA disease measures, and we are particularly impressed with the findings showing significant improvement in PsA disease activity with Zepbound used alongside Taltz, an already rapid-acting and durable PsA treatment. These results demonstrate how an integrated treatment approach has the potential to improve the standard of care in a compelling and comprehensive way."

Adverse events in participants treated with concomitant administration of Taltz and Zepbound were generally mild to moderate, and the types of adverse events were consistent with the known safety profile of each medicine. The most common adverse events occurring in ≥5% of participants were nausea, diarrhea, constipation and injection site reactions in the concomitant treatment arm, and injection site reactions and upper respiratory tract infections in the Taltz monotherapy arm.

Taltz is a monoclonal antibody that selectively binds with interleukin 17A (IL-17A) cytokine and inhibits its interaction with the IL-17 receptor. Zepbound is the only FDA-approved dual GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) receptor agonist obesity management medication.

"While treatment guidelines for psoriatic arthritis recommend management of obesity, the reality is these two chronic diseases are often addressed separately and moving the needle in psoriatic arthritis has remained challenging," said Joseph F. Merola, M.D., Professor and Chair, Department of Dermatology and Professor of Internal Medicine in the Division of Rheumatic Diseases, UT Southwestern Medical Center. "The observed benefit with treatment using Taltz and Zepbound appears to meaningfully impact psoriatic disease activity, indicating that for many patients, PsA is an obesity-related condition. This integrated therapy approach represents a potential paradigm shift and could lead to better outcomes for those living with both diseases."

Hi,

I'm from Cape Town, South Africa and am in my mid 50s. Have been diagnosed with PsA since 2020 but have had it probably since 2007 when it was first diagnosed as carpal tunneil syndrome. I've recently begun treatment with Humira after being on Methotrexate, Salazopyrin and anti-inflammatory pills. Unfortunately these caused my to develop Chronic Kidney Disease and Liver fibrosis, causing the need to switch. I am also on Prednisone, although my Rheumatologist wants to phase it out once the Humira is working effectively. 

It's nice to find a forum where other people can share experiences so that I don't feel quite so alone in the struggle, thank you to the founders and members!

Vunakizumab is a subcutaneous anti-interleukin (IL)-17A humanized monoclonal IgG1/κ antibody being developed by Suzhou Suncadia Biopharmaceutical for the systemic treatment of psoriasis and psoriatic arthritis.

This is a post hoc analysis of a phase III, randomised controlled trial.

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This study was a post hoc analysis of a Phase III trial (NCT04839016), which aims to investigate whether early response to vunakizumab can predict long-term efficacy in plaque psoriasis patients.

A total of 461 plaque psoriasis patients receiving vunakizumab treatment were included for analysis. Early response to vunakizumab was defined by patients achieving a psoriasis area and severity index (PASI) 50 at week (W) 2. Efficacy analysis included PASI 75/90/100 and static physician's global assessment (sPGA) 0/1 response rates in both groups. Safety was analysed in both groups.

At W2, 249 patients achieved an early response; 212 did not. At W12, higher proportions of patients in the early response group achieved PASI 75/90/100 and sPGA 0/1 versus the without early response group (98.4% vs. 88.2%, 88.0% vs. 66.0%, 50.2% vs. 25.0%, 84.7% vs. 64.6%, respectively; all p < 0.001). The early response group had higher proportions of patients who maintained PASI 75/90/100 and sPGA 0/1 from W12 to W52 versus the without early response group (88.8% vs. 76.4%, 74.7% vs. 54.7%, 39.4% vs. 20.8%, 68.7% vs. 54.2%, respectively; all p < 0.001).

Multivariate logistic regression analysis showed that early response to vunakizumab was independently associated with PASI 100 response at W52 (odds ratio = 1.772, p = 0.027). The incidence of adverse events was similar between groups. Patients with moderate-to-severe plaque psoriasis receiving vunakizumab show a favourable clinical response, regardless of achieving early response or not. Particularly, patients with early response at Week 2 are significantly more likely to achieve better long-term treatment outcomes.

Wishing all our members a very happy and healthy new year, if you haven’t posted for a while do pop-in and tell us how things are going.

If on the other hand you are not a member why not come and joins us, you will find a very friendly bunch of people ready to listen and share information about living with psoriasis.

Pphytoconstituents of Euphorbia neriifolia exhibit stronger binding affinities toward the receptor protein 5hi4 (macrocyclic IL-17A antagonist) compared to the standard anti-psoriatic drugs Methotrexate and Apremilast.

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Psoriasis is a chronic autoimmune skin disorder characterized by persistent inflammation and excessive keratinocyte proliferation. Although conventional immunosuppressive therapies are clinically effective, their long-term use is often associated with adverse side effects, highlighting the need for safer alternative treatments.

Euphorbia neriifolia, a traditional medicinal plant known for its anti-inflammatory properties, has been investigated for its potential anti-psoriatic activity. In the present study, molecular docking was performed to evaluate the binding affinities of key phytoconstituents from E. neriifolia against interleukin-17A (IL-17A; PDB ID: 5HI4), a major cytokine implicated in psoriasis pathogenesis.

Docking analysis revealed that compounds such as Taraxerol, Glutinol acetate, and Epifriedelanol showed the highest binding affinities, with scores of −10.3, −10.0, and −10.0 kcal/mol, respectively, surpassing the reference drug methotrexate (−9.2 kcal/mol). Density functional theory (DFT) calculations further supported the electronic stability and reactivity of the top-ranked compounds, indicating their potential suitability as bioactive leads.

The integration of docking and DFT results highlights the novelty of this study, as E. neriifolia phytochemicals have not been extensively explored against IL-17A compared to other medicinal plants studied for psoriasis. The in vitro biological activity of the plant extract was also evaluated by using the L929 fibroblast bioassay, and the IC50 value was found to be 168.18 μg/mL.

Overall, the findings suggest that selected phytochemicals from E. neriifolia exhibit promising interactions with IL-17A, supporting their possible therapeutic role in psoriasis. These findings support further mechanistic and in vivo studies to validate IL-17A inhibition.

Takeda’s Zasocitinib landmark phase 3 plaque psoriasis data show promise to deliver clear skin in a once-daily pill, catalyzing a new era of treatment.

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Takeda today announced positive topline results for the two pivotal Phase 3 randomized, multicenter, double-blind, placebo- and active comparator-controlled studies of zasocitinib (TAK-279), a next-generation, highly selective oral tyrosine kinase 2 (TYK2) inhibitor, in adults with moderate-to-severe plaque psoriasis (PsO). The studies demonstrated superiority of zasocitinib compared to placebo for the co-primary endpoints, static Physician Global Assessment (sPGA) 0/1 and Psoriasis Area and Severity Index (PASI) 75, at week 16, with a significantly greater PASI 75 response rate seen as early as week 4 and continuing to increase through week 24. The studies also met all 44 ranked secondary endpoints, including PASI 90, PASI 100 and sPGA 0 against placebo and apremilast, showing the potential of a convenient once-daily pill to deliver complete skin clearance for patients with PsO.

Zasocitinib was generally well-tolerated. The safety and tolerability profile of zasocitinib in the Phase 3 studies remained consistent with prior studies, including the Phase 2b plaque psoriasis study. The most common adverse events through week 24 were upper respiratory tract infection, nasopharyngitis and acne, with no new safety signals identified. “It is incredibly rewarding and exciting to see our Phase 2 results validated in Phase 3, with more than half of patients treated with zasocitinib achieving clear or almost clear skin (PASI 90) and about 30 percent achieving completely clear skin (PASI 100) at week 16, with response rates continuing to increase through week 24,” said Andy Plump, M.D., Ph.D., president of R&D at Takeda. “These findings help demonstrate that highly selective inhibition of TYK2, a key mediator of IL-23 and other signaling pathways fundamental to psoriasis, may provide patients with significant reductions in their disease burden, including for many, the possibility of complete skin clearance.”

Takeda intends to present the results at upcoming medical congresses and plans to submit a New Drug Application with the United States Food and Drug Administration and other regulatory authorities starting in fiscal year 2026.

Zasocitinib is also being evaluated in a head-to-head study against deucravacitinib in plaque psoriasis and psoriatic arthritis.

A systematic review of clinical outcomes and safety profiles of Phosphodiesterase-4 (PDE4) inhibitors in managing psoriasis and psoriatic arthritis.

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Background:
Phosphodiesterase-4 (PDE4) inhibitors exert therapeutic effects by blocking intracellular signal transduction pathways. Recently, their use in the treatment of psoriasis (PSO) has shown promising results in several clinical trials. However, methodological data on their safety and efficacy are limited.

Methods:
A search for randomized controlled trials (RCTs) involving PDE4 inhibitors in PSO and psoriatic arthritis (PsA) was conducted using pub med, Embase, and Cochrane Library databases from January 2012 to October 2023. For PSO and PsA, the Psoriasis Area and Severity Index (PASI) 75 and the American College of Rheumatology (ACR) 20 were set as the primary efficacy endpoints. Adverse events (AEs) were categorized based on eight human body systems.

Results:
A comprehensive analysis of 28 RCTs involving 6825 patients who were orally or topically administered PDE4 was performed. Those who were administered 30 mg apremilast twice daily demonstrated boosted response rates for ACR 20 and PASI 75. To a lesser extent, enhanced response rates for PASI 75 and ACR 20 were observed in patients who received 20 mg apremilast twice daily. Adverse effects were predominantly minor and included diarrhea, nausea, and headache.

Conclusions:
The analysis concluded that the efficacy of PDE4 in treating PSO and PsA was superior to that of the placebo, particularly with apremilast at a dosage of 30 mg taken twice daily. The adverse reactions were mild.

I've read some of our members have been prescribed Prednisolone so I thought I would put up a recall notice.

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Activase Pharmaceuticals Limited is recalling two batches of Prednisolone 5mg Soluble Tablets as a precautionary measure due to a limited number of reports of blister pockets becoming swollen over time.


Affected Lot Batch Numbers

Batch No	Expiry date	Pack size	First distributed
2409006	31/05/2027	30	06/03/2025
2409007	31/05/2027	30	06/05/2025

Patients should continue to take the medication from these batches unless the blister strips exhibit signs of swelling as the quality of the tablets will not be impacted. If you have received one of the batches of medication and the blister strip exhibits swelling, return it to your dispensing pharmacy. If you have any concerns about your medication speak to your pharmacy in the first instance.

This recall is being actioned at pharmacy and wholesaler level as a precautionary measure.

*Activase Pharmaceuticals Limited have confirmed that this issue is limited to the batches listed in this notification and that no other batches are affected.

This study aims to describe from diagnosis, the patient demographics, disease characteristics, treatment patterns and disease progression in a cohort of patients diagnosed with psoriasis to understand real-world clinical practice for managing these patients.

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Background:
Categorisation of psoriasis (PsO) disease severity in patients varies, although body surface area (BSA) affected is commonly used (< 3% ‘mild’, 3%–10% ‘moderate’ and > 10% ‘severe’). While moderate-severe PsO has been well-studied, more limited information regarding mild-to-moderate PsO is available.

Objectives:
To assess diagnosis, treatment patterns and disease progression for patients diagnosed with mild-to-moderate PsO.

Methods:
Data were drawn from the Adelphi Real World PsO Disease Specific Programme, a cross-sectional survey with retrospective data collection from dermatologists and their consulting adult PsO patients in France, Germany, Italy, Spain and the United Kingdom, conducted December 2021 to March 2022. Dermatologists reported on patient demographics and clinical characteristics at survey, diagnosis and treatment initiation. Patients self-reported the impact of PsO on their quality of life.

Results:
Overall, 209 dermatologists provided data for 875 patients, with 356 (40.7%) providing self-reported data. At initial presentation, 35.3% of patients were diagnosed with mild PsO, despite 79.7% of these patients having a BSA of 3%–10%. Further, 64.7% of patients were diagnosed with moderate PsO, although 62.8% had a BSA > 10%. Between diagnosis and current treatment initiation, patients diagnosed with mild PsO showed greater deterioration than those diagnosed with moderate PsO (mean relative BSA increase of 113.2 ± 307.2% compared to 17.7 ± 93.6%; p < 0.001).
Most patients received topical therapy and/or phototherapy at diagnosis (mild: 94.9%, moderate: 85.5%; p < 0.001). Those diagnosed with moderate PsO were more likely to receive systemic treatments at diagnosis (p < 0.001) and biologics at diagnosis and time of survey (p = 0.029 and p < 0.001, respectively).
Patients diagnosed with moderate PsO showed greater quality-of-life impact in the DLQI (p = 0.006) and WPAI (p = 0.002 and p = 0.006, respectively).

Conclusions:
Dermatologists may underestimate severity and treatment requirements in patients diagnosed with mild-moderate PsO. Further research into PsO underdiagnosis and advanced treatment use in cases of mild PsO may provide better optimised treatment strategies.

The primary objective of this study was to assess current practices for latent tuberculosis infection (LTBI) screening and the use of preventive tuberculosis therapy before starting systemic psoriasis therapies, specifically Methotrexate (MTX) and IL-17/IL-23/IL-12/23p40 inhibitors.

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Background and Objectives:
Preventive tuberculosis (TB) therapy before initiating MTX or IL-17/IL-23/IL-12/23p40 inhibitors for latent tuberculosis infection (LTBI) is supported by indirect evidence of TB reactivations with TNF inhibitors. However, direct evidence for MTX or IL-17/IL-23/IL-12/23p40 inhibitors is limited. To better evaluate the risk of TB reactivation, data on LTBI patients exposed to these medications without preventive TB therapy are necessary. This study was conducted as part of the update of the European and German psoriasis guidelines aimed to assess current LTBI screening and preventive treatment practices.

Patients and Methods:
An online survey was distributed via German, European and international dermatological societies, yielding 326 complete responses.

Results:
LTBI screening was performed by 45% of respondents before MTX initiation and 95% before IL-17/IL-23/IL-12/23p40 inhibitors. Preventive TB therapy was initiated “always” or “almost always” in 38% of MTX cases and “never” or “almost never” in 31%. For IL-17/IL-23/IL-12/23p40 inhibitors, preventive TB therapy was used in 66% of cases “always” or “almost always,” 16% case-by-case and 9% “never” or “almost never.”

Conclusions:
LTBI screening and preventive TB therapy for MTX lack standardization. While screening is common for IL-17/IL-23/IL-12/23p40 inhibitors, a significant proportion of LTBI patients receive these treatments without preventive TB therapy.

Pecondle a monoclonal antibody targets the IL-23p19 subunit, preventing IL-23 from binding to cell surface receptors and has the potential to offer a more effective treatment option for patients with psoriasis.

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PECONDLE® (picankibart injection) has received approval from China's National Medical Products Administration (NMPA) for the treatment of moderate-to-severe plaque psoriasis in adult patients who are candidates for systematic therapy.
 
PECONDLE® is the world's first IL-23p19 antibody whose registrational Phase 3 clinical trial met its primary endpoint with over 80% of subjects achieving a 90% improvement in the Psoriasis Area and Severity Index (PASI 90) at Week 16.
   
Among comparable biologics, PECONDLE® offers the longest dosing interval during the maintenance period (once every 12 weeks). It is poised to provide Chinese patients with moderate-to-severe plaque psoriasis comprehensive benefits, including significant skin clearance, improved quality of life, and enhanced dosing convenience.

This approval was based on a pivotal registrational Phase 3 clinical trial, CLEAR-1 (NCT05645627), which evaluated the efficacy and safety of picankibart in Chinese participants with moderate-to-severe plaque psoriasis. The study results showed that:

• At week 16, the proportion of participants achieving PASI 90 (80.3%) and sPGA 0/1 (93.5%) was significantly higher in the picankibart group than in the placebo group (2.0% and 13.1%, p < 0.0001 for both);
  
  
• At week 52, the proportions of participants achieving PASI 90 and sPGA 0/1 in the picankibart 100 mg and 200 mg q12w maintenance treatment groups were stable and maintained at a high level;
  
  
• The proportion of participants who achieved PASI 75, PASI 100, sPGA 0, and DLQI 0/1 was significantly higher in the picankibart group than in the placebo group (p < 0.0001), and picankibart showed varying degrees of improvement in psoriasis in special areas (scalp, nail, palmoplantar and perineal);
  
  
• The overall safety of picankibart was favorable. The most common adverse events (AEs) was upper respiratory tract infection, which was consistent with the safety profile of other IL-23p19 agents. No new safety signals were identified.
  

There could soon be a patch for treating psoriasis.

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Psoriasis is promoted by signaling through the IL-23/IL-17 pathway. Existing oral or topical treatment regimens can hardly balance acute flare-ups with long-term maintenance.

A dual-layer soluble microneedle (MN) that combines methylprednisolone (MP) and upadacitinib (UPA) was developed using an immediate-release–controlled-release spatiotemporal program to achieve rapid anti-inflammatory effects and sustained immunosuppression. The outer layer contains mechanically robust gelatin–polyvinyl alcohol (Gel-PVA) hydrogel loaded with MP, while the inner layer contains light-curable methyl acrylate hyaluronic acid (MeHA) to encapsulate UPA (UPA/SBA-15)-loaded mesoporous silica.

The results revealed that the MNs penetrated the thickened stratum corneum, releasing 70% of MP within 2 h, and UPA release was sustained via SBA-15 mesopores over the next 48 h, significantly inhibiting IL-17A, IL-1β, IL-6, and TNF-α expression. In a psoriasis mouse model, the patch group revealed an approximately 90% Psoriasis Area and Severity Index (PASI) reduction, with normal pathological epidermal thickness achieved.

Compared with those in the tacrolimus group (positive control group), serum and skin inflammatory factor levels were significantly lower, with no systemic toxicity. This MN platform achieves pain-free, precise, and low-toxicity transdermal glucocorticoid and JAK1 inhibitor delivery through synergistic effects of mechanical penetration and mesoporous sustained release, offering translational potential for personalized psoriasis treatment.

This study set out to determine whether biologic therapy for psoriasis is associated with a reduced incidence of psoriatic arthritis.

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Background:
Psoriasis is a chronic inflammatory skin disorder that often precedes psoriatic arthritis. Conflicting evidence exists regarding whether biologic therapies for psoriasis can prevent or delay psoriatic arthritis onset.

Objectives:
To determine whether biologic therapy for psoriasis is associated with a reduced incidence of psoriatic arthritis.

Methods:
A retrospective cohort study was performed utilizing Optum's de-identified Clinformatics® Data Mart Database, from January 1, 2007, to February 29, 2024. Patients with moderate-to-severe psoriasis were identified by phototherapy use. Among these, some continued on phototherapy, and others switched to a biologic. Individuals with a psoriatic arthritis diagnosis or history of biologic therapy prior to phototherapy initiation were excluded. Cases of psoriatic arthritis developing within 1 year after biologic initiation were also excluded to minimize protopathic bias. Outcomes included the incidence of psoriatic arthritis, measured as incident cases per 1000 person-years. Hazard ratios (HRs) for psoriatic arthritis development were calculated using a multivariable Cox proportional hazards model.

Results:
Of 36,508 patients who received phototherapy for psoriasis, 26,470 met eligibility criteria. Among these, 2611 patients switched to biologics, while 23,859 patients did not. The overall PsA incidence rate was 7.85 per 1000 person-years. Patients continuing phototherapy alone had an incidence rate of 8.06 per 1000 person-years, compared with 6.75 in the biologic cohort. After multivariable adjustment for demographics, comorbidities, insurance type and oral systemic therapy, biologic use was associated with a lower likelihood of psoriatic arthritis development compared with phototherapy (adjusted HR, 0.66; 95% CI, 0.53–0.83; p < 0.05).

Conclusions:
In this study of moderate-to-severe psoriasis patients, those who initiated biologic therapy demonstrated a lower incidence of psoriatic arthritis than those continuing on phototherapy alone. This suggests that biologic treatments may delay or prevent psoriatic arthritis in psoriasis patients.

Ergosterol is a sterol found in fungi and this study suggest it could be used in the management of psoriasis.

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Retinoic acid receptor-related orphan receptor gamma-t (RORγt) is one of the nuclear receptor transcription factors that plays a key role in the differentiation of pro-inflammatory IL-17+ T helper cells. Recently, RORγt has attracted increasing attention as a potential drug target for the treatment of several human inflammatory diseases, including psoriasis and Crohn's disease.

In this study, we revealed that ergosterol (ERG) was a novel RORγt inverse agonist, which decreased RORγt transcriptional activity, to regulate collagen fiber deposition and to inhibit pro-inflammatory cytokines, including TNF-α, IL-1β, IL-6, IL-17, IL-22, and IL-23 in the skin lesions of IMQ-induced mice with psoriasis. Furthermore, ERG could repair the epidermal barrier function by upregulating tight junction proteins, such as claudin, occludin, and ZO-1, thereby alleviating psoriasis symptoms.

These findings suggested that ERG might be used as a promising novel RORγt inverse agonist in the management of psoriasis.