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.

Hello everyone,

I have a diagnosis of psoriasis, made a couple of months ago.  Legs, thighs, arms, hands and feet.   Using Enstilar at the moment which helps.

I had a diagnosis of atopic eczema, full body, about a year ago,  got better over time, then bright red rectangular patch on both forelegs, no-one very sure what that was, and  dermatology said varicose eczema, but I think that was wrong. That faded with steroid cream.  Now had a rather typical psoriasis rash.

So I know its early days for me.... I am 78 years old. I also have severe Chronic Kidney failure,  no dialysis though yet.



I am curious to know if the progression from atopic eczema to psoriasis is common, or recognised, or unusual.  

Thank you for reading this, and for any reply

Patrick

In areas of high impact, 72% of patients with scalp psoriasis and 85% with genital psoriasis treated with icotrokinra achieved site-specific clear or almost clear skin at Week 52 in Phase 3 ICONIC-TOTAL study.

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Johnson & Johnson today announced new long-term 52-week data from the Phase 3 ICONIC-TOTAL study evaluating icotrokinra, a first-in-class investigational targeted oral peptide that precisely blocks the IL-23 receptor, in adults and pediatric patients 12 years of age and older (adolescents) with plaque psoriasis (PsO) affecting high-impact sites.

The ICONIC-TOTAL study, simultaneously evaluated adults and adolescents with at least moderate scalp, genital and/or hand/foot plaque psoriasis with ≥1% Body Surface Area (BSA) affected. Through Week 52, icotrokinra demonstrated high and durable rates of site-specific psoriasis clearance affecting all of these high-impact and difficult-to-treat areas of the body.

• 72% of patients with scalp psoriasis achieved a scalp-specific Investigator’s Global Assessment (ss-IGA) 0/1 score and 57% achieved ss-IGA 0
  
• 85% of patients with genital psoriasis achieved a Physician’s Global Assessment of Genitalia (sPGA-G) 0/1 and 73% achieved sPGA-G 0
  

In the smaller subset of patients with hand/foot psoriasis, treatment with icotrokinra showed a numerically higher rate of skin clearance at Week 16, which increased through Week 52 with patients achieving a hand and/or foot Physician’s Global Assessment (hf-PGA) score of 0/1 increasing from 42% to 62%.

“Many of the patients in my practice experience significant distress when psoriasis affects sensitive areas such as the scalp, genitals, hands, and feet,” said Edward (Ted) Lain, MD, MBA Executive Director of the Austin Institute for Clinical Research in Austin, Texas, and study investigator. “The durable response rates observed in the ICONIC-TOTAL study show that icotrokinra has the potential to be a meaningful new option for effectively managing moderate-to-severe plaque psoriasis long-term in both adults and adolescents.”

Overall response rates among patients treated with once daily icotrokinra were maintained through Week 52, with 67% of patients treated with icotrokinra achieving clear or almost clear skin (Investigator’s Global Assessment (IGA)f 0/1) and 44% achieving completely clear skin (IGA 0) at Week 52. The overall response rates were also comparable among patients who received icotrokinra for all 52 weeks and those who transitioned from placebo to icotrokinra at Week 16 (67% versus 68% achieved IGA 0/1, respectively). Across treatment groups, adverse event and serious adverse event rates were similar through Week 52 compared to those through Week 16, with no new safety signals identified.

“The new long-term data from ICONIC-TOTAL adds to the robust findings seen across several studies this year, including the recently reported ICONIC-LEAD 52-week data,” said Liza O’Dowd, MD, Vice President, Immunodermatology and Respiratory Disease Areas Lead, Johnson & Johnson Innovative Medicine. “Psoriasis that affects high-impact skin sites often results in greater physical discomfort for patients due to the sensitivity of these areas. Icotrokinra is being developed with the goal of setting a new standard of treatment that offers patients the precision of a targeted therapy, high level skin clearance and favorable safety profile with the ease of a once daily pill.”

si-544 has demonstrated an excellent safety and tolerability profile in two completed Phase 1b clinical trials in atopic dermatitis patients and, more recently, in psoriasis.

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selectION, Inc a clinical-stage biopharmaceutical company developing novel treatments for T cell-mediated autoimmune diseases, today announced the successful completion of its phase 1b proof-of-concept trial evaluating si-544, a first-in-class Kv1.3 blocker in patients diagnosed with psoriasis vulgaris.

“These results mark a significant milestone, as si-544 has, for the first time, clinically confirmed the long hypothesized and remarkable therapeutic potential of Kv1.3 in T cell autoimmunity,” said Antonius Schuh, Ph.D., CEO of selectION. “This trial clinically validates Kv1.3 dependency as an ideal clinical entry point to disrupt the chronic activation of pathogenic, autoreactive T cells. si-544 has the potential to become a disease modifying and safe treatment option, offering meaningful and durable reduction of disease burden across a broad spectrum of T cell-mediated autoimmune diseases.”

This Phase 1b study was a randomized, double-blind, placebo-controlled proof-of-concept trial in patients diagnosed with mild-to-severe psoriasis vulgaris. Patients received 2 subcutaneous injections of si-544 or placebo (ratio 3:1) per week over a period of 4 weeks and were monitored for a period of 12 weeks post drug washout.

The trial enrolled 45 patients across four clinical sites in Germany. Its primary objective was to evaluate the safety and tolerability of si-544, including monitoring adverse events, laboratory and ECG findings, and vital signs. Secondary endpoints included pharmacokinetics, pharmacodynamics, immunogenicity, and efficacy across key dermatologic measures, including psoriasis area and severity index (PASI), physician’s global assessment (PGA), and body surface area (BSA).

Key findings:

• si-544 was well tolerated with no related serious adverse effects, dose-limiting toxicities, or safety signals observed
  
• A short 4-week treatment cycle resulted in significant clinical improvement as measured by change in Psoriasis Activity and Severity Index (PASI)
  
• Signs of clinical efficacy were seen as early as week 2 of the treatment period
  
• Disease stabilization and continued healing were observed over the entire 12-week monitoring period, post drug washout
  
• Patients treated with si-544 maintained full immunocompetence
  

Hello there. New member and I’m at my wits end. 

Started off with a small scratch on my head around 2007. Within years it spread all over my body but in small, manageable plaques I could treat, initially with Dovobet, then and now with Enstiler. 

The last 12 months it’s changed from plaques and is now all over my body in one big, red rash that I have figured out a cycle of its weekly events. 

Monday it’s at its worse. It now hurts like sun burn. I cover it all with the foam and by Wednesday I can pretty much fill a hoover with the dead skin. Then it’s flat but still very red but no or little dead skin by Wednesday. I then feel like I have even worse sun burn before a couple of days relief but completely red and unsightly. By Sunday night the lumps appear and then it’s rinse and repeat again from Monday. There is no escaping it and it is now at the point where I cannot live a normal or comfortable life, which I could before. I have never been bothered by people looking at me in public and would wear T shirts and shorts. Not anymore. It is ruining my life. 

12 months ago I started smoking and drinking heavily and I know there can be no coincidence, but kicking the two is hard and I use them both as an escape when I look at what the psoriasis is doing to me and how it it how a physical pain as well as a psychological one. 

Why has it changed from manageable plaques to covering my torso as an entirety, and large plaques on my arms and legs? I am only blessed so far it hasn’t affected my face. I am going through 2 cans of foam every 4 weeks, plus tubs and tubs of post shower moisturiser in the form of Adex.

Could knee arthralgia and cartilage thinning in psoriasis patients be clues to early psoriatic arthritis ?

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Background:
To compare femoral cartilage thickness between patients with psoriasis (PsO) and psoriatic arthritis (PsA), and to investigate whether knee joint pain in PsO patients could be an early risk factor for PsA.

Methods:
Fifty-nine patients (28 PsO and 31 PsA) were included in this cross-sectional study. Demographic data were collected, and clinical assessments were performed using the Psoriasis Area and Severity Index (PASI) and the Disease Activity Score 28 (DAS28). PsO patients were evaluated for knee arthralgia symptoms within the past month. Femoral cartilage thickness was measured bilaterally at the medial femoral condyle, lateral femoral condyle, and intercondylar area using ultrasonography.

Results:
Femoral cartilage thickness was significantly lower in PsA patients compared to those with PsO (p < 0.05). Among patients with PsO, those reporting arthralgia (n = 14) had significantly reduced lateral femoral condyle cartilage thickness in both knees compared to those without arthralgia (p < 0.05). Spearman correlation analysis revealed a negative correlation between age and lateral cartilage thickness (e.g., right LFC: ρ = −0.338, p = 0.009, 95% CI –0.55 to −0.09). PASI scores showed a consistent positive correlation with femoral cartilage thickness across regions; for example, the correlation with the left LFC was significant (ρ = 0.504, p < 0.01, 95% CI 0.29–0.67). These associations indicate that both demographic and disease-related factors may influence cartilage status in PsO and PsA, although the confidence intervals indicate some degree of uncertainty and call for validation in larger cohorts.

Conclusions:
Femoral cartilage thinning is evident in PsA patients and may begin even in the subclinical phase. In PsO patients, the presence of arthralgia, especially in the lateral femoral condyle, may reflect early structural changes and could serve as a predictor for PsA development. Ultrasonographic assessment offers a noninvasive, accessible method for early detection and follow-up.

This study investigated lifestyle related serum metabolites associated with late onset psoriasis risk and evaluate their predictive potential.

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Background:
Although healthy lifestyle behaviours are associated with a lower risk of psoriasis, the underlying metabolic mechanisms remain unclear.

Objectives:
To investigate lifestyle-related serum metabolites associated with late-onset psoriasis risk and evaluate their predictive potential.

Methods:
We analysed 190,692 participants (aged 38–73) from UK Biobank with complete data on lifestyle and serum metabolites. Healthy lifestyle was assessed based on diet, exercise, smoking and BMI. The association between lifestyle-related metabolites and late-onset psoriasis risk was identified by a sequential analytic strategy that combined the Cox regression and elastic net regression model. A machine learning model was developed to predict psoriasis risk using clinical features, polygenic risk scores (PRS) and critical metabolites.

Results:
During a median of 14.6 years of follow-up, 2114 incident late-onset psoriasis cases were documented among 186,812 participants. Ideal lifestyle factors were significantly associated with reduced disease burden, with BMI showing the highest population attributable fractions (PAF) of 24.1%. We identified 11 of 134 lifestyle-related metabolites that were significantly associated with the risk of late-onset psoriasis. These predominantly mapped to lipid and glucose metabolism pathways, comprising seven lipoprotein subclasses, two ketones, unsaturation degree and phenylalanine. The addition of these metabolites into clinical characteristics and PRS could significantly improve the performance of predicting the risk of late-onset psoriasis (AUC 0.860, 95% CI 0.857–0.863).

Conclusion:
Multiple lifestyle-related serum metabolites are associated with the incidence of late-onset psoriasis, and their integration with traditional clinical features and genetic susceptibility shows promise in enhancing the predictive accuracy of late-onset psoriasis using a machine learning–based model.

Transition from psoriasis to psoriatic arthritis was associated with distinct alterations of the peripheral blood T cell compartment with Tc17 cells exhibiting the greatest discriminatory power.

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Objective:
Cellular mechanisms driving transition from psoriasis to psoriatic arthritis have remained largely elusive. Thus, we investigated changes within the peripheral blood T cell compartment associated with the transition phase.

Methods:
In an observational study, 116 patients were examined and categorized into subgroups including psoriasis with at least one risk factor for transition to psoriatic arthritis, subclinical psoriatic arthritis according to EULAR taskforce recommendations from 2023, and definitive psoriatic arthritis meeting the CASPAR criteria. Demographic and clinical characteristics of patient subgroups were analyzed. Deep T cell phenotyping using multicolor flow cytometry and machine learning techniques were applied.

Results:
Overlapping T cell endotypes were found among patients with subclinical psoriatic arthritis exhibiting the most notable divergence from the others. Frequencies of effector memory CD4+ T (TEM) cells, T helper 17 (Th17) and T cytotoxic 17 (Tc17) cells differed between psoriasis with at least one risk factor for transition, subclinical psoriatic arthritis and psoriatic arthritis. Transition-associated changes of Tc17 cell frequencies were confirmed by machine learning-assisted unsupervised clustering analysis. Moreover, patients with enthesitis could be distinguished from those without, with Tc17 cells being the main distinctive feature.

Conclusion:
Transition from psoriasis to psoriatic arthritis was associated with distinct alterations of the peripheral blood T cell compartment with Tc17 cells exhibiting the greatest discriminatory power. These findings provide insight into pathomechanisms driving disease progression during transition from psoriasis to psoriatic arthritis and identify Tc17 cells as foremost novel potential therapeutic target for the prevention of transition.