Hi all,
Just had a text from my brother, informing of an article in The Daily Express re: Young woman who has killed herself as a direct result of the depression and anxiety related to psoriasis. How awful and tragic for both her and her family.
My brother has been questioning me about how I feel, as he says he knows how bad my psoriasis is at present. Of course I have reassured him but it did make me think.
Not once has a g.p. or a consultant ever asked me how I feel, how is my daily life affected etc..
Actually it effects my daily life, my relationships, work etc.. greatly.
For example: at work they have a Hoover handy for me as I flake everywhere. After sitting in long meetings, I get up and look at the floor and it is covered in my skin so I get the Hoover and clean it. At the end of the day, I Hoover at Head Office as the cleaners staff are unhappy, doesn't matter that they know it isn't contagious and actually I am so self conscious I would do it anyway. When I go to clients homes, I can see them focusing on my hands and have to first explain that my condition is not contagious before I can support them!
I am lucky I have supportive family and a husband who is very understanding, because we no longer go for meals out anymore because I shed so much skin, I do not go with him to work functions anymore as the last time I did people were incredibly rude and one person actually said, I would stay home if I looked like that!
I look and feel revolting, it is revolting! I am in pain! I am exhausted. I am at times made to feel like I am a hypochondriac. I have psoriasis in places that are too embarrassing to discuss and am uncomfortable most of the time.
So, I have often said my psoriasis did not develop until later in life, I do not know how I would have coped if it had started when I was young.
I am at the hospital tomorrow to see the Consultant, and I will be impressing on them their own guidlines. I will be impressing upon them, the difficulties we all face in daily life. I will not be fobbed off with U.V. And heavy duty steroids any longer. I know Doctors are only human, I know they make mistakes and I am not in anyway implying they are useless, just that after 8yrs of seeing them, it is time they took seriously the impact of psoriasis on daily life.

Fred: hope I put this thread in the right place, apologies if not.

Following on from my request to Tanlou about starting a new thread about going onto Humira, she has asked me to get the thread going for her as she's not sure how to start a new one.

So this thread will be about Tanlou's experience of using Humira for the first time, she will update it as she goes.

Over to you Tanlou, and thank you for sharing.

Nice site and I really approve of the concept. Impressive amount of available.
Interestingly (well to me anyway) I have had skin problems for over 40 years (I'm 58) and have been treated for excema all this time. Until my first (yes) visit to a consultant earlier this year who said it was psoriasis. TBH I thought I had both over the years but no GP can be bothered to think about anything beyond the myriad of creams and lotions to choose from. I only found out I had been using a steroid cream after 30 years. No-one had ever thought to mention it.
Having just read about Dovobet on your site-I can say the consultant who prescribed it for me never mentioned anything about how it is used.
Anyway, I am very fortunate that for most of this time it has been confined mainly to my feet, with my hands being affected for the last few years making me go back for lots of useless GP appointments. They all wanna 'cure' ya. Eventually they gave me the referral I asked for. Dovobet works so far.
I work for a disability charity and would be happy to contribute to the site, not likely to be on too regularly though, but keep up the good work.

Dealing with a lot of pain and tenderness in my heels for many months now. along with other joint pain. Can't hardly walk most morning and nights. Also having trouble getting my Enbrel. Considering I been on it ten years it shouldn't be hard to get it filled. Getting the run around with the specialty pharmacy our insurance switch to this year. They should of kept it the same didn't have any trouble with the one I was using for 10 years. Hope I get it soon. My psoriasis is flaring. Went dermatologist last month and I can't get into rheumatologist till sometime in February. Just frustrated and tired of hurting so much.

Following on from these threads: Merck highlites R&D of anti-interleukin-23 and Merck present MK-3222 findings at AAD
Merck and Sun Pharma today announced an exclusive worldwide licensing agreement for the therapeutic antibody candidate, tildrakizumab, (MK-3222), which is currently being evaluated in Phase 3 registration trials for the treatment of chronic plaque psoriasis.

Quote:

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Under terms of the agreement, Sun Pharma will acquire worldwide rights to tildrakizumab for use in all human indications from Merck in exchange for an upfront payment of U.S. $80 million. Merck will continue all clinical development and regulatory activities, which will be funded by Sun Pharma. Upon product approval, Sun Pharma will be responsible for regulatory activities, including subsequent submissions, pharmacovigilance, post approval studies, manufacturing and commercialization of the approved product. Merck is eligible to receive undisclosed payments associated with regulatory (including product approval) and sales milestones, as well as tiered royalties ranging from mid-single digit through teen percentage rates on sales.

“Consistent with our previously announced global initiative to sharpen our commercial and R&D focus, including prioritizing our late stage pipeline candidates, we are pleased to enter into this agreement with Sun Pharma to help realize the potential of tildrakizumab for patients with chronic plaque psoriasis,” said Iain D. Dukes, Ph.D., senior vice president, Business Development and Licensing, Merck Research Laboratories.

"Sun Pharma is very pleased to enter into this collaboration with Merck, a recognized leader in the field of inflammatory/immunology therapies, for this late-stage candidate for chronic plaque psoriasis,” said Kirti Ganorkar, senior vice president, Business Development, Sun Pharma. “This collaboration is a part of our strategy towards building our pipeline of innovative dermatology products in a market with strong growth potential.”

Well lately my knee has ballooned up it's crazy just walking to the front door seems an effort (old before my time kinda feeling)
Seen the rheumatoligist today she told me I need to lose some of my chunky tummy easier said than done ( but must be done ) she also told me to join the gym if I can afford it ( well if I'm quitting chocolate I'm sure I'll manage it) anyone with the condition use the gym? Or would I be wasting my money? of what exercises/ activities do you do?
Thanks in advance. X

Hello all
I have suffered with psoriasis for 22 years now and after trying all steroid treatment, UV treatment, tar treatment and Methotrexate I have now been given Fumaderm to try.  I am on the initial pack and concerned about the side effects it might cause. I have a friend who has been on it for 2 years and doesn't have any psoriasis now, and she looks fab for it, but just wanted to get other opinions.

Hi,
I just registered here. I have had psoriasis for 10 years and got psoriatic arthritis in my first year. In fact, the psoriasis hit the same month I hit menopause, and the arthritis 4 months later. I had some plaque, but mainly my psoriasis type is guttate.

I did feel that when I lost my periods, I gained this disease. It was like I had a way to release my own toxins until then.

For 4 years I tried to fight off the psoriasis with a naturopath's help. I did see some clearing, but the arthritis was awful and nearly crippling. I had it in most of my large joints, but my fingers and toes was worst.

At that point, I finally went to a teaching college where they had tested the biologics. My new derm got me on Enbrel. The following day, I did not need my naproxen pain pills. Within several weeks I noticed a huge difference in my skin. But 4 months later, the skin problems came back. Luckily, 5 years later, I am still in remission from the arthritis.

In spring of 2013, my specialists decided my skin was so bad that I should be put on methotrexate. But I also have a liver condition, so I wasn't happy about methotrexate. I visited my naturopath and she suggested I try LDN or low dose naltrexone. The other doctors were going to start the methotrexate in the fall, so I felt like I had a few months to try the LDN.

Long story short, I responded very well on LDN. I've had one PASI score of 0 and another of 6...but my skin is actually the same (just different doctors). I have pictures and will gladly share them. I have been 90% clear for more than a year. I take 4 mg naltrexone each night before bed. I had no side effects. This has been the most wonderful experience. I am still on Enbrel.

Oddly, I tried to search here for LDN, and the search feature wants 4 letter phrases or more. I then searched for naltrexone, and couldn't find that either.

I have been on the Inspire Psoriasis Foundation Forum for years, and I have learned to hate it because of advertising and being steered by the foundation with all their impersonal emails. Also, I am appalled by the people who attack folks for trying alternative therapies.

I hope I can share my good news and find a place where people aren't locked into the medical/pharmaceutical field's dictates. As we all know, there is no therapy that works for all of us and we have to advocate for ourselves and be willing to try different paths.

Personally, I believe we all share symptoms, not always the same cause. But I believe that the liver and proper digestion/absorption is the key to healthy skin.

I'm looking forward to meeting folks here.

Dulane

Hey all I'm a newbie to this forum recommended to me just a quick intro
I'm a sufferer of psoriasis and have been for 14 years it's started getting worse was just plaque but now the dermo believe guttate has now started up woop like I did have enough
I'm also a sufferer of psoriatic arthritis and ive suffered with that for around 5 year. Psoriasis doesn't like creams and I've had zero success with anything I've had radiation in my knee for the arthritis (yttrium injection) sadly I'm still suffering after having it twice thanks for reading. Hope to speak to you all soon
Lucky xx

I had never heard of TSW until recently when I accidently stumbled upon a site. Steroids is something that I have always been cautious about when prescribed, but have had them by shots, orally, as an inhaler and in creams and oils so I found the information on topical steroid withdrawal informative.

I'm not putting links or info here as anyone interested can do a search but wanted to share the info for anyone using steroid creams and/or oils such as myself that had never heard of TSW.

This novel study of 104 psoriasis patients asked them to complete a postcard entitled ‘Dear Psoriasis…’ – to collect survey data on their personal models of psoriasis. It suggests patient support and psychological treatment should be made available as part of routine care.

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Background:
People with psoriasis report high levels of undermanaged distress. This is compounded by the problem that some patients find it difficult to discuss their emotions. Distress prevents optimal self-management, which may exacerbate psoriasis flares, thereby creating a vicious cycle.

Objectives:
To offer people with psoriasis a novel way of expressing their personal models of psoriasis in order to gain a better understanding of their experiences of living with the condition.

Methods:
We used a qualitative technique – asking people with psoriasis to complete a postcard entitled ‘Dear Psoriasis…’ – to collect survey data on their personal models of psoriasis.

Results:
One hundred and four returned postcards provided new insights into the extent of and reasons for distress in psoriasis. Seven dominant themes emerged: identity and relationships; battleground; control; emotional consequences; hypervigilance; coping; treatment burden.

Conclusions:
Reports of distress were common, and for many it was long-standing. Some reported low self-esteem and self-denigration bordering on self-loathing, and described being hypervigilant and in a constant battle with their skin. Many people did not expect to have intimate relationships, resulting in reduced social support for patients in the future. This research underscores the need for patient support and psychological treatment to be made available as part of routine care.

Hello new here thankyou for leting me join.

An interesting article that looks in to inner ear damage with psoriatic patients (PsA), the study demonstrates strong evidence for inner ear damage.

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Objective:
Although psoriatic arthritis (PsA) is a common chronic inflammatory rheumatic disease, little is known about audiovestibular impairment in this condition. We aimed to establish whether audiovestibular manifestations were present in patients with PsA.

Methods:
A set of 60 consecutive patients who fulfilled the Moll and Wright criteria for PsA and 60 matched controls were studied. During the period of recruitment, individuals were excluded who had a history of cardiovascular disease, cerebrovascular complications, peripheral artery disease, renal insufficiency, syphilis, Meniere disease and other vestibular syndromes, infections involving the inner ear, barotrauma, or were in treatment with ototoxic drugs.

Results:
Most patients with PsA were men (63%). The mean age at the time of our study was 52.9 years and the mean age at the onset of symptoms was 33 years. Thirty-six (60%) of the 60 patients showed abnormal hearing loss in the audiogram compared to only 5 (8.3%) of the 60 controls (p < 0.001). Values of audiometric tests (pure-tone average and speech reception threshold) yielded significant differences between patients and controls (p < 0.001). The audiogram disclosed a bilateral and symmetrical sensorineural hearing loss (SNHL) in PsA with predominant pattern of high frequency SNHL in patients with PsA (46.7%) compared to controls (8.3%, p < 0.001). Patients with PsA exhibited abnormal vestibular tests more commonly than controls. A significantly increased frequency of abnormal computerized dynamic posturography with a predominant vestibular loss pattern was also observed in patients (23.3%) compared to controls (0%, p < 0.001).

Conclusion:
Our current study demonstrates strong evidence for inner ear damage in patients with PsA.

Just wanted to say hello...I am still awaiting my official diagnosis after a biopsy...but sadly will most likely to join the psoriasis club.

My story...

About two months ago I developed a ring-like lesion on my bikini line...I was taking swim lessons with my youngest son and figured I probably picked up ringworm at the pool (I have had it before so I thought I knew what it was for sure!)...so I applied some OTC antifungal cream...to no avail

Kept spreading for 2 weeks so I called my derm and she ordered the hardcore rx type anti fungal cream for me...which I dutifully applied twice daily. 2 weeks later STILL no change and STILL spreading and getting very inflamed and basically growing together into one big rash (sigh).

Went into the derms office for her to look at and she did the whole, suck in her breath through her teeth when she saw it...(you know it's bad when they do that!) but she also was pretty sure it was ringworm so she said to either just keep applying the cream and would take time to go away or take the oral anti-fungal (which my husband and I joking called the death pill because of it's side effects)...I decided I had it with the whole thing and was going to take the oral meds. 3 weeks of it and it was still there!!

Derm said there is no way it could be ringworm if the meds had no effect at all...and by this time it's still spreading (bum crack, hands, wrists...typical!) and she thinks it's most likely psoriasis. She took a biopsy to confirm...still awaiting results. Sad face.

That's my story! The derm gave me a steroid cream to use to see if it helps at all. Its just so strange to get a skin condition in the middle of ones life (im 35)...I have never even had the slightest bit of dry skin ever...never use lotion, nothing! At least my husband is understanding...he has extremely bad eczema...so we are going to make quite the pair!

I love any suggestions from anyone else suffering from it in the same location...especially women! Thanks for listening!!

Kirsten

This study which is ahead of full publication in Arthritis Research and Therapy looked at new psoriatic arthritis patients and suggest that a better understanding is needed as to why they don't stay on first treatments for a long period.

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Introduction:
This study aimed to describe treatment changes (discontinuation, switching, and therapy add-on) following the initiation of a biologic or nonbiologic oral disease-modifying antirheumatic drugs (DMARDs) in psoriatic arthritis (PsA) patients.


Methods:
Adult patients with 2 PsA diagnoses from physician office visits, initiated on a biologic or non-biologic oral DMARD, were selected from the Truven Health Analytics MarketScan Research Database (2005 to 2009). Patients were required to have continuous insurance coverage 6 months prior to and 12 months post index date (first prescription fill date). Treatment discontinuation, treatment switch, and therapy add-on were captured over the 1 year period following the index date. Treatment changes were described separately for patients initiated on nonbiologic and biologic DMARDs.

Results:
A total of 1,698 and 3,263 patients were initiated on an oral nonbiologic DMARD and biologic DMARD respectively. For patients initiated on nonbiologic DMARDs, 69% had 1 therapy change over the 12 month study period (median time 85 days). Among patients who had a therapy change, 83% discontinued, 29% switched therapy (64% switched to a biologic DMARD), and 25% had a therapy add-on (76% added-on with a biologic DMARD). For patients initiated on a biologic DMARD, 46% had 1 therapy change (median time 110 days). Among patients who had a therapy change, 100% discontinued, 25% switched therapy (92% switched to another biologic DMARD), and 7% had a therapy add-on with a nonbiologic DMARD.

Conclusion:
This study suggests that PsA patients newly initiated on a nonbiologic/biologic DMARD do not remain on the index treatment for a long period of time. A better understanding of factors related to these early treatment changes in PsA patients are needed.

LINK REMOVED

Here an article on scientific research and the flaws in it. If this is the status of real scientific research, how shall we weight the results of pharma paid research on their own products then?

Seems life is kind of a roulette...

The market for treatments of psoriatic arthritis therapies will grow nearly 66 percent increasing to $3.7 billion in 2023 do to increased uptake of premium-price biologics and novel therapies that are expected to launch during the 2013 to 2023 forecast period.

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Decision Resources Group finds that the market for psoriatic arthritis (PsA) therapies will grow nearly 66 percent, increasing to $3.7 billion in 2023, owing to the continued uptake of premium-price biologics and novel therapies that are expected to launch during the 2013 to 2023 forecast period. In 2013, five marketed TNF-alpha inhibitors dominated sales in the PsA market with over 90 percent of the $2.3 billion major-market total; adalimumab (AbbVie/Eisai's Humira) was the overall sales leader. Over the next decade, TNF-alpha inhibitors will retain their sales-leading position, but recently launched treatments ustekinumab (Janssen's Stelara) and apremilast (Celgene's Otezla), together with noval therapies—which include the anti-interleukin-17 monoclonal antibodies secukinumab (Novartis), ixekizumab (Eli Lilly), and brodalumab (Amgen/AstraZeneca/Kyowa Hakko Kirin) and the Janus-kinase inhibitor tofacitnib (Pfizer's Xeljanz)—will account for approximately 21 percent of 2023 PsA sales combined in the United States, France, Germany, Italy, Spain, United Kingdom and Japan.

Of the five agents entering the PsA market, tofacitinib (Pfizer's Xeljanz) will experience the most uptake during the forecast period. Tofacitinib and recently launched apremilast feature oral formulations and unique mechanisms of action, thus allowing them to compete for TNF-alpha inhibitor-refractory patients, as well as experience uptake as "stop gaps" for conventional DMARD failures before stepping up to treatment with biologics.

Less-expensive biosimilar versions of several biologics will launch beginning in 2015 and will erode biologics' sales through 2023, with the largest impact on the TNF-alpha inhibitor class.

Interviewed thought leaders report that conventional DMARDs and TNF-alpha inhibitors are the clinical mainstays for mild and moderate-to-severe PsA, respectively, and will face only moderate loss of patient shares to recently launched and incoming novel therapies.

Decision Resources Group Director Bingnan Kang, Ph.D.
"The addition of the TNF-alpha inhibitors to the PsA treatment algorithm represented a significant step forward in the management of this heterogeneous disease. Despite advances in the diagnosis and treatment of PsA, significant opportunity remains for developers of additional disease-modifying agents and agents with a high degree of efficacy against multiple disease manifestations."

"Physicians are keen for results of pivotal clinical trials of emerging PsA therapies. Interviewed thought leaders tell us that should ixekizumab and/or tofacitinib prove to be as or more effective than active comparator arms (versus adalimumab) in their respective Phase III trials, these therapies would experience stronger uptake compared with other novel agents entering the PsA market."

"Biosimilar versions of etanercept, adalimumab and infliximab are expected to launch in most or all of the major markets during the forecast period and to account for approximately 36 percent of TNF-alpha inhibitor sales for PsA in 2023. Our primary research indicates that most rheumatologists will feel comfortable prescribing biosimilars for PsA, based on biosimilars' clinical trial data in RA, thereby reducing biosimilars' barrier to entry in this market."

This article published in The International Journal of Rheumatic Diseases measured changes in the serum levels of adiponectin, resistin and visfatin, and the associations of such changes with the extent of disease activity and insulin resistance in Psoriatic arthritis (PsA) patients.

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Aim:
Psoriatic arthritis (PsA) is an inflammatory form of arthritis typically associated with psoriasis and/or psoriatic nail disease. Adipocytokines were once thought to influence development of (only) insulin resistance and diabetes mellitus. However, it is now clear that adipocytokines play important roles in development of the inflammation associated with either autoimmune or auto-inflammatory disorders. In the present study, we measured changes in the serum levels of adiponectin, resistin and visfatin, and the associations of such changes with the extent of disease activity and insulin resistance in PsA patients.

Material and methods:
A total of 67 subjects (28 with PsA and 39 healthy controls) without hypertension or diabetes mellitus were enrolled. Adiponectin, resistin and visfatin levels, and the extent of insulin resistance (assayed using the homeostasis model [HOMA-IR]), were measured in all subjects. Assessment of PsA disease activity was done with the Disease Activity Index for Psoriatic Arthritis (DAPSA).

Results:
Psoriatic arthritis patients had considerably higher serum levels of adiponectin, resistin and visfatin than did healthy controls (all P < 0.05). In the logistic regression analysis, the following variables may contribute to complex pathogenesis of PsA: adiponectin (P = 0.001, OR = 3.1, 95% CI = 1.6–6.0), resistin (P = 006, OR = 1.8, 95% CI = 1.2–2.9) and visfatin (P = 0.031, OR = 3.9, 95% CI = 1.1–13.9). In contrast, we have not detected any correlation between DAPSA and adipocytokine serum levels (P > 0.05).

Conclusion:
There is no correlation between adipocytokines and disease activity. Although serum adiponectin, resistin and visfatin levels are higher in patients with PsA, pathophysiological significance of the result has to be evaluated with more extensive studies.

I know that we are each going to be different on this as there are different type of psoriasis and different types of treatment represented here on the forum but as someone recently starting treatment, I'm looking each day at signs of improvement. Some days I think things are looking up and other days I don't feel I'm closer to getting clearer. Since treatment takes time and I doubt anyone woke up to say "I'm clear!" I thought I'd ask if anyone wanted to share what they noticed was happening while they were "clearing up". Did you still have bad days when it looked worse, did it just gradually over time keep improving or did it maybe get worse before getting better?

For me, I haven't noticed a huge improvement yet and yes, I know it's still early for me. Less itching (although sometimes I wonder if that's just me being overly hopeful) and my ears almost cleared... but I was on a steroid medpac and I'm guessing it helped with that as they have since gone back to how they were before. My scalp is peeling more than ever I think, but I don't know if that is a good sign or bad. The "redness" still comes and goes, goes as in not away just not as red some days as others.

Also, maybe how long into treatment before you noticed an improvement? (Again, I know that will vary according to treatment, type of p and just individual person)

Dupuytren contracture (DC) is a fibrocontractile disease of the palms where the fingers bend towards the palm and cannot be fully extended, this study looked at the correlation between psoriasis and dupuytren contracture.

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Aim:
To evaluate the prevalence of DC in the full range of clinical psoriasis phenotypes.

Methods:
In total, 98 patients with psoriasis attending our psoriasis clinic were examined for DC, based on predetermined criteria. In addition, 84 patients with DC, obtained from a specialist hand clinic, were assessed using a validated psoriasis questionnaire. We utilized Bayes theorem and bootstrap simulation to calculate the conditional prevalence of DC, then we used the results to compare the prevalence of DC between patients with psoriasis and a nonpsoriasis population.

Results:
The percentage of patients with DC was 19.6% in the psoriasis population and 3.6% in the nonpsoriasis population. Development of DC showed a phenotypic predilection, with 39.1% of patients with predominantly palmoplantar involvement and 38.9% of patients with intertriginous psoriasis developing DC compared with 12.7% of patients with psoriasis who did not have these two phenotypical presentations.

Conclusions:
Our data show a positive correlation between psoriasis and DC. Patients with the palmoplantar phenotype of psoriasis were more likely to develop DC. By understanding this relationship, dermatologists may diagnose DC early in its onset in patients with psoriasis, prompting referral to hand surgeons when appropriate.