Hi, I have just come across this site whilst trying to research the difference between dovobet/dovonex.

I have today been diagnosed with severe nail psoriasis on both my fingers & toes. I also have a few minor small plaques on my body.

My consultant, this morning has advised I take Acitretin but I need to have the blood tests first. So today he prescribed Dovobet , & without realising, I left the pharmacy with Dovonex.

Is there a major difference between the 2 & the outcomes expected ?

Should I go back & get it changed?

Thanks for any help

Hey guys!

How is everyone doing? My first post
I'm 21 years old, I've been diagnosed with psoriasis Feb 2014. I was living in Nigeria all my life, I moved to Toronto 4 years ago and ive been perfectly clean. Only recently I've been almost 80% covered with psoriasis. I can say I'm pretty lucky I do not have it on my face, I'm already very shy, the P on my face would have totally destroyed my confidence. I'm guessing my P got triggered due to the cold winter? but then why not 2-3 years ago when I moved? why now?

I've been going to the derm since Feb 2014, and have been using prescribed topical steroid creams, clobex spray and what not, all it did was burn a layer of my skin. I do not think it helped at all. Recently I started Homeopathy, I do see some changes but not significant enough. Apparently the process takes 3-6 months.

The derm suggested I do Phototherapy...3 times a week for 5 minutes each session. would you guys recommend this? is this a temporary solution? have any one of you tried this? I heard it might trigger sun burns and even skin cancer.

Thanks for reasding guys!

Tl;dr- would you guys recommend phototherapy?

Doctors at The University of the Philippines Manila – Philippine General Hospital say that Clinicians should be attuned to the skin signs heralding HIV/acquired immunodeficiency syndrome, in order to facilitate early diagnosis and treatment.

Quote:

---

Knowledge of both the common and atypical presentations of human immunodeficiency virus (HIV)-associated dermatoses may be helpful in arousing suspicion of HIV, especially in patients with no reported risk factors.

Herein, we report the case of an otherwise healthy, nonpromiscuous 29-year-old man who presented to our institution with an eight-week history of plaques with oyster shell-like scales on the trunk, extremities and genital area. The plaques were associated with fever, and intermittent knee pain and swelling.

Initial diagnostic tests were suggestive of drug hypersensitivity syndrome, and the patient’s condition improved with treatment using oral prednisone. However, the lesions recurred when the dose of prednisone was tapered, even after the culprit drug had long been discontinued.

Repeat skin punch biopsy and arthrocentesis revealed a diagnosis of psoriasis vulgaris with psoriatic arthritis. Due to the atypical presentation of psoriasis, the patient was counselled to undergo HIV testing, which came back positive.

Clinicians should be attuned to the skin signs heralding HIV/acquired immunodeficiency syndrome, in order to facilitate early diagnosis and treatment.

Gosh, all these symbols! All I know is that this is causing me much distress. Doctors suggest steroids but didn't realise it was everywhere -have gone down that route -it's now getting difficult to control -people making comments at work! I know I shouldn't but scraping off with my nails - relief instant but pain afterwards. It's on my face!

Hi, first post to this forum. My son has Chrons and Psoriasis and Psoriatic Arthritis. I do think there is a link, but have no knowledge of any formal tests or official info on it. I just think so.

Hi everyone, this is worth a look.



"Uniting the world of autoimmune arthritis diseases under one 'virtual' roof.

"WAAD" is a Virtual Event held annually on May 20th.  To accommodate all people, the "virtual doors" open at 6am ET/USA May 19th & close on May 21st at 5am ET/USA, allowing all people to participate in live events during May 20th in their own time zone.

THIS IS AN ONLINE EVENT.  ANY PERSON IN THE WORLD CAN ATTEND WORLD AUTOIMMUNE ARTHRITIS DAY AS LONG AS THEY HAVE INTERNET SERVICE."

Yes Jim it's a study, but you may like this one. It was published in The British Journal of Dermatology

This observational study recorded data on quality of life, treatment efficacy and drug dosing in patients suffering from psoriasis treated with Fumaderm® under conditions of daily practice in 78 dermatological centres.

Quote:

---

Patients and methods:
In this prospective, multicenter, non-interventional trial we included adult patients with severe plaque psoriasis under outpatient conditions receiving Fumaderm® according to the current summary of product characteristics for systemic treatment of psoriasis. At baseline and after 3, 6 and 12 months the dosing regimen under daily conditions, dermatology life quality index (DLQI), and clinical efficacy with the psoriasis area and severity index (PASI) were documented.

Results:
A total of 249 patients were included. The mean DLQI score at study entry was 9.95, the mean PASI was 16.8. The average treatment dose of Fumaderm® was 2.8 tablets daily. More than 70% of patients were treated with 1 to 3 tablets daily and <30% were treated with a dose ranging from 4 to 6 tablets daily. DLQI and PASI improved in the entire study population by 67.2% and 66.6%, respectively. Specifically, when analyzing patients who started Fumaderm® within 4 weeks before baseline the mean DLQI score decreased from 11.8 to 2.9 (75% reduction) and the mean PASI score from 19.84 to 7.35 after 12 months (63% improvement).

Conclusion:
This is the first field study analyzing the use of Fumaderm® and the improvement of quality of life in patients with psoriasis under daily outpatient conditions. The improvement of DLQI obtained with Fumaderm® was comparable to the improvement observed in patients with psoriasis treated with modern biologics. Importantly, in most patients with good clinical response the treatment dose was 1 to 3 tablets daily.

Hi
I have been on Fumaderm for about 6 weeks now and though my progress is slow I was wondering if anyone has experienced a rash when taking it?

Looby

Following on from this post Amgen's Brodalumab Phase II Data Amgen And AstraZeneca Announce Positive Results From Phase 3 Study Of Brodalumab (AMG 827) In Patients With Moderate-to-Severe Plaque Psoriasis.

Quote:

---

Amgen (NASDAQ: AMGN) and AstraZeneca today announced that the Phase 3 AMAGINE-1TM study evaluating brodalumab in patients with moderate-to-severe plaque psoriasis met all primary and secondary endpoints for both evaluated doses. Brodalumab is the only investigational treatment in development that binds to the interleukin-17 (IL-17) receptor and inhibits inflammatory signaling by blocking the binding of several IL-17 ligands to the receptor. Primary endpoints were patients achieving at least a 75 percent improvement from baseline in disease severity at week 12, as measured by the Psoriasis Area Severity Index (PASI 75), and patients achieving clear or almost clear skin at week 12 according to the static Physician Global Assessment (sPGA 0 or 1).

A significantly higher proportion of patients treated with brodalumab achieved a PASI 75 response (primary endpoint), as well as PASI 90 and PASI 100 responses at week 12 (secondary endpoints) compared to placebo. Results showed that 83.3 percent of patients in the 210 mg group and 60.3 percent of patients in the 140 mg group achieved PASI 75 responses compared to placebo (2.7 percent). Results also showed that 70.3 percent of patients in the 210 mg group and 42.5 percent of patients in the 140 mg group achieved PASI 90 responses compared to placebo (0.9 percent). Further, 41.9 percent of patients in the 210 mg group and 23.3 percent of patients in the 140 mg group achieved PASI 100 responses compared to placebo (0.5 percent). Of the 661 patients enrolled in this study, 46 percent reported prior biologic use and 28.7 percent weighed more than 100 kilograms (kg) at baseline (mean weight for the study population was 90.8 kg).

A PASI score is a measure of psoriatic plaque redness, scaling and thickness and the extent of involvement in each region of the body. Treatment efficacy is often measured by the reduction of PASI from baseline (i.e., a 75 percent reduction is known as PASI 75, a 90 percent reduction is known as PASI 90 and PASI 100 is total clearance of skin disease).

The most common adverse events that occurred during the placebo-controlled period in the brodalumab group (more than 5 percent of participants) were nasopharyngitis, upper respiratory tract infection and headache. Serious adverse events occurred in 1.8 percent of patients in the 210 mg group and 2.7 percent of patients in the 140 mg group compared to 1.4 percent for placebo during the placebo-controlled period.

"Data from the AMAGINE-1 study suggest that brodalumab may offer a new level of efficacy for patients with moderate-to-severe plaque psoriasis, a disease that affects more than 100 million people globally," said Sean E. Harper, M.D., executive vice president of Research and Development at Amgen. "This is the first read-out from our Phase 3 psoriasis clinical program and we look forward to obtaining additional Phase 3 data from our two head-to-head studies versus ustekinumab later this year."

Hi Everyone,

Has anyone else experienced tremendous all over body itchiness approximately 3 weeks after their Stelara injection? I have no visible P and no rash of any kind but this itching starts suddenly about 3 weeks after my Stelara injection and lasts for about 1 month, gradually improves until my nest injection when the cycle starts all over again!
My GP has tried giving me oral medications to stop the itching but nothing provides relief!
Has anybody else had this experience?

Hi Everyone,

I was happy to find this group. Psoriasis can be very isolating, even when you're clear the worry of side effects and when your P will reappear is always with you.
I have been battling this monster for 12 years and am currently having success with Stelara.
I have tried pretty much everything else, topicals, light therapy, methotrexate, cyclosporine, embrel and remicade if anyone has any questions.

More new treatments on the horizon for people with psoriatic arthritis, this one is from Covagen a privately held Swiss Biotech company.

Quote:

---

Switzerland, May 5, 2014 – Covagen today announced it has initiated a Phase Ib/IIa study with COVA322, a bispecific TNF/IL-17A inhibitor. COVA322 is Covagen’s lead bispecific FynomAb® developed for treatment of patients with rheumatoid arthritis, psoriatic arthritis and other inflammatory diseases. The trial will enroll 39 patients with psoriasis and evaluate safety as well as biological activity of COVA322. Enrollment in the trial and dosing of COVA322 has begun for the first cohort of patients.

“With COVA322, Covagen has moved its first proprietary FynomAb into the clinic,” said Mathias Locher, Ph.D., chief development officer of Covagen. “COVA322 has a novel mechanism of action by simultaneously inhibiting both TNF and IL-17A. This dual inhibition has the potential to result in superior efficacy compared to current treatment options for rheumatoid arthritis, psoriatic arthritis and other inflammatory diseases.”

Julian Bertschinger, Ph.D., chief executive officer of Covagen added: “We believe this first clinical study with COVA322 in psoriasis patients may indicate its significant potential to improve the treatment of inflammatory diseases and help to validate the capabilities of our proprietary bispecific FynomAb platform. We expect to have top-line data in the first quarter of 2015.”

The primary aim of the Phase Ib/IIa trial is to evaluate the safety, tolerability and pharmacokinetics of a single ascending dose of COVA322. The randomized, double-blind, placebo-controlled, multi-center study will be conducted in Germany in 39 patients with psoriasis. Secondary endpoints include readouts on psoriatic skin lesions as well as biological responses measured in skin biopsies.

Hi everyone, I hope you are all ok. I was wondering if you could help me. The last few days the Psoriasis has been so sore and none of the creams I use are working. Do ay of you know of some that you have used that may help me please? I have used Oilatum, Dovobet and many others that I can't remember the names. Thank you all so much.

The University of Manchester launch training scheme open to GPs and specialist medics in the North West of England, for practitioners aiming to improve health outcomes for their patients with psoriasis.

Quote:

---

Research shows even doctors specialising in skin care receive very little training about how to manage psoriasis as a long-term condition with the effects that this condition can have on all aspects of life. As well as the other medical conditions associated with psoriasis, smoking, being overweight, inactivity and excess alcohol use much more common in people with psoriasis and affect flares but patients rarely receive adequate support to make lifestyle changes.

Dr Christine Bundy, one of the theme leads on the National Institute for Health Research (NIHR)-funded Identification and Management of Psoriasis Associated ComorbidiTy (IMPACT) research programme, is involved in the launch of a new training programme for practitioners aiming to improve health outcomes for their patients with psoriasis. This training will officially be launched in Manchester on Thursday 1 May.

Dr Bundy said: "Our research shows in addition to the presence of cardiovascular disease, patients often also have low mood and this impacts on motivation to self-manage psoriasis. In addition, we have reports that most clinicians, even those with a special interest in psoriasis, do not feel skilled or confident in supporting patients to change their lifestyle behaviour to help manage their condition better yet we know evidence based methods to manage mood and behaviour can improve quality of life and help people recover from psoriasis flares quicker.

“Not identifying these additional factors which are often associated with psoriasis is not only bad news for the patients it also has financial implications for the future health spend in the NHS.”

Clinicians who do want training in how to support patients often do not have access to a quality assured, relevant and tailored programme to enable them to develop and practice the necessary skills, researchers say. Some are able to attend, usually industry sponsored, training events but access to those events is restricted and the opportunities are ad hoc and not part of any established or accredited programme of continuing professional development.

The world-renowned team from the University of Manchester and Salford Royal NHS Foundation Trust is now launching a pilot programme to better train clinicians in the North West which, if successful, they hope could be rolled out on a larger scale.

Set to train GPs and medics over the next six months, it will involve helping practitioners develop their skills in the management of psoriasis as a long term condition with particular emphasis on supporting motivation to make lifestyle, behaviour changes.

Professor Chris Griffiths, consultant dermatologist at Salford Royal NHS Foundation Trust and IMPACT Principal Investigator, added: “We’ve looked at the barriers doctors face in treating the patient for all their symptoms.

“A large part of our training will focus on how to have the conversations that can make a difference to people’s lives such as noticing whether their psoriasis is affecting other areas of their life for example drinking too much, over-eating, being inactive or feeling low and depressed.

“There’s often time pressures in a 10 minute consultation but these techniques are not about adding to doctors' workloads but setting patients on the right pathway of treatments and lifestyle changes earlier so that they spend fewer years in the wilderness with their psoriasis being treated inadequately.”

A survey of some medics questioned about current training highlighted they believe it is insufficient in general and especially inadequate to manage unhealthy behaviour”. Another admitted to confusion and said: “I thought of psoriasis primarily as a skin complaint. I am aware that there are systematic problems but I sometimes find it difficult to put the two together”.

Patients however reported a need for doctors to recognise that psoriasis was more than a skin complaint. One said: “It’s a skin condition but it goes beyond that, it sort of runs deeply…it got to the stage where I was thinking about it so much I actually cancelled meeting my friends. Toby Hadoke a well-known London based comedian with psoriasis reported: "It took 25 years for a clinician to say to me, we can manage your psoriasis and the impact it has on your life, that was a lifeline for me.”

The training scheme will be open to GPs and specialist medics in the North West from June this year.

Anyone interested in the training scheme should contact the training programme manager alison.j.littlewood@manchester.ac.uk

Quote:

---

Aim:
The aim of the study was the evaluation of supplementation with Pycnogenol®, French maritime pine bark extract (registered trademark of Horphag Research Ltd.) to improve the effects of the management of psoriasis and reduce the need for treatments.

Methods:
Patients (age range 30-45) with moderate/severe plaque psoriasis were included in a 12-week registry study that did not interfere with 'standard management'. The minimum Psoriasis Area Severity Index (PASI) score at inclusion was 10. Subjects with 10-29% (grade 2) and 30-49% (grade 3) of involved area were included. Oxidative stress (plasma free radicals) was measured. Patient-reported measures included the Dermatology Life Quality Index (DLQI). The supplement was used at a dosage of 150 mg/day (50 mg three times daily).

Results:
The two registry groups (standard management and standard management+supplementation) were comparable. Dropouts were due to logistical problems. Single PASI items were evaluated: a decrease in the affected body area in boths groups was observed. The decrease in affected areas was more pronounced in the Pycnogenol group in all body regions. The severity score (erythema, induration, desquamation) improved more significantly with Pycnogenol. Considering the water content of skin in all areas, the increase was higher with Pycnogenol. The quantity of exfoliating cells (score from -5 to +5) was significantly reduced in both groups, with a better action using Pycnogenol. Skin moisture improved with treatment in all subjects, with better effects using Pycnogenol. Using a modified (12 items) DLQI indicating how much psoriasis had affected the patient's life in the previous week, Pycnogenol-supplemented subjects performed better for each single parameter in comparison with standard management. Improvement in the treatment time (-32% in comparison with standard management) and costs (decreased on average 36.4% in comparison with standard management) were observed in the supplement group. A decrease in consumption of other drugs was observed with the supplement. Oxidative stress was significantly lower in the supplement group at 12 weeks.

Conclusion:
These results indicate the efficacy of Pycnogenol supplementation in improving control of the most common clinical aspects of psoriasis and in reducing oxidative stress. Further studies may indicate the possible systemic or local use of Pycnogenol and its role in controlling side effects and costs of standard management.

Hi, I am new to this page. My name is Stephen I am 34 years old and have had Psoriasis for about 13 years. I started a new treatment last year called Infliximab and it started to work and I was clear, but since January the Psoriasis has come back worse and I don't know what the Doctor will do next.

This study set out to find the unmet needs of psoriasis & psoriatic arthritis patients, and concluded there are several identified unmet needs that warrant additional attention and action.

Quote:

---

Background:
Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (PsA), but are limited by methodology or enrollment requirements.

Objective:
To further the understanding of the unmet needs of psoriasis and PsA patients.

Methods:
This was a large, multinational, population-based survey of psoriasis and/or PsA patients in North America and Europe. Patients were selected by list-assisted random digit dialing and did not have to currently be under the care of a health care provider, a patient organization member, or receiving treatment; 139,948 households were screened and 3426 patients completed the survey.

Results:
The prevalence of psoriasis/PsA ranged from 1.4% to 3.3%; 79% had psoriasis alone and 21% had PsA. When rating disease severity at its worst, 27% (psoriasis) and 53% (PsA ± psoriasis) of patients rated it as severe. Psoriasis patients indicated that their most bothersome signs or symptoms were itching (43%), scales (23%), and flaking (20%). Of psoriasis patients, 45% had not seen a physician in a year; >80% of psoriasis patients with ≥4 palms body surface area and 59% of PsA patients were receiving no treatment or topical treatment only. Of patients who had received oral or biologic therapy, 57% and 45%, respectively, discontinued therapy, most often for safety/tolerability reasons and a lack/loss of efficacy.

Limitations:
The survey lacked a control group, did not account for ethnic and health care system differences across countries, and was limited by factors associated with any patient survey, including accurate recall and interpretation of questions.

Conclusions:
Several identified unmet needs warrant additional attention and action, including improved severity assessment, PsA screening, patient awareness, and treatment options.

There are a lot of studies about a link with Depression and Psoriasis, and although surveys are fine it could be interesting to have a survey right here on Psoriasis Club.

Guests and members can vote in the poll above, members can also post in this thread if they wish. 

Your vote is anonymous though I will be able to see the names of members that voted, so if you want to remain anonymous you should log-out to vote.

Obviously posts in this thread are in the public domain so you should only post what you are happy with.

So the question in the poll above is "As a psoriasis patient have you ever suffered with depression?" Vote in the poll above, and/or post in this thread.

Depression, Anxiety Common with Psoriatic Arthritis
Melissa Leavitt
People with psoriatic arthritis are at greater risk for depression and anxiety than people with psoriasis alone, according to findings from a recent study.
The study, led by researchers from the University of Toronto, asked patients at Toronto Western Hospital to complete a questionnaire assessing symptoms of depression and anxiety. Participants included 306 people with psoriatic arthritis, and 135 people with psoriasis alone.
Survey results revealed that 36.6 percent of participants with psoriatic arthritis had anxiety, while 22.2 percent had depression. Among participants with psoriasis, the rates were lower, yet still notable: 24.4 percent of people with psoriasis had anxiety, and 9.6 percent had depression.
The prevalence of depression and anxiety among people with psoriatic arthritis is not surprising, said Dr. Dafna Gladman, a co-author of the study. "But it was important to document it."
Although past research has assessed mental health comorbidities among people with psoriatic disease, this study is one of the first to zero in on mood disorders in psoriatic arthritis specifically.
The findings highlighted the need for increased awareness of these conditions among patients and caregivers.
"We've identified it as an issue, and now doctors should really be looking for it," Gladman said.
Gladman noted that even though patients identified themselves as being depressed, many had not received treatment for their depression. This may be due to the fact that mood disorders can easily go undetected in a clinic setting.
"When a patient comes to you with either skin psoriasis or joint disease, you concentrate on those physical findings," she said.
To ensure that patients get the comprehensive care they need, she recommends a multidisciplinary approach so that patients see physicians with different specialties.
"Somebody—the family doctor, a psychologist—should be assessing these people," she said.

This new study on the use of Simponi (Golimumab) looked into it's use over 5 years for treating psoriatic arthritis.

Quote:

---

Objectives:
Assess golimumab's long-term efficacy/safety in psoriatic arthritis (PsA).

Methods:
Adults with active PsA (≥3 swollen and tender joints, active psoriasis) were randomly assigned to subcutaneous placebo, golimumab 50 mg, or golimumab 100 mg every 4 weeks (q4wks) through wk20. All patients received golimumab 50 mg or 100 mg q4wks from wk24 forward. Methotrexate was allowed and taken by approximately half the patients. Findings through 5 years are reported herein. Efficacy assessments included ≥20% improvement in American College of Rheumatology (ACR20) response, C-reactive-protein-based, 28-joint-count Disease Activity Score (DAS28-CRP) response, ≥75% improvement in Psoriasis Area and Severity Index (PASI75) scores, and PsA-modified Sharp/van der Heijde scores (SHSs).

Results:
126/405 (31%) randomised patients discontinued treatment through wk252. Golimumab was effective in maintaining clinical improvement through year-5 (ACR20: 62.8–69.9%, DAS28-CRP: 75.2-84.9% for randomised patients; PASI75: 60.8–72.2% among randomised patients with ≥3% body surface area involvement) and inhibiting radiographic progression (mean changes in PsA-modified SHS: 0.1–0.3) among patients with radiographic data. While concomitant methotrexate did not affect ACR20/PASI75, it appeared to reduce radiographic progression. No new safety signals were identified. Antibodies-to-golimumab occurred in 1.8%/10.0% of patients with/without methotrexate).

Conclusions:
Long-term golimumab safety/efficacy in PsA was demonstrated through 5 years.