I have quick question I thought someone might be able to answer. I am vitamin B12/folic deficient (possible anemia). I was wondering if it’s a cause of PsA. Anyone have any ideas? I know that drugs such as MTX can cause this problem, but it’s been years since I took MTX. I am on Celebrex, which may also cause this issue, but my doctor told me it takes years to develop this with that drug.

Hi Everbody,

My name is Jamie, and I'm from the UK. I live on the most easterly point of England.

I'm new to this forum but one of the reasons I have joined is that I have Psoriasis on my face have done for say 8 years now. I'm looking for a way of managing it and wondered if any other males out there could give me some advice. The reason I say males is that it is really shaving which is the problem.

I went to the dead sea and got cleared. In some areas of my body the remission period lasted over a year but on my face it was literally back after 2 weeks. This I believe is due to shaving. Ok, Psoriasis is under the skin but by shaving we form a small injury thus allowing the psoriasis to reappear - the skin is always vulnerable especially there.

If anybody has any suggestions, advice or experiences I would be so pleased to hear from you.

I will be active on here posting various things and I look forward to hearing from you

Kind regards
Jamie

HLA-B is a human gene that provides instructions for making a protein that plays a critical role in the immune system. HLA-B is part of a family of genes called the human leukocyte antigen (HLA) complex. The HLA complex helps the immune system distinguish the body's own proteins from proteins made by foreign invaders such as viruses and bacteria.

This study published in The British Journal of Dermatology set out to clarify the association between psoriasis and HLA-B.

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Background:
Currently there is no consensus about the association between psoriasis and human leucocyte antigen (HLA)-B.

Objectives:
To clarify the association between psoriasis and HLA-B.

Methods:
Articles were selected, following predefined criteria, from case–control studies on the association between psoriasis and HLA-B published between 1 January 1972 and 11 November 2012, and included in the pub med and ISI Web of Knowledge databases.

Results:
Thirty-seven eligible articles covering 16 206 participants (14 644 white and 1562 Asian) were included. Sixty HLA-B alleles were reported, among which 26 were associated with susceptibility to disease, 24 were protective and 10 were unassociated. For unspecific psoriasis, there were three strongly susceptible alleles (OR ≥ 3·0) in white and four in Asian subjects, with HLA-B*57 and HLA-B*13 common to both races; there were four strongly protective (OR ≤ 0·3) alleles in white and seven in Asian subjects, with HLA-B*07 common to both. For psoriasis vulgaris, nine alleles were strongly associated with susceptibility in white subjects and five in Asians, with HLA-Bw*37 and HLA-B*57 in both; three alleles were strongly protective in white subjects and one in Asians, with none in common. Cases of psoriatic arthritis and guttate psoriasis were reported only in white subjects, with eight and seven strongly susceptible alleles, and two and three strongly protective alleles, respectively. Analyses of onset age showed that praecox patients with family history were significantly more susceptible to HLA-B*13 and HLA-B*57 than tardive ones.

Conclusions:
A significant association was identified between psoriasis and 50 HLA-B alleles. The association varied in terms of race, and clinical type and onset age of psoriasis.

Background:
Previous twin studies have shown greater concordance rates for psoriasis in MZ than in DZ twins, and heritability estimates between 66% and 90%. This supports a genetic influence on psoriasis, but also highlights the fact that genes are not the only explanation for the disease.

Objectives:
To study the concordance of psoriasis in a population-based twin sample.

Methods:
Data on psoriasis in 10 725 twin pairs, aged 20–71 years, from the Danish Twin Registry was collected via a questionnaire survey. The concordance and heritability of psoriasis were estimated.

Results:
In total, 4·1% of the men and 4·2% of the women had a lifetime history of psoriasis. The proband-wise concordance for psoriasis was larger in monozygotic than in dizygotic twins, 0·33 vs. 0·17. Genetic factors explained 68% (60–75%) of the variation in the susceptibility to psoriasis, whereas the rest of the variation was explained by nonshared environmental factors.

Conclusion:
The results confirm that psoriasis is a complex multifactorial disease controlled by both exogenous and endogenous factors.

Source: NO LINKS ALLOWED

Background:
Genetic predisposition to psoriasis, an inflammatory skin disease affecting 0·2–4% of the world population, is well established. Thus far, 41 psoriasis susceptibility loci reach genome-wide significance (P ≤ 5 × 10−8). Identification of genetic susceptibility loci in diverse populations will help understand the underlying biology of psoriasis susceptibility.

Objectives:
The primary objective of this study was to examine psoriasis susceptibility associations previously reported in Chinese and caucasian populations in a Pakistani cohort.

Methods:
Blood samples and phenotype data were collected from psoriasis cases and controls in Islamabad, Pakistan. DNA was isolated and genotypes of selected susceptibility markers were determined. The data were analysed using χ2 tests or logistic regression for psoriasis association.

Results:
HLA-Cw6 showed the strongest association [odds ratio (OR) 2·43, P = 2·3 × 10−12]. HLA-Cw1 showed marginally significant association (OR 1·66, P = 0·049), suggesting that the HLA-Cw1-B46 risk haplotype may be present in the Pakistani population. Three other loci (IL4/IL13, NOS2, TRAF3IP2) showed nominally significant association (P < 0·05).

Conclusions:
HLA-Cw6 is strongly associated with psoriasis susceptibility in the Pakistani population, as has been found in every other population studied. In addition, HLA-Cw1 showed marginal association, reflecting the relative geographical proximity and thus likely genetic relatedness to other populations in which the HLA-Cw1-B46 haplotype is known to be associated. A larger cohort and a denser marker set will be required for further analysis of psoriasis associations in the South Asian population.

Source: onlinelibrary.wiley.com

This is a questionnaire based study from The Dutch Psoriasis Association published in The British Journal of Dermatology.

Objectives:
The aim of this investigation is to gain knowledge about the prevalence and clinical manifestations of nail psoriasis and patient experiences of treatment of nail psoriasis.

Methods:
A structured, self-administered questionnaire was distributed to all members (n = 5400) of the Dutch Psoriasis Association. The questionnaire enquired about sociodemographic patient characteristics, disease-related data and treatment of nail psoriasis. Patients reported their nail manifestations with photographs after instruction. Patients with nail psoriasis were compared with patients without nail psoriasis.

Results:
A response rate of 27% was achieved. The prevalence of nail psoriasis was 66·0%. The most frequently observed psoriatic nail manifestation was pitting (65·4%), whereas red spots in the lunula were infrequently seen (6·5%). Patients with nail psoriasis more frequently stated psoriasis capitis (75·8% vs. 65·7%), genital psoriasis (32·7% vs. 20·3%) and psoriatic arthritis (46·4% vs. 30·6%) compared with patients with psoriasis without nail involvement. Only 16·0% of patients received treatment for nail psoriasis. Systemic therapies were most frequently stated as being effective for nail lesions.

Conclusions:
Nail manifestations seem to be more prevalent in patients with psoriasis than previously thought. In addition, nail psoriasis is shown to be associated with widespread and more severe forms of psoriasis, and different treatment options are experienced as being effective for nail psoriasis. Notwithstanding, nail psoriasis is still an often overlooked feature of the disease.

Source: NO LINKS ALLOWED

Biocon, Asia's premier biotechnology company, today announced the launch of its ‘first in class’ novel biologic ALZUMAb™ (Itolizumab), the world’s first anti-CD6 monoclonal antibody to be introduced for treating patients with chronic plaque psoriasis, in India.

ALZUMAb™ (Itolizumab) is the world’s 'first-in-class' humanized anti-CD6 MAb that has a unique mechanism of action (MOA) targeting the CD6 pathway. CD6 is a pan T-Cell marker involved in co-stimulation, adhesion and maturation of T-Cells, which have been found to play a leading role in autoimmune diseases. ALZUMAb™ (Itolizumab), by binding to CD6, down regulates T cell activation, causes reduction in synthesis of pro-inflammatory cytokines and possibly plays an important role by reducing T cell infiltration at sites of inflammation.

ALZUMAb™ with a unique Mechanism of Action (MOA) offers superior safety and similar efficacy profile compared to other existing therapies, and has a long remission period with very low opportunistic infection rate. Its launch in India for psoriasis is the first milestone on a promising and exciting journey towards new treatment options for life-changing autoimmune diseases. Biocon is committed to taking ALZUMAb™ (Itolizumab) from India to patients worldwide with a global partner.

Source: NO LINKS ALLOWED

Hi all,
Someone my wife knows has suggested Soa Natural Soap as being really good for P. it looks like an American site and I wondered if anyone is using it or has tried it?
Cheers
John

Telormedix is a biopharmaceutical company focused on targeted immunity and modulation of the innate immune system for treating cancer and autoimmune diseases.

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Telormedix SA, a clinical stage biopharmaceutical company focusing on toll-like receptor 7 (TLR7) small molecules in the treatment of cancer and inflammatory diseases, today announced that it has raised funding from the European Eurostars Programme to coordinate an international research project involving a consortium of companies aimed at developing new formulations of one of the Company’s promising drug candidates, TMX-302, for the treatment of psoriasis. The psoriasis anti-inflammatory treatment project, operating under the acronym PAT, will have a total budget of €1.77 M and will involve consortium partners Biopta, Midatech Biogune, Molecular Profiles and the University Hospital Zurich (USZ).

The PAT project will initially focus on developing new oral and topical formulations of TMX-302 using Midatech’s nanoparticles formulated using Molecular Profile’s technology. Both routes of administration are viewed as practicable for the treatment of psoriasis. Once a range of formulations has been developed, Biopta will screen them by using human fresh tissue in vitro assays to select the best candidates. These candidates will then be studied and compared to currently used therapies in well-established humanized animal models of psoriasis at the Department of Dermatology of the USZ.

Dr. Johanna Holldack, CEO at Telormedix, commented:

“We are absolutely delighted to have secured this funding with such a world class consortium to bring TMX-302 to preclinical proof of concept. We believe that modulators of TLR-7 have a significant chance of being important new treatments for inflammatory diseases like psoriasis.”

NICE (National institute for health and care excellence) UK have just released QS40 Quality standards for the treatment of psoriasis in the UK. This follows on from the last report about guidance for GPs which you can read here: NICE issues new guidance for GPs treating psoriasis

The QS40 is a bit long and boring to put it all on here but here a few basics.

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Psoriasis is an inflammatory skin disease, which most commonly presents as red, scaly plaques. These may vary in extent from a few patches to generalised skin and associated joint involvement. The disease typically follows a relapsing and remitting course, and can result in significant functional, psychological and social morbidity.

The prevalence of psoriasis is estimated to be around 1.3–2.2% in the UK. Men and women are equally affected. Psoriasis can occur at any age, although is uncommon in children (0.71%) and the majority of cases occur before 35 years. Psoriasis is associated with joint disease in a significant proportion of patients (reported in 1 study at 13.8%).

Psoriasis has a significant impact on health and wellbeing with consequent effects on employment and income, underlining the need for prompt, effective treatment, and long-term disease control. Symptoms related to the skin, problems related to treatments, psoriatic arthritis, and the effect of living with a highly visible, stigmatising skin disease have an important bearing on wellbeing. Even people with less severe disease state that psoriasis has a major effect on their day-to-day life.

A variety of treatment options are available, ranging from topical therapies to phototherapy and systemic therapy (non-biological and biological). For most people, psoriasis is managed in primary care, with specialist referral being needed at some point for up to 60% of people. Specialist tertiary care is needed in the very small minority of people with especially complex, treatment-resistant or rare forms of psoriasis. People receiving systemic therapy need ongoing supervision in specialist settings, sometimes with shared care arrangements for drug monitoring in primary care.

A recent UK audit in the adult population found wide variations in practice, particularly in relation to access to specialist treatments (including biological therapy), appropriate drug monitoring, specialist nurse support and psychological services.

NICE quality standards are a concise set of prioritised statements designed to drive measureable quality improvements within a particular area of health or care. They are derived from high-quality guidance, such as that from NICE or other sources accredited by NICE. This quality standard, in conjunction with the guidance on which it is based, should contribute to improvements.

The quality standard for psoriasis specifies that services should be commissioned from and coordinated across all relevant agencies encompassing the whole psoriasis care pathway. A person-centred, integrated approach to providing services is fundamental to delivering high-quality care to people with psoriasis.

The quality standard should be read in the context of national and local guidelines on training and competencies. All healthcare practitioners involved in assessing, caring for and treating people with psoriasis should have sufficient and appropriate training and competencies to deliver the actions and interventions described in the quality standard.

Background:
Humira (Adalimumab) approval by the European Medicines Agency on December 2007 as second-line therapy of moderate to severe chronic plaque psoriasis was based on scientific evidence from clinical trials, but patients in daily clinical practice are different and results may differ in different geographical settings.

Aims:
To analyse the efficacy, safety and retention of treatment with adalimumab in a cohort of patients with moderate to severe psoriasis at a referral centre in Barcelona, Spain.

Methods:
Retrospectively collected efficacy and safety data of a cohort of 119 consecutive patients treated with adalimumab for moderate to severe psoriasis in daily practice between January 2008 and March 2013. Efficacy was determined using as treated (AT) and intention-to-treat (ITT) analysis. Drug survival was analyzed by the Kaplan-Meier method with log-rank test and Cox regression.

Results:
One hundred and nineteen patients received adalimumab therapy with mean treatment duration of 25 months (median 25, range, 2-60). In 49 (41%) of our cases, adalimumab was the first biologic ever used. PASI75 response rates at week 16, 6 months and 1 year of treatment were 64%, 67%, and 76% (AT) and 64%, 60%, and 54% (ITT), respectively. The corresponding PASI90 response rates were 49%, 60%, and 70% (AT), and 49%, 52%, and 50% (ITT), respectively. Biologic naïve patients had significantly higher PASI75 and PASI90 response rates at week 16, 6 months, and one year of treatment. Combination treatment (used in 22% of our patients) was associated with increased PASI75 and PASI90 response rates at 6 months. The variables which were associated with a significantly higher probability of drug survival were PASI75 response status at week 16, 6 months and 1 year, PASI90 response status at 6 months and 1 year, and biologic-naïve status of the patient. The ability to lengthen and need to shorten injection intervals to maintain response were respectively associated with higher and lower probability of drug survival. Multivariate analysis using Cox regression model showed PASI75 response status at 1 year (P=0.002) and lengthening of injection intervals (P=0.015) as the only significant variables.

As regards safety, 48 adverse events (AE) occurred in 29 patients, and were serious in 8 patients (0.032 serious adverse events per patient-year). Paradoxical flares of psoriasis were seen in 3 patients and flares of arthritis in 2. Infections accounted for 53% of recorded AE and 88% of serious AE, and were the reason for discontinuation in 2 patients.

Conclusion:
The efficacy results are consistent with those of a previously published U.K. study. Even though biologic-naïve status and efficacy parameters denoting a good or excellent response at different time points appear to be associated with a higher probability of drug survival in this cohort of patients, PASI75 response status at 1 year and the ability to maintain response lengthening the injection intervals were the only independent variables predicting drug survival on multivariate analysis. Infections, including de novo infection by M. tuberculosis, accounted for most serious AE, and paradoxical flares of psoriasis and psoriatic arthritis are a relatively frequent occurrence in daily clinical practice.

Source: NO LINKS ALLOWED

More on Humira: https://psoriasisclub.org/showthread.php...165#pid165

This article was published in The British Journal of Dermatology and suggests it is difficult to assess the clinical relevance of plant extracts for the treatment of psoriasis.

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Psoriasis sufferers frequently use preparations of plant extracts. Physicians need to be aware of the current evidence concerning of these products.

This review evaluates the efficacy and safety of preparations of plant extracts used topically for psoriasis. Searches were conducted of pub med, EMBASE, Cochrane library, two Chinese databases and article reference lists.

Randomized Controlled Trials investigating extracts of single plants were included. Preparations of multiple plants and combinations of plant extracts plus conventional therapies were excluded.

Two authors conducted searches, extracted data, and assessed Risk of Bias. Outcomes used in meta-analyses were: clinical efficacy, Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and symptom scores.

The 12 included studies investigated extracts of: Mahonia aqulifolium (n=5), Aloe vera (n=3), Indigo naturalis (n=2), Kukui nut oil (n=1), and Camptotheca acuminate nut (n=1). Methodological quality was variable. Six studies provided data suitable for meta-analysis of clinical efficacy versus placebo (RR 3.37, 95% CI: 1.36-8.33). Experimental studies indicate components of Indigo, Mahonia and Camptotheca have anti-inflammatory, anti-proliferative and other actions of relevance to psoriasis.

The clinical trial evidence provides limited support for preparations containing extracts of Mahonia aquifolium, Indigo naturalis and Aloe vera for the topical management of plaque psoriasis based on multiple studies. No serious AEs were reported.

Due to the small size of most studies and methodological weaknesses, strong conclusions cannot be made. The magnitudes of any effects cannot be measured with accuracy, so it is difficult to assess the clinical relevance of these preparations.

Hi,

This is my first post on the forums but I have been here in the past when looking for advice after a bad flare up.

I currently have pustular psoriasis and I'm taking methotrexate to keep it under control. I've found it works pretty well but I find that any intense sun exposure causes a flare up.

One of the main reasons for joining is that I'm looking to get rid of my UVB sunbed. I bought it about a year ago after a referral for light treatment took over 4 months. It was a bit of an act of desperation as I was getting married and the last thing I wanted was to be covered in psoriasis on my wedding day.

I'm pretty certain that the long time between referral and treatment was what cause my psoriasis to go from gutate to pustular. My dermatologist has said that because of the change that there's no way light treatment would work anymore which is kid of frustrating.


Thanks,

Murray

I've been saying all along that Stelara is helping with my Psoriatic Arthritis, though maybe not as good as Enbrel or Humira this is good news for people with PsA.

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Janssen-Cilag International NV ("Janssen") announced today that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion recommending the use of STELARA® (ustekinumab), alone or in combination with methotrexate, for the treatment of active psoriatic arthritis in adult patients when the response to previous non-biological disease-modifying anti-rheumatic drug (DMARD) therapy has been inadequate.

Based on the CHMP's positive opinion, a final decision from the European Commission is expected during the third quarter of 2013. If approved, STELARA will become available for patients living with active psoriatic arthritis, a chronic autoimmune disease characterized by both joint and periarticular tissue inflammation (enthesitis, inflammation of the site where ligaments or tendons insert into the bones, and dactylitis, inflammation of an entire digit, e.g., finger or toe, often called "sausage digit"), and psoriasis skin lesions. The disease affects approximately 4.2 million people across Europe,1-5 and there is currently no cure.

"We are pleased that the CHMP has issued a positive opinion for STELARA in the treatment of psoriatic arthritis as we look to bring this new therapeutic option to patients living with active psoriatic arthritis," said Jerome A. Boscia, M.D., Vice President, Head of Immunology Development, Janssen Research & Development, LLC. "Data from the Phase 3 clinical program, one of the largest conducted for a biologic to date in psoriatic arthritis, showed STELARA effective in improving symptoms and signs of active psoriatic arthritis in anti-tumor necrosis factor (TNF)-alpha naïve and experienced patients. We believe STELARA has the potential to play a critically important role in the treatment of this chronic disease and look forward to the European Commission's decision."

The CHMP adopted the opinion based on a review of data from two pivotal Phase 3 multicenter, randomised, double-blind, placebo-controlled trials of ustekinumab, a fully human anti-interleukin (IL)-12/23p40 monoclonal antibody, administered subcutaneously, in patients with active psoriatic arthritis (PSUMMIT I and PSUMMIT II), which evaluated the efficacy and safety of subcutaneously administered STELARA 45 mg or 90 mg at weeks 0, 4 and then every 12 weeks. The trials included patients diagnosed with active psoriatic arthritis who had at least five tender and five swollen joints and C-reactive protein (CRP) levels of at least 0.3 mg/dL despite previous treatment with conventional therapies. PSUMMIT II also included patients who had previously experienced treatment with TNF inhibitors. The primary endpoints for both studies were the proportion of patients demonstrating at least a 20 percent improvement in arthritis signs and symptoms (American College of Rheumatology [ACR] 20) at week 24. Secondary endpoints at week 24 included in the submissions were: improvements in Health Assessment Questionnaire Disability Index (HAQ-DI) scores, a 50 or 70 percent improvement in arthritis signs and symptoms (ACR 50 or ACR 70) and at least a 75 percent improvement in psoriatic skin lesions as measured by the Psoriasis Area Severity Index (PASI 75) in patients with at least three percent body surface area involvement at baseline. The studies also captured improvements in enthesitis and dactylitis scores for patients with enthesitis and/or dactylitis at baseline.

To make a long story short, my hip is completely gone and stopped taking the Celebrex. Both my hands started and feet started swell. Fast forward until today, and I wanted to cut my hands off they hurt so bad. So gave in and saw my GP. He suggested Prednisone. Both my derm and Rhumey said absolutely no steriod pills/injections at this point. So I refused and gave me a narcotic instead. So now I am stoned writing this thread. Not sure if I made the correct decision, but don't want to have rebound flare that could possibly unmask something more serious that my plaque.

What do you think; did I have the right to make that choice?

Hi folks!

I'm new here so if I've posted in error, kindly let me know.

I just wanted to share with others the success I've had with a non-medicinal treatment for my moderate psoriasis.

For about two months I've been adding hemp hearts to my diet and I've had an incredible improvement in my psoriasis; incredible!

If anyone has any thoughts, comments...let me know.

Hi,

Looking at the most recent research, it would appear that individuals who have psoriasis have really benefitted from CBT treatment! I am told this is not available in the UK but I suspect it has been used in the US... anyone heard anything?

Hello Everyone,

I am Nicola and im 29. I have suffered with psoriasis for 15 years (since going to the drs with a small patch on my head, not knowing what it was!) - since then i've had my ups and downs and so has my skin!
I have had so many treatments I struggle to remember, all the topical treatments under the sun, light therapy, ciclosporin, homeopathy, chinese medicine (wouldnt recommend, it stripped my stomach lining), acupunture (prob not the right spelling!), vegetarian diet, brocolli diet, having a child (this is of course, not the only reason I had a baby! and yes, it did clear my psoriasis up, but can back with a vengence!) and have finally settled on camouflage make up for my face (thanks to the wonderful Red Cross who I am forever thankful for! and supermarket creams/olive oil!

More recently the dreaded psoriasis is creeping onto my legs which is the worst thing ever because it was the only thing I had to show off! so I am gutted about it but trying not to let it get me down! I am trying to get the sun on my legs as its always brilliant for me! (although have never used a sunbed).

About three years ago (I was in my mid twenties) I was asked to leave a resturant for offending a 'regular customer' with my psoriasis (i refused to pay the bill) and I have had low points due to my skin but then I have days where I think 'who cares!' - they are the best days and I am experiencing one of those periods now!

I may in the future consider mexotrexate (once Ive had another child) but for now I am focusing on the positives! and its nice to finally have people to share my experiences with!

Hi! My name is Jason and I have had Psoriasis for approximately 6 1/2 years. I was diagnosed with plaque psoriasis in 2007 after having issues with dry, flaking scalp and being convinced it was bad dandruff and going to the Dermatologist. Since that time, and being put on more topicals that can be imagined, it has continued to spead. It is mostly confined to my scalp, but I also have spots pretty much everywhere else. I have a history of autoimmune conditions in my family, with my Mom having RA and I grandfather who had psoriatic (sp?) nails (which I have as well, sadly).

Finally, last week I went to the dermatologist, determined that I would get something that would help. The doctor saw how discouraging my reaction to the topicals was, and put me on the first of what he calls the "Big Guns", Methotrexate. I am taking 5 mg and will be going to 10 mg in two weeks.

I am finally wanting to get serious of knocking this out as best I can, and I want to help others do the same. Thanks again for reading, and hope we can chat soon!

J

hi everyone im chen from Philippines and i have a psoriasis for about 8 years..hope this forum help me to understand what psoriasis is..