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Celgene Corporation today announced that the U.S. Food and Drug Administration (FDA) has approved OTEZLA® (apremilast), the Company's oral, selective inhibitor of phosphodiesterase 4 (PDE4), for the treatment of adult patients with active psoriatic arthritis.

"OTEZLA works differently from other therapies approved for psoriatic arthritis through the intracellular inhibition of PDE4," said Philip Mease, MD, Director of the Rheumatology Clinical Research Division of Swedish Medical Center and Clinical Professor, University of Washington. "The approval of an oral therapy with a novel mechanism of action for patients with psoriatic arthritis offers a different approach to patient care."

The approval was based on safety and efficacy results from three multi-center, randomized, double-blind, placebo-controlled trials.

"Patients and physicians have expressed their desire for a safe and effective therapy for psoriatic arthritis that has the potential to simplify patient management. Celgene is excited to be expanding our transformational science into the therapeutic realm of Inflammation and Immunology, with a new approach for patients with psoriatic arthritis," said Scott Smith, Global Head, Inflammation and Immunology, Celgene Corporation. "The FDA approval of OTEZLA is good news for patients and healthcare professionals who are looking for a different way to manage this disease."

OTEZLA® (apremilast) is expected to be available in the U.S. in March 2014 and will be dispensed through a comprehensive network of specialty pharmacies. For more information about OTEZLA distribution and the exclusive treatment support services (including reimbursement assistance and 24/7 nurse support), doctors and patients can contact Otezla SupportPlus™ at 1-844-4OTEZLA (1-844-468-3952) or visit [web]www.OTEZLA.com[/web] for more information.

The J&J biologic medicine, guselkumab, achieved the main goal of the Phase II study at all five dosing regimens tested by clearing or reducing the psoriasis to a minimal measure after 16 weeks of treatment in a far greater percentage of patients than in the group that received a placebo. It also appeared to be as good as or more effective than AbbVie's big selling Humira at four of the tested doses.

"The efficacy of guselkumab in the treatment of moderate to severe plaque psoriasis looks promising according to these Phase IIb study results," Dr. Kristina Callis Duffin, one of the study's investigators, said in a statement.

Results were determined using Physician Global Assessment (PGA) scores - a zero to 5 scale in which 0 indicates the disease has been cleared, 1 represents minimal disease and 5 indicates the most severe symptoms.

Guselkumab led to scores of 0 or 1 in as high as 86 percent of patients who received 100 milligrams of the drug every eight weeks, and in 83 percent of patients who were injected with 200 mg of the J&J medicine at the start of the trial and at week 4 and then every 12 weeks.

At the lower end, 34 percent of patients who got 5 mg of the drug to start and at week 4 and then every 12 weeks achieved PGA scores of 0 or 1. That was still deemed to be statistically significant compared with 7 percent for those who got a placebo.

In the Humira (adalimumab) group, 58 percent had scores of 0 or 1 after 16 weeks of treatment.

Results of the 293-patient trial, dubbed X-Plore, were presented at the American Academy of Dermatology (AAD) meeting in Denver. J&J has not yet said which of the treatment regimens would be advanced to larger, pivotal Phase III trials.

Guselkumab, which would be a follow-up treatment to J&J's Stelara, works by blocking interleukin-23, or IL-23, a protein that has been associated with chronic inflammation and is believed to play a role in psoriasis.

Morningstar analyst Damien Conover said the drug "is really under the radar right now." He currently sees sales reaching about $500 million several years after approval, but said estimates could change if later Phase III data were impressive.

In addition to the primary goal, significantly higher proportions of guselkumab patients achieved at least a 75 percent improvement in psoriasis as measured by the Psoriasis Area Severity Index (PASI 75) at week 16. Those results ranged from 44 percent of patients taking the lowest dose up to 81 percent at higher dosing regimens. That compared with 5 percent for placebo and 70 percent for Humira.

A 90 percent improvement was seen in as high as 62 percent of patients who got 100 mg of guselkumab every eight weeks.

The results remained consistent or showed additional improvement after 40 weeks of treatment, the company said.

After a year of treatment, serious adverse side effects were reported in 3 percent of those treated with guselkumab and 5 percent for Humira.

There were no cases of tuberculosis or opportunistic infections. One guselkumab patient reported a malignancy and there were three major adverse heart events, including one fatal heart attack, in patients with pre-existing cardiovascular risk factors, the company said.

Source: NO LINKS ALLOWED

Following on from Secukinumab V Enbrel Novartis announced today that a new phase IIIb head-to-head study of IL-17A inhibitor secukinumab (AIN457) versus Stelara® (ustekinumab) in moderate-to-severe plaque psoriasis has started patient enrolment.

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A total of twenty-five secukinumab abstracts, including two pivotal phase III convenience studies to be presented for the first time, will be unveiled at the 72nd Annual Meeting of the American Academy of Dermatology (AAD), taking place in Denver, Colorado, USA from 21-25 March 2014.

"We are pleased to announce the start of CLEAR, our global phase IIIb head-to-head psoriasis study of secukinumab versus Stelara at the 2014 AAD annual meeting, which will provide further evidence regarding the benefit IL-17A inhibitor secukinumab brings to patients," said Tim Wright, Global Head of Development, Novartis Pharmaceuticals. "We initiated this study following the positive results from the phase III FIXTURE study, which showed secukinumab was significantly superior to Enbrel in clearing skin, and we look forward to presenting additional new phase III data from our specialty dermatology portfolio at AAD."

About the CLEAR phase IIIb head-to-head study of secukinumab versus Stelara
CLEAR (Comparison to assess Long-term Efficacy, sAfety and toleRability of secukinumab vs. ustekinumab), the new 52-week, multicenter, randomized, double-blind study, is the second head-to-head phase III study initiated with secukinumab, and will compare the long-term safety, tolerability and efficacy of secukinumab versus Stelara, a current standard-of-care therapy, in patients with moderate-to-severe plaque psoriasis. The target enrollment for this global phase IIIb study is approximately 640 patients with sites in 25 countries across North America, Europe, Asia and Australia.

The primary endpoint measured at Week 16 is at least 90% reduction in the severity of psoriasis symptoms (redness, thickness and scaling) and the extent of skin affected by the disease, known as Psoriasis Area and Severity Index (PASI) 90. PASI 90 is considered the best evidence of efficacy and is therefore a more robust measure of the extent of skin clearance compared to the standard efficacy measures used in most psoriasis clinical studies.

The CLEAR study follows the pivotal phase III head-to-head FIXTURE study, which showed secukinumab was significantly superior to Enbrel® in clearing skin. Enbrel is a current standard-of-care anti-TNF-alpha medication approved to treat moderate-to-severe plaque psoriasis, and results from the FIXTURE study were first announced in October 2013

Hi my name is Pam,
I am having what I think is psoriasis. I am finding small patches of red itchy scaly patches of skin here and there, and am battling very thick patches of it all over my scalp.
I live in Po-Dunk, and have not told my Dr. about this yet. If I sneeze he wants to send me in for every invasive test known to western medicine.
Really, I am just in the last few days figuring out what is going on.

I had the scalp issue before many years ago, and remember finding a tar shampoo that I used diligently and it did eventually go away. But it is back with a vengeance.

The small patches, (The biggest one is approaching the size of a dime) are popping up here and there, and am finding more everyday.
I am so frightened I am afraid to share this new discovery with anyone in my life.
~Pam~

For a large portion of my life I had my psoriasis treated with various topical steroid ointments and creams,which were quite effective at reducing the plaques. I was told by my doctors and dermatologist that one of the side effects was skin thinning, but being foolish I just wanted to be rid of the scales. I used them on and off for many years. I just kept putting in for repeat prescriptions and without question they were prescribed. I found after a few years that the slightest knock on my legs would rip the skin open. I used to be very self conscious about my psoriasis, and as an engineer I was constantly banging my legs, when out on sites and often excused myself and went to the privacy of my van to roll up my trousers to reveal blood pouring out so I got to carrying a roll of tube gauze with me and steri strips to repair the damage.
When I stopped using steroid creams it seemed as if my skin recovered a bit. But I still have to be careful, and was wondering if others have had the same experience or worse. Or was I just unlucky

This is my first time on this forum and I hope someone has some suggestions for me.
I have been diagnosed with Postulate Psoriasis on the bottom of my foot. I, of course, have tried the steroids and only helped until I quite using them.

Has anyone found a natural treatment that has helped.

Calcipotriol/betamethasone dipropionate ointment most commonly know as Dovobet / Daivobet / Taclonex is studied for effectiveness and safety in pediatric patients with mild to moderate plaque psoriasis.

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Background:
Psoriasis in children has a significant negative impact on the quality of life (Qol) and effective treatment can improve this. The two-compound ointment calcipotriol 50 μg/g and betamethasone dipropionate 0.5 mg/g is an effective treatment option for moderate to severe psoriasis in adults.

Objectives:
To prospectively study the effectiveness and safety of calcipotriol/betamethasone dipropionate ointment in pediatric patients with mild to moderate plaque psoriasis in daily clinical practice and to investigate the influence on Qol.

Methods:
Data were obtained from a prospective longitudinal pediatric psoriasis registry, called Child-CAPTURE. Severity was assessed by the Psoriasis Area and Severity Index (PASI) and body surface area (BSA). The Children's Dermatology Life Quality Index (CDLQI) was used to assess Qol. Visual Analogue Scores (VAS) for pain and itch were used. For safety data the number of (serious) adverse events was recorded.

Results:
Seventy-three patients (mean age 10.8 years, range 3-18) were treated for a median time of 35.0 weeks (range 1.0-176.0). At week 12, mean PASI decreased 15.4% (from 5.2 to 4.4), BSA barely changed, and median CDLQI decreased significantly from 5.5 to 4.0. VAS pain and itch declined. At week 24, mean PASI decreased to 4.3 (17.3%). No related serious adverse events were observed.

Conclusions:
In this daily clinical practice study in pediatric psoriasis, calcipotriol/betamethasone dipropionate ointment initially improves mild to moderate psoriasis and then maintains its effect. In addition, it improves Qol, with few adverse events.

This article published in The British Journal of Dermatology sets out to to better understand the mechanism of action of Enbrel (etanercept) by examining very early changes in the lesional skin of psoriasis.

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Background:
Anti-TNF-α therapy has made a significant impact on the treatment of psoriasis. Despite being designed to neutralize TNF-α activity, the mechanism of action of these agents in the resolution of psoriasis remains unclear.

Objectives:
To better understand the mechanism of action of etanercept by examining very early changes in the lesional skin of psoriasis patients responding to etanercept.

Methods:
20 chronic plaque psoriasis patients were enrolled and received 50mg etanercept twice weekly. Skin biopsies were obtained before treatment and on days 1, 3, 7 and 14 post-treatment. Skin mRNA expression was analysed by QRT-PCR and microarray; cytokine and phosphoprotein levels were assessed using multiplexed bead arrays.

Results:
In etanercept responders, we observed no significant changes in IL-17A, IL-22 and IFN-γ mRNA or protein in the first week of treatment; however, there was a 2.5-fold down-regulation of IL17RC mRNA (p<0.05) after day 1, accompanied by decreased ERK1/2 phosphorylation. Transcriptional analysis revealed genes suppressed by etanercept significantly overlapped with IL-17A-induced genes, and a marked overlap was also observed between the genes suppressed by etanercept and by the anti-IL17A therapy ixekizumab. Finally we show that TNF-α enhances the expression of IL-17RC and shRNA inhibition of IL-17R expression abrogates synergistic gene induction by TNF and IL17A.

Conclusions:
These results suggest that the early responses of psoriasis plaques to etanercept may be due to decreased tissue responsiveness to IL-17A due to suppressed IL17RC expression in keratinocytes, blunting the strong synergy between TNF-α and IL-17, which contributes to the maintenance of psoriasis lesions.

This article published in The British Journal of Dermatology assesses whether methotrexate use increases the risk of developing fibrosis.

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Background:
Methotrexate is an effective treatment for psoriasis but concerns regarding the development of liver fibrosis prevent optimal use.

Objectives:
To assess whether methotrexate use increases the risk of developing fibrosis.

Methods:
Searches were performed on MEDLINE, Embase, the Cochrane database and Clinical Trials Register from inception until September 2013 for studies including at least two liver biopsies in people with psoriasis. Double extraction using predefined data fields was performed. RCTs and observational studies were considered. Statistical analysis was performed using Review Manager 5. Quality of observational studies was assessed using a study quality bias checklist.

Results:
Eight observational studies met the inclusion criteria (N=429). The pooled risk difference (RD) of developing significant liver fibrosis was 0.09 (95% CI: -0.03, 0.20). The RD for developing ‘any fibrosis’ was 0.22 (95% CI: 0.04, 0.41). The RD for cirrhosis was 0.04 (95% CI 0.02, 0.07). There was no clear association between cumulative dose of methotrexate and fibrosis. Obesity, diabetes and alcohol use were under reported. The quality of included studies was weak and the degree of selection bias means the results are not generalisable to all patients with psoriasis taking methotrexate.

Conclusions:
High quality, population based studies that consider potential confounders common in the psoriasis population taking methotrexate are justified to better predict the subset of patients at risk of liver fibrosis. In this highly selected population, methotrexate use contributes to the development of ‘any’ fibrosis without clear evidence of risk stratifiers.

Hello!

I have been lurking around here for quite some time so I figured I'd introduce myself.

I'm 24 and live in the great state of Wisconsin. I have had scalp psoriasis for about 3 years now. Currently it covers about 40% of my head as well as around my ears. I saw a dermatologist about 2 years back who prescribed me Clobox. This cleared me up while I applied it regularly but I eventually discontinued using it about a year back because I read about the harmful side affects of prolonged use of topical steroids. I am still using another prescription called Protopic around my ears. I actually have not seen anyone on this site that has used it but after reading up on it a bit I found out that it is sort of a new drug on the market and has been prescribed for many different skin conditions. I use a small amount about 3-4 times a week before I go to bed and notice that the scaling/ redness around my ears goes away but comes back if I don't use it for a few days. As for my scalp, I use a coal tar shampoo twice a week and an organic tea tree/ peppermint oil shampoo the rest of the time (from Trader Joes, such an awesome store!). I also have been recently been using baking soda mixed with the shampoo and have noticed that I don't scale as much (if at all). The redness is still there, but it seems to help with the itching as well. Sometimes it helps with the raised edges but notice that I'll still flair up if I'm stressed out. I am planning on seeing another Dermatologist sometime soon (now that I am on my own insurance) and was wondering what some of you have to say about a first time consultation. What have you done to work with your doctor to get the best results at treating your psoriasis?

Now on to the fun stuff.

I am an avid disc golfer, weight lifter, runner and bass player. I like to stay active and try to keep positive although psoriasis sometimes makes me a bit self conscious. I used to hate getting haircuts but I have found a place that I feel comfortable at. I usually talk about psoriasis with them and how I'm working on treating it and have started to realize that people who cut hair have seen everything under the sun when it comes to scalp and hair health.

That's me in a nutshell, I'm really happy to find a forum like this that is so welcoming and has so much knowledge to share with those of use that are still learning!

-Eric

I have (almost) beat this thing in two months after years of visiting a dermatologist with little luck. I am not against doctors or endorsing any product. What I did was in desperation and it worked in just over two months. I am 99 percent clear on my shins which is where the problem area was. This story is about what I did. I truly believe the key was keeping the area moisturized and natural sun when you can. The pictures should be accessible at the link below.

The Mixture:

I started out with putting liquid Vitamin D, cocoa butter petroleum jelly generic from Wal-Mart and Turmeric on the bad area. I would apply the triple combination the morning with rubber gloves and wrap with cling wrap over the mixture and an ACE style bandage to prevent the staining of clothing. I wore the bandage all day long. I cleaned the area at the end of the day with Dermarest Psoriasis Skin Treatment and added MG217 after cleanup and before the lamp. I also took up to 200mg Zinc and around 10,000 UI Vitamin D orally a day. I took half of both in the morning and the other half at bed time.

The lamp:

I bought two reptile bulbs, REPTISUN 10.0 UVB bulbs (48 inch 36 watt) and put them in a 32 watt 48 inch fixture from Lowes. I would put my legs (uncovered) under this light for at least an hour. Sometimes more sometimes less.

I did both treatments least 5 days a week during winter as it was easy to cover up with long pants. It took some time learning the securing the bandages so they would stay all day. I ultimately used safety pins. On the weekends I would apply MG217, liquid vitamin D and sometimes diaper rash ointment from Wal-Mart. I would get under the lamp as often as possible.

Last week I stopped with the petroleum/turmeric/bandage thing and went to just the MG217 and diaper rash cream and I can see its coming back. Next week I will go back to the petroleum/turmeric/bandage on Monday and Tuesday then lay off and see if it keeps in check. More later.
David

Thought this was interesting, the price of Dovobet is frightening !!

Hello you lot,
I'm back, I think. You see, I seem to remember joining before now, but lost my account I must have 

Any how, for those that don't know me...
Geeky 37 year old bloke.
Likely Aspergers but not yet diagnosed.
Married with 2 children (aged 4 and 7, the kids that is, wifey is much closer to my age ).
Chronic Plaque Psoriasis since about 7 years old.
Psoriatic Arthritis first diagnosed at about 17 years old.
Been through about every treatment the NHS has to offer....
Currently having success with Stelara for about a year. Skin mostly clear although a little worse at the mo'. Joints not too bad either, although I don't think thats much to do with the Stelara. A change of lifestyle the last few months has meant I can look after myself better; Stretching/exercise/meditation etc. Currently no painkillers, funny story that, co-codamol was making my pain worse after I got addicted to it. So with some effort I got 'clean' and have been quite a lot better since.

RE: PM's - I can't reply yet, must need to post more and prove I'm no robot.

All the best,
Daniel

(soldersplash)

There has been a big media report about a Flesh Eating Disease in Pangasinan province of the Philippines, and the report is false according to the Philippine Information Agency and they appealed to media to check the validity of news reports on health-related cases before releasing to the public.

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LINGAYEN, Pangasinan, Feb. 26 (PIA) -- The supposed “mysterious flesh-eating illness” in Pangasinan is a hoax, the provincial health officer said in a press briefing on Tuesday.

Provincial Health Officer Dr. Anna Maria Teresa de Guzman belied a news report that two patients were suffering from a “mysterious” disease that is eating the flesh of its victims.

She said the patients from the towns of Santa Barbara and Villasis are actually afflicted with psoriasis and leprosy.

“Both ailments are controllable, not contagious and pose no threat to the public,” De Guzman said.

The Provincial Health Office came out with a finding after looking into a report from ABSCBN’s news program ‘Bandila” on Monday night that the patients were afflicted with rare necrotizing fasciitis or flesh-eating disease.

De Guzman said in 2011, the patient from Santa Barbara was diagnosed with leprosy, a disease that causes skin sores.

She added the patient was already treated but a drug reaction triggered the leprosy to resurface.

“Nagkaroon siya ng hypersensitivity doon sa gamot kaya nagkaroon ng reaction sa kanyang katawan (She developed hypersensitivity from a drug which caused skin reaction),” De Guzman said.

She has no menstrual period, a sign of malnutrition and anemia, which aggravated her condition, she said.

The patient, who was initially-treated in another private health facility, has now completed the treatment but may still need debridement for her skin lesions, she added.

The second patient from Villasis is ailed with severe case of psoriasis (a skin disease that causes peeling and red marks on the skin) with arthritis which prevents him from walking.

She said the victim already had psoriasis since birth (genetic) which was triggered due to various factors including weather changes and stress.

“The two reported patients are now admitted at the Pangasinan Provincial Hospital in San Carlos City to undergo further treatment and medical diagnosis,” she added.

De Guzman said the report only connected the two case studies to a prophecy by a self-titled prophet Sadhu Sundar Selvaraja of Jesus Ministries in April 2013 warning that a flesh-eating disease would spread from the Ilocos province to the world. He also prophesied the typhoons that caused destruction and heavy flooding in Luzon and Visayas last year.

She appealed to media to check the validity of news reports on health-related cases before releasing to the public.

Researchers at The Centre for Dermatology Research at Wake Forest Baptist assessed how often steroids were prescribed to treat psoriasis and trends in their use over time.

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When it comes to psoriasis management guidelines, use of systemic corticosteroids are discouraged, but a new study from Wake Forest Baptist Medical Center indicates they are widely prescribed by dermatologists.

Researchers at The Center for Dermatology Research at Wake Forest Baptist assessed how often these drugs - prednisone, dexamethasone and methylprednisolone - were prescribed and trends in their use over time.

"Expert guidelines discourage their use for psoriasis due to concerns about causing flares of generalized pustular psoriasis, but there are no randomized controlled trials of systemic corticosteroids in psoriasis to look at these issues," said Scott A. Davis, M.S., a co-author of the study and assistant director of the Center for Dermatology Research at Wake Forest Baptist Medical Center.

Davis and colleagues used National Ambulatory Medical Care Survey data to determine the systemic medications prescribed for psoriasis from 1989 to 2010. They found that systemic corticosteroids were prescribed at 650,000 of 21 million psoriasis visits. Of these prescriptions, 93 percent were from dermatologists. Corticosteroids were the second most commonly prescribed systemic medication for psoriasis, according to the study which appears online this month ahead of print in the journal of Cutaneous Medicine and Surgery.

Despite the warnings and concerns, the drugs are widely used, the study showed. "Psoriasis has an enormous impact on patients' lives, and there have been major recent advances in treatment," Davis said. "While the new treatments are highly effective and appear very safe, they are costly; their effects are well studied. In contrast, while corticosteroids have been available for decades, their use in psoriasis has not been extensively studied."

I am wondering if anyone has any advice or tips on dealing with nail Psoriasis.
Mine are pretty bad at the moment, pitted and very sore if i knock them. Two of them look like they are coming away from the nail bed (which makes me feel queasy everytime i think about it.)

I guess its hard to treat but just wondered if there was anything out there.

Anacor Pharmaceuticals announced today that a peer-reviewed article describing the recent progress of boron-based compounds in medicine and the properties of these compounds that support their development for the treatment of various skin disorders will be published in the February 17, 2014 edition of the Journal of Clinical and Aesthetic Dermatology. “From the Test Tube to the Treatment Room: Fundamentals of Boron-Containing Compounds and Their Relevance to Dermatology” is co-authored by James Q. Del Rosso, D.O., F.A.O.C.D., dermatologist in private practice at Las Vegas Skin and Cancer Clinics in Henderson, Nevada and Clinical Professor of Dermatology at Touro University College of Osteopathic Medicine in Henderson, Nevada and Jacob. J. Plattner, Ph.D., Senior Vice President of Research, Anacor Pharmaceuticals.

The authors note that the therapeutic benefit of incorporating boron into a chemical compound is derived from boron’s unique physical, chemical and structural properties. Boron has an empty p-orbital which gives it the capacity to form covalent bonds at a target site on a protein, rendering the protein inactive or less active. Several examples of proteins that boron-containing compounds have been found to inhibit include phosphodiesterase-4 (PDE4) thereby reducing the cytokine production in psoriasis and atopic dermatitis; leucyl tRNA synthetase thereby blocking protein synthesis in dermatophytes; and β-lactamases, thereby reducing resistance to antibiotic therapy.

The authors also note that, until recently, the use of boron in drug development has been widely overlooked. Initially, boron was incorporated into drug candidates as boronic acid which made the compounds overly reactive resulting in off-target binding and decreasing their potential effectiveness as therapeutic agents. However, since then, researchers found that if they incorporated boron into compounds as part of a cyclic structure rather than as an acid, they were able to produce small boron-based molecules that are highly stable, demonstrate effective target binding and selectivity and exhibit optimal physical properties that allow access to the necessary site of the disease target.

“The use of boron in drug discovery and development is very exciting to dermatology and other fields of medicine. Boron’s unique properties allow it to bind to target proteins involved in key pathophysiologic pathways which has opened the door to new potential therapies in dermatology including fungal infections such as onychomycosis, atopic dermatitis, psoriasis, acne, bacterial infections and other skin diseases,” said Dr. Del Rosso.

Boron-based compounds currently in development for dermatologic indications include tavaborole, which is being reviewed by the FDA for the treatment of toenail onychomycosis and AN2728, a PDE4 inhibitor which has completed Phase 2 studies in psoriasis and atopic dermatitis. A third compound, AN3365, is being evaluated as a gram-negative antibiotic. All three compounds were discovered and are being developed by Anacor Pharmaceuticals.

Source: anacor.com

*Anacor is a biopharmaceutical company focused on discovering, developing and commercializing novel small-molecule therapeutics derived from its boron chemistry platform.

A new study published in Science Translational Medicine shows there could be a new target for the treatment of psoriasis, and it is the first time that this gene has been identified as having a specific link to the condition.

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Cytokines are critical checkpoints of inflammation. The treatment of human autoimmune disease has been revolutionized by targeting inflammatory cytokines as key drivers of disease pathogenesis. Despite this, there exist numerous pitfalls when translating preclinical data into the clinic.

We developed an integrative biology approach combining human disease transcriptome data sets with clinically relevant in vivo models in an attempt to bridge this translational gap. We chose interleukin-22 (IL-22) as a model cytokine because of its potentially important proinflammatory role in epithelial tissues.

Injection of IL-22 into normal human skin grafts produced marked inflammatory skin changes resembling human psoriasis. Injection of anti–IL-22 monoclonal antibody in a human xenotransplant model of psoriasis, developed specifically to test potential therapeutic candidates, efficiently blocked skin inflammation.

Bioinformatic analysis integrating both the IL-22 and anti–IL-22 cytokine transcriptomes and mapping them onto a psoriasis disease gene coexpression network identified key cytokine-dependent hub genes. Using knockout mice and small-molecule blockade, we show that one of these hub genes, the so far unexplored serine/threonine kinase PIM1, is a critical checkpoint for human skin inflammation and potential future therapeutic target in psoriasis.

Using in silico integration of human data sets and biological models, we were able to identify a new target in the treatment of psoriasis.

New research published by Research And Markets shows Market value of Systemic psoriasis treatments are set to rise from $5 billion in 2013 to $10.4 billion by 2020.

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The systemic psoriasis treatment market value in the eight major countries (8MM) — the US, Canada, France, Germany, Italy, Spain, the UK and Japan — is expected to more than double in the near future, jumping from $5 billion in 2013 to $10.4 billion by 2020, at a significant Compound Annual Growth Rate (CAGR) of 11.1%

The company’s new report states that across the 8MM, 4.1 million people were diagnosed with some form of moderate-to-severe psoriasis in 2013. This number is expected to climb slightly to 4.4 million by 2020, with 1.5 million of the population being treated with systemic agents.

Fiona Chisholm, report analyst, says: “This growth in the treatment population will be driven by a marginal rise in the global prevalence of psoriasis, as well as an increase in the diagnosis rate resulting from higher disease awareness and improved diagnostic methods.

“Additionally, psoriasis is increasingly being recognized as a serious systemic disease with associated quality of life impairment and disability, rather than as a simply cutaneous disease. As perceptions of psoriasis continue to change, healthcare professionals will consider treatment as non-optional.”

Although some revenue losses are anticipated to occur throughout the forecast period, due to patent expiries, the introduction of new, novel biologics with positive efficacy profiles will drive further market growth.

According to the authors, secukinumab, brodalumab and ixekizumab are three particularly promising, late-stage pipeline monoclonal antibodies directly targeting IL–17, a pro-inflammatory cytokine. In addition to these upcoming biologics, some orally administered, small molecule compounds are also expected to enter the market over the coming years, such as Xeljanz, a janus kinase inhibitor, and apremilast, a PDE4 inhibitor.

This report was built using data and information sourced from proprietary databases, primary and secondary research, and in-house analysis conducted by a team of industry experts.