Background:
Previous investigations have demonstrated that a combination of (Enbrel) etanercept (ETN) and narrowband ultraviolet B (NB-UVB) phototherapy is more effective than ETN alone. However, it is unclear if this combination is more effective than NB-UVB phototherapy alone.

Objectives:
To evaluate whether the combination of NB-UVB phototherapy with ETN improves the efficacy of ETN alone in the treatment of moderate-to-severe psoriasis.

Methods:
We enrolled 322 consecutive patients with moderate-to-severe plaque-type psoriasis, who were treated with NB-UVB phototherapy as the first-line treatment option. Patients who did not achieve a 75% improvement in Psoriasis Area and Severity Index (PASI 75) were treated with conventional systemic therapies for psoriasis. If they were ineligible for these, they were treated with ETN 50 mg twice weekly. If they did not achieve PASI 75 within 12 weeks, NB-UVB phototherapy was added.

Results:
PASI 75 was achieved in 262 patients (81·4%) treated with NB-UVB phototherapy. Sixteen patients (5·0%) dropped out for personal reasons and 24 (7·5%) were treated with at least one of the conventional systemic treatments for psoriasis. Twenty patients (6·2%) were treated with ETN. The combination regimen was needed in eight patients (2·5%) with poor response to both phototherapy and ETN alone. All of these patients achieved PASI 75 and three of them had a complete remission after 14·6 ± 3·3 NB-UVB exposures. The combined treatment was well tolerated without acute adverse events. Unfortunately, all of these patients relapsed, with PASI > 10 within 2·8 ± 1·7 months.

Conclusions:
The combined treatment has a synergistic effect for clearing plaque-type psoriasis previously unresponsive to ETN and NB-UVB phototherapy alone. The clearance rate is very high in a very short time without short-term adverse effects. However, concerns regarding potential cocarcinogenicity remain. Therefore the number of patients who require, and could benefit from, the combined treatment is likely to be small.

Source: NO LINKS ALLOWED

Enbrel etanercept

Background:
Pathomechanisms of both psoriasis and atherosclerosis may involve platelet activation. Activated platelets show increased P-selectin; CD62 expression, and mean platelet volume (MPV). Impaired brachial artery flow-mediated dilatation (FMD) is related to atherosclerosis.

Objectives:
To determine the presence of subclinical atherosclerosis in patients with psoriasis (without overt cardiovascular complications or traditional cardiovascular disease risk factors), compared with controls.

Methods:
In this case–control study, 25 patients with psoriasis and 25 age- and gender-matched healthy individuals were subjected to assessment of MPV, CD62 expression using flow cytometry, and brachial artery FMD and transthoracic echocardiography by cardiac ultrasound scanner.

Results:
A statistically highly significant increased CD62 expression, but not MPV, was found in cases compared with controls, and in patients with moderate/severe psoriasis compared with either mild cases or controls (P < 0·001). CD62 expression was statistically significantly positively correlated with the Psoriasis Area and Severity Index (PASI) score (P < 0·001), baseline brachial artery diameter (P = 0·03) but not FMD and aortic root diameter (ARD; P = 0·03). ARD was statistically significantly higher in patients with moderate/severe psoriasis compared with controls (P = 0·017). Stepwise simple linear regression analysis revealed that PASI score was the most important factor affecting CD62 expression (P < 0·001).

Conclusions:
Our study showed increased atherosclerosis risk in patients with psoriasis, particularly those with moderate/severe disease, as evidenced by increased expression of platelet CD62 compared with healthy controls. Moreover, we found a positive correlation between CD62 expression and ARD (another possible marker of atherosclerosis), with positive correlation to the PASI score; the most important factor influencing CD62 expression. However, our data on MPV and FMD do not support the use of either value for diagnosing subclinical atherosclerosis in patients with psoriasis in further studies.

Source: NO LINKS ALLOWED

*Atherosclerosis (also known as arteriosclerotic vascular disease or ASVD) is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol and triglyceride.

Here is a study published in the British Journal of Dermatology which suggests that psoriasis is due to a breakdown of immune tolerance to the microbiota of the skin.

Quote:

---

There is a known association between psoriasis and Crohn disease (CD). Patients with CD are five times more likely to develop psoriasis, and, conversely, patients with psoriasis are more likely to develop CD.

Many gastroenterologists now accept that CD results from a breakdown of immune tolerance to the microbiota of the intestine in genetically susceptible individuals. The microbiota of the skin have recently been investigated in psoriasis.

Firmicutes was the most common phylum, and Streptococcus the most common genus identified. Beta-haemolytic streptococci have been implicated in both guttate and chronic plaque psoriasis. Furthermore, the innate immune system has been shown to be activated in psoriasis, and many of the genes associated with the disease are concerned with the signalling pathways of the innate immune system, notably interleukin-23 and nuclear factor κB.

Patients with psoriasis also have an increased incidence of periodontitis, a disease thought to be due to an abnormal response to normal oral commensals.

Based on the similarities between CD and psoriasis, we propose that psoriasis is due to a breakdown of immune tolerance to the microbiota of the skin. In support of this hypothesis we provide evidence for microbiota in the skin, activation of the innate immune system, and genetic abnormalities involving the innate immune system.

Hi my name is angus,i have just been diagnosed at age 38.My father had this and i rather hoped in it skipping a generation but now i have it too.

Hello everyone!


I was wondering if anyone knows if working out alot makes psoriasis worse?
I try exercise and everytime I do my psoriasis tend to flare up and become all red, but then later it just goes back to normal psoriasis and not that very red. But I was just wondering if it worsens the condition or is it just in my head?

For a couple of years I have been switching between dovobet and silkis (calcitriol) for my skin but after returning from my adventure Stateside I had to get a new prescription (my luggage went on an adventure of it's own - with all my creams/ointments in it) and was surprised to discover that my pharmacist had given me dovobet gel....

I had no idea there was a gel.... It comes in a really handy bottle that enables you to apply small drops to the affected area, and it is so much less greasy than the ointment I had been using before.

So far I have found it appears to be more effective in clearing my skin, perhaps because it is more readily absorbed into the skin.

Has anyone else used it? If so, what are your opinions?

Krissie

Hi everyone and good afternoon evening wherever you are!

Went to the doctors last week and asked for exorex lotion as I had heard it was very good for clearing up guttate psoriasis! It has cleared across my chest nearly gone from arms, legs are starting to look more sunburnt now, which is how my chest looked before it eventually went away! tummy is looking much better too and more sunburnt also.

Has anyone used the lotion? I quite like it although it can't be used if you are planning on going out into the sunshine because it contains real coal tar! It smells okay too and is quite a thin lotion and pleasant to use.

anyone else had good results using exorex. It is really expensive too if you can't get it on prescription.

Thank you all

Have a great afternoon evening

xx

Novartis announced today top-line results from the head-to-head Phase III psoriasis study which showed the superiority of secukinumab (AIN457) in clearing skin to Enbrel®* (etanercept), an anti-tumor necrosis factor (anti-TNF) therapy. In addition, secukinumab (AIN457) met all primary and secondary endpoints.

The FIXTURE trial (the Full year Investigative eXamination of secukinumab vs. eTanercept Using 2 dosing Regimens to determine Efficacy in psoriasis) was a randomized, double-blind, double-dummy, placebo-controlled, multicenter global study of subcutaneous secukinumab (AIN457) in moderate-to-severe plaque psoriasis involving 1,307 patients. It was designed to demonstrate efficacy after 12 weeks of treatment, compared to placebo and etanercept, and to assess the safety, tolerability and long-term efficacy up to 52 weeks. Established treatment measures were used to assess the efficacy of secukinumab (AIN457) including PASI 75 (Psoriasis Area and Severity Index 75) and the Investigator's Global Assessment (IGA mod 2011), a standard tool to assess the clearing of skin after treatment.

"These results showing that secukinumab (AIN457) is superior to Enbrel, a current standard-of-care therapy, are great news for people living with moderate-to-severe plaque psoriasis," said Tim Wright, Global Head of Development, Novartis Pharmaceuticals. "With 40-50% of people living with moderate-to-severe plaque psoriasis dissatisfied with their current therapies, there is clearly an unmet medical need for new therapies that act faster and longer to relieve pain, itching and other symptoms."

Full results from the secukinumab (AIN457) Phase III study program, the largest undertaken in moderate-to-severe plaque psoriasis to date, are expected to be presented at major medical congresses later this year.

Secukinumab (AIN457) is the first medicine selectively targeting IL-17A to present Phase III results. IL-17A is a central cytokine (messenger protein) in the development of psoriasis, and is found in high concentration in skin affected by the disease. Research shows that IL-17A plays a role in driving the body's autoimmune response in disorders such as moderate-to-severe plaque psoriasis and is a preferred target for investigational therapies.

In the FIXTURE study, the observed safety profile of secukinumab (AIN457) was consistent with previously reported results from Phase II studies in moderate-to-severe plaque psoriasis and no new safety concerns were identified.

Source: NO LINKS ALLOWED

Hi I was just wondering how people cope with constant itchiness. I have had Psoriasis for 35 years on and off. But after having a clear spell of about 4 years. It has come back with avengance and I am struggling to cope with the itchiness all the time and i'm being really good putting on my creams but to no relief.

Hello
Im very new to this site so just wanted to post something.
I, also have guttat psoriasis and this is my first time actually talking/chatting/posting to anyone that have the same condition

Good evening all,
Having recently been diagnosed with Psoriasis at the age of 63 it came as quite a shock, never having had a skin complaint in my life before.
I am slowly coming to terms with it and hope to have it under control soon. Finges crossed.
No doubt there is a lot to learn about this problem hence my reason or joining this forum.
Hopefully lots of answers to my questions will be on the site somewhere once I have found my way around.
Thanks for reading my post and it won't be the last you hear from me.
Regards, Ed's Mom

Hi everyone and good morning

Has anyone used glycerin on their skin to treat their psoriasis? What is the best way to use it? Do you apply directly to your skin or mix it with lotion or something? Is it effective. I have guttate which is fading in some areas but have heard great things a bout glycerin.

Amazon seem to have a huge range of glycerin to buy, which one is the best?

Thank you

Hope you all have a nice day!

xx

I have 1 Humira pen leftover, unused, unopened, kept refrigerated that I do not need anymore. I hate to throw it away. Any ideas what to do with it? Is it legal to sell it??

I was on Humira for 2 years, but it stopped working for my Psoriatic Arthritis. I am now on Remicade.

Thanks for any input!

Hello I always take alcohol or brandy for about 4 to 5 shots just to make me sleep every night. My question is its really worse my Psoriasis problem?

Hi all,

Just joined this forum, found it while browsing psoriasis, (can just about spell it now) and treatments.
I'm 48 and have had this condition for around 10 years now, it started in my scalp but spreads to different bits of me and in different forms - whenerver and wherever it pleases.
At the moment I've got the scalp flaky patches in my scalp (they are a constant). Elsewhere there are some red blotches and large reddish spots in other places.
I don't get how it changes though - other times I've had scaly and flaky blotches but not now, instead they are red and sore.
I use T Gel on my scalp - I heard olive oil was good, has anyone tried this, also that you should wash your hair and scalp in cool water, not hot??
I've used creams but don't remember what they were - once used a steroid cream, which seemed to make it worse so I stopped. Anyone any tips for complementary medicine?

Cheers folks,

Filmbuff

Hello how is everyone tonight? Me, I am just blah. I am tired of my Psoriasis, just like everyone else on this forum probably is. I am new to this forum, so here is a bit about myself:

I am 33 and had Plaque and Inverse Psoriasis since I was a kid and was official diagnosed in 2003. Also, I have had pain in my hip and hands/fingers since I was a kid. I have not been diagnosed with PsA or RA as of yet. For my P, I have tried the following laundry list of medications: Cellcept, Enbrel, Methotrexate, Humira, Soriatane, and now Stelara and Celebrex.

Stelara has been the best so far; I am approximately 85% clearance without any visible inflammation after three shots. However, my hips and hands/fingers still hurt considerably. My Dermatologist thinks I could have PsA, and recommended that I see a Rheumatologist. My new Rheumatologist mentioned the M word (methotrexate; a curse word to me) 31 times during the visit. I had some blood work done (no results yet), and eight x-rays.

For the most part, I can live with the pain in my hip and hand/finders, but now I have stiffness and fatigue every morning (feels like I beat myself up in the gym for the first time in a long time). The stiffness and fatigue came directly after I stopped Humira (Humira cause my P to flare). I am sorry for the wall of text. I am a HTFU type of guy, but for the first time in my life I just want to cry. I hate this curse! I am thinking about giving up Stelara, but is there anything else left? Any suggestions?

I was just prescribed urea lotion a few days ago. An addition to my regimen. There's no limit in using it. We can use it twice a day or as needed. It attracts water hence it moisturizes the affected areas. It helps me specialLy on my elbows. Psoriasis in these areas became thinner after 3 days of using the lotion..

Hello everyone!

Just been looking on amazon at pine tar soap. Has anyone ever tried it for psoriasis? Is it any good? and is it safe? I have heard it may contain creosote which causes cancer

If anyone has tried it what did you think?

Hope your all having a nice day!

xx

Hi!  I came from the Philippines.  I have psoriasis for over 6 years, just an estimate[/font].  I just could not remember when it started.  I was diagnosed sometime in 2010.  However, i did not mind it too much as it only started on my left elbow. Though I didn't mind it too much, I had gone from one doctor to another.  I was prescribed ointments for anti-fungal infections however it was not cured.  Then early this year, i noticed a red spot below my throat which prompted me to see a dermatologist.  That was on February 5, 2013 that I started seeing a derma. You know what the derma told me?  She said i'm lucky my psoriasis has not spread all over my body.  Now, i have them in both hands, and some parts of my body.  Thanks to the dermatologists that i visited my psor is controlled.  Actually i visited 2 dermas one in the place where i live and the other is in Quezon City.  Both of them are so good.  I love seeing them both.

Hi everyone!

Haven't posted in a couple of weeks as I am still finding my way around the site.

My doctor has prescribed Daktacort cream for me 1%. It seems really good and has cleared up a couple of inverse patches of psorasis for me.

As I mostly have guttate and it seems much dryer I am wondering if it will now get better on its own or can I use some of the daktacort, little bits at a time on small patches of skin to treat some of the guttate.

As i said on a previous thread I wouldn't use the cream all over as it is cortisone and not good for all over use as it is bad for the adrenal glands and also thinning of skin.

I have had guttate now for nearly a month and am fed up of it and want it to clear which i am hopeful it will do in time. But i would like to clear it up quicker if i can.

Thank you for listening

xx