Hey everyone i've just started clinical trials for 2 new meds, one is a tablet and the other one is an injection.

I was wondering if anyone else had started the trials?

I will keep you updated on how trials are going and if its helping my psoriasis.

bye for now.

jasse.

I've added a new link in the green bar for members View My Groups if you click it you will see groups that you are a member of and/or groups you can join.

I had to add extra groups for the new newsletter subscription, see here for more info: Newsletter Subscription

So for now you will only see your default user group Newbie, Novice, Member, or 100 + Member I Just Cant Stop, and the option to choose Newsletter Group which will send you the monthly newsletter.

Hope that explains the reason for the new link. If you have any questions or comments please let me know.

Now we have extra user groups, please let me know if you have any suggestions for other user groups that you think could be of interest to members.

Thanks.

Fred.

I first started showing symptoms of psoriasis about a year ago. The first month was the worst, because it took my doctors about this long to figure out what was going on. I was finally referred to a dermatologist, who instantly diagnosed me with gutate psoriasis. She recommended I try light therapy as well as clobetasol propionate. I tried this, which did make the psoriasis better, but the tanning beds also brought up a lovely fungal infection which gave me white spots all over my arms and back (it sounds gross, but it was just another awkward kind of spots in addition to my psoriasis). Also, I did not want to continue with the tanning beds for too long because my family does have a history of skin cancer. I only did short amounts of time, but still, it makes me nervous. I was treated for the fungal infection, and my dermatologist added Dovonex to my treatment for psoriasis. Now, after about a year of really struggling, I feel I am really learning to manage this.

I take a lot of baths with epson salt, which seems to help some. I also have finally found a lotion that keeps my skin moisturized without irritating my VERY sensitive skin. For anyone who has sensitive skin/skin allergies in addition to psoriasis, I recommend trying St.Ives' Oatmeal and Shea butter lotion. Occasionally I will still use the clobetasol or the dovonex to get a bad patch under control, but I find I really hardly need it with the epson salt baths and st. Ives lotion.

Anyway, I just wanted to share because I feel like I am really learning to live with and manage my psoriasis. I'm glad to know this forum exists, because there have been a lot of times in this past year where I have felt alone with this condition. It is nice to be able to scroll through posts and see that I am not alone, and also to see the different ways other people are managing and treating this. Thank you all for sharing.

Taro Pharmaceutical reported today that it has received approval from the U.S. Food and Drug Administration (“FDA”) for its New Drug Application Topicort® (desoximetasone) Topical Spray, 0.25%.

*Topicort® (desoximetasone) Topical Spray, 0.25% is a corticosteroid indicated for the treatment of plaque psoriasis in patients 18 years of age or older.

Source: NO LINKS ALLOWED

*Topicort is also available in 0.05% Cream, 0.25% Cream, 0.05% Gel, & 0.25% Ointment. It's active ingredient is Desoximetasone a topical corticosteroids.

Someone was asking me more about the User CP so here goes.

As a member of Psoriasis Club you have your own User Control Panel (User CP) where you can make changes to the way your account works. To access it you need to click the link in the green bar above where it says Control Panel top left.

OK now you're in your User CP lets run through what you can do here.

At the top you will see your Usename, Number of posts you have made, Your email address (*don't worry only you can see this), The date you registered, And your primary user group.

Below that you will see your Personal Notepad. You can put in here whatever you want, as no one will be able to see it accept you. Make as many changes as and when you want, but remember to scroll down and hit the "Update Notepad" button. More on personal notepad Personal Notepad]

Next you will see thread subscriptions and your threads, self explanatory really.  

• Menu
  
• User CP Home: Your user control panel.
  
• Messenger More on PMs Private Messages
  
• Compose: From here you can send a private message to another member. (*you need to have made 5 posts to use this)
  
• Inbox: This has private messages you have received from another member.
  
• Sent Items: A list of private messages you have sent.
  
• Drafts: Messages are stored here that you have not sent or finished with.
  
• Trash Can: Private messages you have deleted are stored here untill you empty it.
  
• Your Profile
  
• Edit Profile: Here you can change things that are shown in your profile. Bio, Treatment, Location, Psoriasis Score, Birthday, And after you have made 10 posts you can choose a Custom User Title. More on custom titles User Titles/Ranks
  
• Change Password: Change your password here.
  
• Change Email: You can change your email address here.
  
• Change Avatar: Here you can add a nice little picture to your profile so you look different to everyone else. More on Avatars Avatar / Photo in your profile
  
• Edit Options: This is where you change your options like Emails, Notifications, Time, View, Etc.
  
• Miscellaneous
  
• Group Memberships: Here you will see your default group plus any others that you can join. I recommend the newsletter group which will send you a monthly newsletter. More on the newsletter Newsletter Subscription
  
• Saved Drafts: This is where posts that you have saved as a draft for publishing later are stored.
  
• Favorite Threads: Yes I know it's spelt wrong in English, this is where you can view threads you have made favourite. EDIT: *This has been removed*
  
• Subscribed Threads: Here is a list of all threads that you have subscribed to.
  
• Forum Subscriptions: This is different to the above. Here you can get a notification of new threads posted in your chosen boards. More on subscriptions Notification of new threads and posts
  
• View Profile: This is what your profile will look like to other members.
  

This is a study published in the British Journal of Dermatology from a Dutch web-based survey about treatment satisfaction.

Background:
Various psoriasis treatments are currently available: topical therapy, photo(chemo)therapy, oral agents, and biologicals. Little is known about patients’ satisfaction with these treatment options. Moreover, the few available studies show methodological shortcomings.

Objectives:
The present study aims to answer the following questions: 1a) How satisfied are psoriasis patients with their current treatment?; 1b) Does patients’ satisfaction significantly differ between treatment types when controlling for demographic and clinical factors?; 2a) How important are specific domains of satisfaction to patients?, and 2b) When taking perceived importance into account, which domains merit the most attention in improving quality of care?

Methods:
Members of the two existing Dutch psoriasis patient associations were invited to complete a web-based survey, which included a study-specific satisfaction questionnaire.

Results:
1293 patients completed the survey (response rate 32%). Overall, patients were moderately satisfied with their current treatment. Patients receiving topical treatment were significantly least satisfied; patients receiving biological treatment were significantly most satisfied. Overall, patients rated ‘treatment effectiveness’ as most important, followed by ‘treatment safety’ and ‘doctor-patient communication’. Domains with the highest ‘room for improvement’ scores were: 1) effectiveness of topical therapy, phototherapy and oral agents, but not biological treatment, 2) convenience of topical treatment, and 3) safety of systemic treatments (both oral agents and biological).

Conclusions:
From the patients’ perspective, biological treatment is promising. To further improve the quality of psoriasis care, the effectiveness and convenience of topical therapies, the safety of systemic therapies, and doctors’ communication skills need to be addressed.

Source: NO LINKS ALLOWED

We all know there is a link between psoriasis and depression, and this study set out to see whether patients with early onset psoriasis differ psychologically from patients with late onset.

Background:
Onset of psoriasis may occur at any age. Early negative experiences often influence personality development, and may lead to physical disease, anxiety and depression in adulthood. Knowledge about onset of psoriasis and psychopathology is limited.

Objectives:
To examine whether patients with early onset psoriasis differ psychologically from patients with late onset, regarding personality traits, anxiety and depression.

Methods:
A descriptive cross-sectional study was conducted among 101 consecutively recruited outpatients with psoriasis. A psychosocial interview was performed followed by self-assessment of validated questionnaires; Swedish universities Scales of Personality (SSP), Spielberger State-Trait Anxiety Inventory (STAI, Form-Y), and Beck Depression Inventory (BDI-II). Psoriasis severity was assessed by the Psoriasis Severity and Area Index (PASI).

Results:
Patients with early onset psoriasis (< age 20) were significantly more anxious and depressed than patients with late onset. In multiple linear regression models, younger age at onset of psoriasis was a significant determinant of higher scores of four personality traits, i.e. SSP-Embitterment, -Trait irritability, -Mistrust and -Verbal trait aggression.

Conclusions:
Our results indicate that early detection of psychological vulnerability when treating children and adolescents with psoriasis seems to be of great importance. Traits of psychological vulnerability and pessimistic personality traits were found to be significantly associated with early onset of psoriasis, but not with disease duration in this study. These traits may be seen as a consequence of psoriasis, and / or as individual traits modulating and impairing clinical course and efforts to cope with psoriasis.

Source: NO LINKS ALLOWED

Hi folks

I'm a newbie to this forum and looking for some advice. I've suffered from scalp psoriasis for over 30 years and tried almost everything but nothing seems to work. I've tried Dovonex scalp solution in the past and t-gel but it no longer keeps it at bay.

I'm looking to see if anyone knows of a shampoo and conditioner and/or scalp solution that treats psoriasis successfully or have given good results. I don't mind buying online or from a high street shop as long as I can get it in the uk.

Any advice would be much appreciated.

Many thanks

Have not been online..... Greetings

The Saudi Society for Dermatology and Dermatological Surgery (SSDDS) announced the launch of the National Record for Psoriasis Patients at a press conference held at the Jeddah Hilton.

Until now, no reliable studies or statistics in Saudi Arabia that record the prevalence of the disease are available. Current studies have been carried out by individual hospitals and do not reflect the exact spread of the disease in the Kingdom.

According to these studies, the national psoriasis rate ranges from 3 to 5 percent. Patients who suffer from the disease require constant monitoring and continuous assessment in addition to follow up visits to determine the impact of treatments on patients.

The new program mechanism begins with a workshop that explains the registration process. Later, a special booklet will be published and distributed in which instructions are provided on how to use the program. A four-month trial period will then place to judge the accuracy of the information and review the results. The final stage will see the program being implemented in hospitals Kingdomwide. The program aims to raise awareness on the disease, treatment possibilities and study and analyze data on psoriasis patients and publish competitive studies and research in international journals and conferences. It also aims to spread the program in the wider Arab region in cooperation with concerned scientific departments.

The comprehensive record, which is not only the first of its kind in the Kingdom but the entire Middle East region, is being implemented by the SSDDS in cooperation with the pharmaceutical company Pfizer. The record aims to know more about the spread of the disease in the Kingdom, the psychological and social impact on patients and their families and the future planning for medication budgets and related requirements.

Source: NO LINKS ALLOWED

A dermatology researcher at *Case Western Reserve University School of Medicine has secured a five-year, $1.9 million federal grant to explore whether a specific molecule may play a pivotal role in the development and progression of psoriasis.

Nicole Ward, PhD, assistant professor of dermatology, is investigating whether interleukin-17C (IL-17C), a protein key to the regulation of the immune system, may also play a role in the onset and escalation of psoriasis, a chronic, debilitating skin disease that affects an estimated 7.5 million Americans.

The award, from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health, is the second Research Project Grant (R01) Ward has received in the last eight months. This grant will allow her to build upon earlier research suggesting a relationship between IL-17C and another protein (called TNF-alpha) in the emergence of psoriasis.

Ward and colleagues published an article in the Journal of Immunology that reported that psoriasis patients have elevated levels of IL-17C in their skin. Following treatment with TNF-alpha inhibitors, a standard therapy, IL-17C levels drop rapidly, even before the skin visibly improves. This development suggests that the presence, or interaction, of IL17-C and TNF-alpha are critical for the pathogenesis of the disease.

Ward and her colleagues also found that mice genetically engineered to overproduce IL-17C in the skin develop spontaneous lesions that resemble human psoriasis, suggesting a potential critical role for this molecule in disease initiation.. She now hopes to identify how IL-17C synergizes with other inflammatory molecules to cause disease—an understanding that may help identify a new target for drug development.

Although psoriasis is among the most common autoimmune diseases in the country, its cause remains unknown. While treatments to alleviate the condition exist, psoriasis has no cure. Patients are also more likely to be diagnosed with inflammatory bowel disease, cardiovascular disease, and depression. Even more troubling, psoriasis patients generally die seven to 10 years earlier than those without the disease.

Research funded by the NIAMS grant will be directed by Ward with collaborators and co-authors of the Journal of Immunology paper, Thomas McCormick, PhD, of Case Western Reserve, and Johann Gudjonsson, MD, PhD, and Andrew Johnston, PhD, of the University of Michigan.

*Case Western Reserve University School of Medicine is the largest medical research institution in Ohio and is among the nation's top medical schools for research funding from the National Institutes of Health. The School of Medicine is recognized throughout the international medical community for outstanding achievements in teaching.

Source: NO LINKS ALLOWED

I found last year when I went on holiday, I had to take a course of Malaria tablets.
When I told the pharmacist I had Psoriasis, they had to order some in specifically for me.
I stopped the MTX before going on holiday, and when I returned, commenced with my weekly 10mg dose.
Suddenly everything started going wrong and treatment was immediately stopped.
It took a while to pinpoint, but the problem was the 7 week course of Malaria tablets.
This treatment played havoc with my Creatine levels in my Liver, with the high count being around 60, mine was over 1800 !!!!!
So please be aware if you are going on holiday, anywhere you have to take a Malaria course, if you are on MTX, stop the MTX treatment for 2 weeks before you start and don't start again until 3 weeks after the Malaria course finishes.
Regards to all
Micky

This study published in Arthritis & Rheumatism looks at response rates and drug survivals of switching TNFi (tumor-necrosis-factor-alpha inhibitor) in psoriatic arthritis patients.

Objective:
To describe switch frequencies and outcomes among patients with psoriatic arthritis switching tumor-necrosis-factor-alpha inhibitor (TNFi) treatment in routine care.

Methods:
Observational cohort study based on the Danish nationwide DANBIO registry. Treatment outcomes were evaluated by ACR20/50/70-responses, EULAR-good-response and 28-joint Disease Activity Score (DAS28)-remission. Kaplan-Meier and regression analyses were used for drug survival analyses and to identify predictors of outcome after switching.

Results:
Of 1,422 patients starting TNFi, 548 patients (39%) switched to a second biological drug during up to 10 years' follow-up. Median follow-up was 2.3 years (interquartile-range, IQR 1.0-4.3 years). Switchers were more frequently women (56%/45%), had shorter disease duration (3 years/4 years), higher Health Assessment Questionnaire (HAQ) (1.1(0.6-1.6)/0.9(0.5-1.4) (median(IQR))), DAS28 (4.8(4.0-5.7)/4.4(3.6-5.2)), visual-analogue-scale (VAS) pain (65(46-77)/62(40-75)mm) and fatigue scores (67(50-83)/64(42-80)mm) (all p<0.05 at start of first TNFi). During the first and second treatment HAQ, DAS28, CRP and VAS-scores had decreased after 6 months' (all p<0.05), median drug survivals were 2.2 vs. 1.3 years (p<0.001). Lower fatigue score increased survival of the second TNFi. After switching, the proportions of patients achieving sustained ACR20/ACR50/ACR70/EULAR-good-response/DAS28-remission after 3-6 months were 22% (number-needed-to-treat, NNT 4.5)/13%(7.9)/5%(20)/19%(5.3)/34%(2.9) respectively. Response rates were lower during the second treatment (compared to first TNFi, all p<0.01). At the 2-year visit, 47% of switchers had achieved ACR20 response. No differences between drug-drug combinations were found.

Conclusion:
39% of psoriatic arthritis patients switched TNFi. Response rates and drug survivals were lower after switching, however, half of switchers had ACR20 response 2 years after starting the first TNFi.

Source: NO LINKS ALLOWED

Just as I thought things where going well, yesterday and today I was in agony. My PsA felt a bit bad a couple of days ago and yesterday whilst working in the garden I suddenly got a huge pain in my left lower back and top of my leg.

I have never experienced anything like it before and it felt like my leg muscles had exploded! couldn't move all day, no sleep even taking loads of pain killers. And this morning had to get Mrs Fred to help me out of bed. No problem there I thought as she has helped me in the past, but as she helped me stand the pain was like someone ripping the nerves from my body.

Anyway went to A&E and explained I had the problem in December where they thought I'd had a kidney stone which had been passed. So more tests, bloods, urine, x-rays, and another scan, and they have said my nerve is trapped in my spine do to my psoriatic arthritis. I've been on a painkiller drip most of the day, and although they wanted to keep me in I'm now back home with loads of painkillers.

Just wondered if anyone else has experienced this?

I'm pretty sure this will sound like a total overreaction but I've taken my Ierston does of methotrexate and not know myself after less HM a week. The day I took it I was manic, day after tearful and tonight I've just screamed at my cat for no reason to the point here she is hiding. I am disgusted ar myself and don't really know where all that rage came from.

Is this normal?

If it is I'd rather be as I was before regardless of how flakey i am. It's not like me to be like this, not even when my periods are due. I'm not rational.

Background:
Our understanding of the genetic bases of predisposition to psoriasis is increasing exponentially due to the progresses of genetics. However, so far little is known about genetic predisposition in relation to the response to psoriasis treatments. Recent data identified genetic predictors for the clinical outcome of conventional treatments such as methotrexate, acitretin and vitamin D derivatives, but few studies are available on genetic predictors of response to biologics.We hypothesized that genetic variations associated with increased risk of developing psoriasis may also act as predictors for the biologic therapy outcome.

Objectives:
Aim of our study was to analyze the presence of three different psoriasis susceptibility genetic variations (HLA-Cw6; TNFAIP3 rs610604 polymorphism; LCE3B/3C genes deletion) in a cohort of patients affected by moderate to severe psoriasis under ustekinumab treatment. Our primary endpoint was to evaluate the association between PASI 75 response at week 12 and HLA-Cw6 status.

Methods:
Fifty-one patients were genotyped by standard methods and psoriasis severity (PASI score) was evaluated at day 0 and after 4, 12, 24 and 40 weeks of treatment.

Results:
We observed increased response to ustekinumab in Cw6POS patients (PASI75 at week 12 96.4% in Cw6POS vs 65.2% in Cw6NEG patients p=0.008). In addition we show that HLA-Cw6POS patients responded faster to ustekinumab, 89,3% of them reaching PASI 50 at week 4, after a single injection (versus 60,9% of HLACw6NEG patients). Superior response of HLA-Cw6POS patients was maintained throughout the study period, reaching the highest statistical significance for PASI 75 at week 28 (96.35% Cw6POS vs 72.7% Cw6NEG; odds ratio 9.8). Analysis of TNFAIP3 rs610604 polymorphism and LCE3B/3C genes deletion did not show any significant association with response to ustekinumab.

Conclusions:
Our observations underline the role of HLA-Cw6 not only as a psoriasis susceptibility gene, but also as a pharmacogenetic marker of response to ustekinumab in psoriasis.

Source: NO LINKS ALLOWED

Here's a piece of news in it's unedited form ahead of full publication about how 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's 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 is due to a breakdown of immune tolerance to the microbiota of the intestine in genetically susceptible individuals.

The microbiota of the skin has recently been investigated in psoriasis. Firmicutes was the commonest phylum, and Streptococcus the commonest 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 signalling pathways of the innate immune system, notably IL-23 and NFκB. Psoriasis patients 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.

Background: 
Phenotypically diverse autoimmune conditions share common genetic susceptibility loci and underlying molecular pathways.

Objectives: 
By systematically searching for single nucleotide polymorphisms (SNPs) associated with another autoimmune disease, rheumatoid arthritis (RA), we aimed to elucidate novel genetic markers of psoriasis.

Methods: 
We investigated 18 SNPs, previously confirmed as being associated with RA, in a U.K. cohort of 623 patients with early-onset psoriasis (presenting before age 40 years), comparing them with 2662 control subjects.

Results: 
Our findings confirm the association of early-onset psoriasis with REL (rs13031237, P = 0·0027). The minor allele of REL had opposing effects upon susceptibility to disease in patients with psoriasis and RA.

Conclusion: 
Similar exploration of additional autoimmune loci and fine mapping of such regions may provide further insight into the genetics and molecular pathophysiology of psoriasis.

Source: NO LINKS ALLOWED

This is another safety study for Stelara (ustekinumab), this one is 5 year use with moderate-to-severe psoriasis.

Background: 
Long-term safety evaluations of biologics are needed to inform patient management decisions.

Objectives: 
To evaluate the safety of ustekinumab in patients with moderate-to-severe psoriasis treated for up to 5 years.

Methods: 
Safety data were pooled from four studies of ustekinumab for psoriasis. Rates of adverse events (AEs), serious AEs (SAEs) and AEs of interest [infections, nonmelanoma skin cancers (NMSCs), other malignancies and major adverse cardiovascular events (MACE)] per 100 patient-years (PY) of follow-up were analysed by ustekinumab dose (45 or 90 mg) and by year of follow-up (years 1–5) to evaluate the dose response and impact of cumulative exposure. Observed rates of overall mortality and other malignancies were compared with those expected in the general U.S. population.

Results: 
Analyses included 3117 patients (8998 PY) who received one or more doses of ustekinumab, with 1482 patients treated for ≥ 4 years (including 838 patients ≥ 5 years). At year 5, event rates (45 mg, 90 mg, respectively) for overall AEs (242·6, 225·3), SAEs (7·0, 7·2), serious infections (0·98, 1·19), NMSCs (0·64, 0·44), other malignancies (0·59, 0·61) and MACE (0·56, 0·36) were comparable between dose groups. Year-to-year variability was observed, but no increasing trend was evident. Rates of overall mortality and other malignancies were comparable with those expected in the general U.S. population.

Conclusions: 
No dose-related or cumulative toxicity was observed with increasing duration of ustekinumab exposure for up to 5 years. Rates of AEs reported in ustekinumab psoriasis trials are generally comparable with those reported for other biologics approved for the treatment of moderate-to-severe psoriasis.

Source: NO LINKS ALLOWED

Another study for Stelara (ustekinumab), this time focusing on it's use for treating severe refractory palmoplantar pustular psoriasis (PPPP). And the results look good.

Background:
Palmoplantar pustulosis (PPP) is characterized by sterile pustules with hyperkeratosis, erythema, scaling and fissuring on the palms and soles. PPP can present alone, or in association with palmoplantar pustular psoriasis (PPPP).

Objectives:
To examine treatment with ustekinumab in patients with severe refractory PPPP.

Methods:
Five patients (two men and three women, age 30–50 years) with severe refractory PPPP were treated with ustekinumab, according to a pre-established protocol. A 45 mg dose of ustekinumab was administered subcutaneously, followed by a 45 mg dose 4 weeks later and every 12 weeks thereafter. The severity of involvement and the therapeutic outcome were evaluated in every patient before, during and after treatment.

Results:
Positive responses to ustekinumab were initially seen in all of the patients 2–3 weeks after the first dose, and were more remarkable after the second injection. Complete resolution of PPPP was achieved at week 20 and was maintained in all patients.

Conclusions:
Ustekinumab appears to be an effective and safe therapeutic option in PPPP, leading to complete or nearly complete resolution of lesions and a significant improvement in patients’ quality of life.

Source: NO LINKS ALLOWED