Hi guys,

New user Not new to Psoriasis or PA though :(

My p is not normally too bad and tolerable - I have it restricted (for the last couple of years) to my elbows (the worst), scalp and belly button!
But as of late, probably in the last 6 months I have had episodes where the P on my elbows gets pustular plaques.. normal scales that are full of greenish puss . Before the pus turns up they get VERY itchy, hot and painful (you never realize how much pressure you put on your elbows until you can't!) It does not tend to last too long but is a bit concerning and I can't seem to finds much out there on what might be causing it. From what I have read and seen of Pustular Psoriasis I don't think it is that, although some of the symptoms that go with it rings some bells...??

Does this happen to anyone else? What triggers it? How can I stop it?? Do I need to see my Doctor?
I am not on any meds or creams (2 rounds of methodextrate(sp) cleared up almost all of it apart from the parts I mention above), I am currently using glycerin to keep it moisturized and I find this is working well and perhaps cleared some of it up.

Thanks in advance

Kiwi

Hey!!
New to this!!
Hoping to speak to people that understand the situation that I'm in. Ive got Psoriasis in my scalp and its spreading to the rest of my body!!
I've been given me different types of cream and I've been referred to a Derm, its spreading to parts of my body where i cant hide it! Its really embarrassing! My friends and family are saying its fine and no-one will notice but i know people are looking and its making me really paranoid!!
I know its getting worse by the day and people keep looking at me and its horrible. I can tell they are looking but trying to hide it!!
I just don't know what to do anymore!!
Should i be scared about seeing a derm??
What am i too expect?
Cheers guys x

Hi, I wish to show an image of my rash which I have taken and placed on my desktop. Can this be done please? Cheers

Right we are housebuilding - with very little money & it gets stressful, now I also have my husbands ex living with us - now I guess I have a right to be stressed?? not really, the house is brill, can't believe we've done this! Melly's ex is ok, we are finding our feet & she contributes to costs so I don;t have problem, she needs somewhere to be safe & Shasa their youngest has commented how much better she is, I'm the caring type so having someone who needs me is ok. Also she has taken over the hovering & loads the dishwasher etc... I cook she clears up - seems to work... so why are my friends telling me its wrong?? surely its not wrong to give someone somewhere to live when they have problems? I don;t feel able to talk to my friends as they all seem horrified? Its not as if its just us & her in the house, we also have 2 other lodgers, one of whom eats with us most nights, it makes life more interesting & I'll admit we are totally different & she gives me a totally different view of life at times! I need my friends support but find they can't see how this works - she is not the predatory type, if I said I was unhappy with the situation Melly would understand, but its not in my nature - so why the message? is it the stress of the situation or the feeling that my friends feel I'm being put upon that is making my foot worse - today its all around the edge & around my toes & feels like someone is pushing in nails when I walk - so I scratch.... ahhhh!! think its time for the saw.... sorry just miserable - and I have a low pain threshold which does not help! been on anti-depressents for long time, have been told not to come off again as I have a chemical imbalance, re-triggered by shingles so the glums are a fact of life, but I worry now that this very fact is making my psoriasis worse?? ahhh!! Fact of life the ex has to stay, I have no problem with her, I've no idea if she has a problem with me, but seems unlikely following the big hug I got the other day! so will someone just tell me I'm doing the right thing..... please

ok whinge over! feel better its off my chest (all 48D of it)

LEO Pharma Inc., a wholly owned U.S. subsidiary of LEO Pharma A/S, today announced that the U.S. Food and Drug Administration (FDA) approved Taclonex® (calcipotriene and betamethasone dipropionate) Topical Suspension, 0.005%/0.064% for the treatment of body plaque psoriasis. Taclonex® Topical Suspension is a first-line single treatment now indicated for both scalp and body plaque psoriasis for up to 8 weeks.

Taclonex® Topical Suspension is the only once-daily, steroid-containing topical treatment that combines the strength and benefits of 2 active ingredients, a vitamin D analog (calcipotriene) and a corticosteroid (betamethasone dipropionate). Taclonex® Topical Suspension requires only one prescription for both scalp and body treatment of plaque psoriasis. Patients using Taclonex® Topical Suspension may also be eligible to participate in LEO Quality Care™, a patient support program.

"A once-daily application makes Taclonex® Topical Suspension an effective, first-line choice of treatment for a significant number of psoriasis patients, with positive clinical results seen in a recent eight-week study," said Dr. Alan Menter, founder of the International Psoriasis Foundation. "In addition to its prior approval for use on the scalp, it has been shown to be safe and effective for use on the body."

In two Phase III clinical studies of more than 1,600 patients with psoriasis on the scalp, and one phase III clinical study of over 1100 patients with psoriasis on the body, a higher percentage of patients treated with Taclonex® Topical Suspension achieved controlled disease than either monotherapies or vehicle used alone. In clinical trials, the most common adverse reactions that occurred in >1% of subjects treated with Taclonex® Topical Suspension and at a rate higher than in subjects treated with vehicle were folliculitis and burning sensation of the skin.

"We are pleased to introduce Taclonex® Topical Suspension as part of our ongoing commitment to helping people achieve healthy skin," said John Koconis, president and chief executive officer of LEO Pharma Inc. "This most recent FDA approval offers a new, single treatment option for patients suffering from plaque psoriasis on both scalp and body locations, and we look forward to continuously driving patient-centered innovation in the field of dermatology in the years to come."

INDICATION AND USAGE
Taclonex® Topical Suspension is indicated for the topical treatment of plaque psoriasis of the scalp and body in patients 18 years and older. Apply Taclonex® Topical Suspension to affected areas once daily for up to 8 weeks. Treatment may be discontinued earlier, if cleared. Instruct patients not to exceed a maximum weekly dose of 100 g.

IMPORTANT SAFETY INFORMATION
FOR TOPICAL USE ONLY. Taclonex® Topical Suspension is not for oral, ophthalmic, or intravaginal use and should not be applied to the face, axillae, or groin. Do not use if atrophy is present at the treatment site.

Hypercalcemia and hypercalciuria have been observed with use of Taclonex® Topical Suspension. If hypercalcemia or hypercalciuria develop, discontinue treatment until parameters of calcium metabolism have normalized. Systemic absorption of topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for clinical glucocorticosteroid insufficiency. Use of topical corticosteroids may require that patients be periodically evaluated for HPA axis suppression and calcium abnormalities. If HPA axis suppression is documented, attempt to withdraw the drug, reduce the frequency of application, or substitute a less potent steroid. Cushing's syndrome, hyperglycemia, and unmasking of latent diabetes mellitus can also result from systemic absorption of topical corticosteroids.

In clinical trials, the most common adverse reactions that occurred in greater-than or equal to 1% of subjects treated with Taclonex® Topical Suspension and at a rate higher than in subjects treated with vehicle were folliculitis and burning sensation of the skin. Other less common adverse reactions (<1% but >0.1%) were, in decreasing order of incidence, acne, exacerbation of psoriasis, eye irritation, and pustular rash. Local adverse reactions may include atrophy, striae, telangiectasias, burning, itching, irritation, dryness, folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, secondary infection, and miliaria and may be more likely with occlusive use or more potent corticosteroids. Some local adverse reactions may be irreversible.

Taclonex® Topical Suspension may cause eye irritation. Avoid eye exposure. Patients who apply Taclonex® Topical Suspension to exposed skin should avoid excessive exposure to either natural or artificial sunlight, including tanning booths, sun lamps, etc. There are no adequate and well-controlled studies of Taclonex® Topical Suspension in pregnant women. Taclonex® Topical Suspension should be used during pregnancy only if the potential benefit to the patient justifies the potential risk to the fetus. Because many drugs are excreted in human milk, caution should be exercised when Taclonex® Topical Suspension is administered to a nursing woman. The patient should be instructed not to use Taclonex® Topical Suspension on the breast when nursing. Safety and effectiveness of the use of Taclonex® Topical Suspension in pediatric patients have not been studied.

Every time I go for an appointment with my dermatologist she goes through the *Dermatology Life Quality Index (DLQI) form. And one of the questions is “Over the last week, how much has your skin influenced the clothes you wear” I always tick the “Not Relevant” box as I’m not into clothes that much.

But I have been giving it some thought after reading a post where Lady B the Stylist with Psoriasis (her words not mine) was talking about Woolly Tights.
I do have a Woolly Jacket I sometimes wear when I’m feeling cold, but I find that wool makes my skin to itchy, especially if I have a few plaques of psoriasis, which can get caught in the wool and end up weeping from the friction.

I mostly wear loose light coloured cotton and have recently found the joy of Bamboo Fibre for socks and duvet cover. A farmer’s wife near to us makes Cashmere socks and did give me a pair, very nice they was too, but at €18 per pair I found €2 Bamboo just as comfy. So I suppose Psoriasis does affect my choice of clothes after all, and I should tick the box "A Little"

What about you, does psoriasis affect your choice of clothes?


*You can find more about the Dermatology Life Quality Index (DLQI) here Dermatology Life Quality Index (DLQI)

TNF (Tumor necrosis factor) inhibitors are a modern popular choice for the treatment of PsA (psoriatic arthritis), and a report by Frost & Sullivan a growth partnership company, suggests there is a need for drug manufacturers to work harder on low cost alternatives. The research finds that psoriatic arthritis pharmacotherapeutics prescribed as add-on therapies to standard background therapy earned revenues of approximately $751.5 million in 2011, and is estimated to reach $1.3 billion in 2017.

"While TNF inhibitors have laid the groundwork for the next generation of effective, disease-modifying biologics, the need of the hour is patient-friendly options with improved profiles, such as oral administration or enhanced tolerability," said Frost & Sullivan Senior Industry Analyst Deborah Toscano. "These novel drugs could offer better long-term clinical outcomes."

"With the impending launch of three new therapies for the treatment of PsA in 2014, the awareness of PsA is expected to increase substantially," noted Toscano. "This will renew interest in PsA, as patients and physicians will finally be presented with alternative treatments."

"However, slow uptake of these new drugs by a conservative regulatory and medical community is likely until they are proven in the market. To gain end-user confidence, companies must make products with a high degree of safety, with significant clinical or economic benefits over TNF inhibitors."

GPs should proactively assess the impact that psoriasis may be having on the daily lives of their patients, advises the National Institute for Health and Clinical Excellence (NICE) in new guidance out today (Wednesday 24 October).

Psoriasis is a skin condition characterised by red, flaky, crusty patches of skin covered with silvery scales. It is believed to affect up to 2.2% of the UK population (i.e. over 1.3 million people) with most cases seen in young people and adults under the age of 35. The disease can contribute to low self-esteem, anxiety, embarrassment and depression, much like other chronic conditions but this may be overlooked by healthcare professionals. For example, over a third of people who have psoriasis report clinically significant anxiety and depression. The condition can also affect a person's participation in social and physical activities, employment and education.

In its first clinical guideline on the assessment and management of the condition, NICE advises GPs and other healthcare professionals to assess the impact that psoriasis has on the physical, psychological and social wellbeing of their patients. They should do this when they first see their patients, before they refer them to specialists, and when they monitor how they are responding to treatments.

Dr Catherine Smith, a consultant dermatologist who chaired the development of the NICE guideline, said: "Psoriasis is much more than a skin irritation. The condition can have profound functional, psychological and social effects on a person's life. It is vital that GPs and other healthcare professionals recognise these possible consequences when they first see their patients, and that they routinely assess the impact that the disease is having on their daily lives. Early and proactive identification will allow patients to receive the support and effective treatment they need in a timely manner. Importantly, accurate assessment of people with psoriasis will ensure they can access the right treatment as early as possible whether in primary or specialist care."

Also in its new clinical guideline, NICE advises that everyone with psoriasis should be assessed for psoriatic arthritis on an annual basis, particularly during the first ten years as this is when the condition is most likely to develop.

Around one in seven people who have psoriasis will develop psoriatic arthritis, a progressive condition, which can cause pain, stiffness and swelling in and around the joints. Early diagnosis is crucial and so annual assessments will allow those with actual or suspected psoriatic arthritis to be referred to specialists sooner.

Dr Natasha Smeaton, a GP who helped develop the NICE guideline, said: "Psoriatic arthritis is rarely seen by GPs and so there may be confusion regarding how it should be diagnosed when compared to other joint problems, such as 'wear-and-tear' arthritis and gout. Early diagnosis is important because the condition is aggressive and associated with progressive joint damage. There are effective treatments available and so patients should receive these as soon as possible.

"The NICE guideline advises healthcare professionals to offer annual assessments for psoriatic arthritis to all of their patients who have psoriasis. They should use a validated tool in these assessments, such as the Psoriasis Epidemiological Screening Tool. This will facilitate more timely referrals to rheumatologists so that patients can receive the treatments they need."

Today's guideline is the first to be produced by NICE to help GPs and other healthcare professionals assess and treat their patients with this condition.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: "Whilst there is no cure for psoriasis, treatments are effective and can include topical therapies, phototherapy and systemic medication, depending on the severity and extent of the disease.

"Clinical practice for the treatment of psoriasis is variable across the NHS. This guideline provides clear advice for the NHS on the assessment and management of psoriasis in order to improve comfort and minimise the effects of living with the condition."

Source: nice.org.uk

Quote:

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Psoriasis is an inflammatory skin disease that typically follows a relapsing and remitting course. The prevalence of psoriasis is estimated to be around 1.3–2.2% in the UK. 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 one study at 13.8%).

Plaque psoriasis is characterised by well-delineated red, scaly plaques that vary in extent from a few patches to generalised involvement. It is by far the most common form of the condition (about 90% of people with psoriasis). Other types of psoriasis include guttate psoriasis and pustular (localised or generalised) forms. Distinctive nail changes occur in around 50% of all those affected and are more common in people with psoriatic arthritis.

Healthcare professionals and patients using the term psoriasis are usually referring to plaque psoriasis, and unless stipulated otherwise, 'psoriasis' is used in this way in the guideline. The phrase 'difficult-to-treat sites' encompasses the face, flexures, genitalia, scalp, palms and soles and are so-called because psoriasis at these sites may have especially high impact, may result in functional impairment, requires particular care when prescribing topical therapy and can be resistant to treatment.

Psoriasis for many people results in profound functional, psychological, and social morbidity, with consequent reduced levels of employment and income. Factors that contribute to this include symptoms related to the skin (for example, chronic itch, bleeding, scaling and nail involvement), problems related to treatments, psoriatic arthritis, and the effect of living with a highly visible, stigmatising skin disease. Even people with minimal involvement state that psoriasis has a major effect on their life. Several studies have also reported that people with psoriasis, particularly those with severe disease, may be at increased risk of cardiovascular disease, lymphoma and non-melanoma skin cancer.

A wide variety of treatment options are available. Some are expensive and some are accessed only in specialist care; all require monitoring. The treatment pathway in this guideline begins with active topical therapies. The Guideline Development Group (GDG) acknowledged that the use of emollients in psoriasis was already widespread and hence the evidence review was limited to active topical therapies for psoriasis.

In this guideline, first-line therapy describes traditional topical therapies (such as corticosteroids, vitamin D and vitamin D analogues, dithranol and tar preparations). Second-line therapy includes the phototherapies (broad- or narrow-band ultraviolet B light and psoralen plus UVA light [PUVA]) and systemic non-biological agents such as ciclosporin, methotrexate and acitretin. Third-line therapy refers to systemic biological therapies such as the tumour necrosis factor antagonists adalimumab, etanercept and infliximab, and the monoclonal antibody ustekinumab that targets interleukin-12 (IL-12) and IL-23. NICE has published technology appraisals on the use of biological drugs, and this guideline incorporates recommendations from these appraisals where relevant (listed in alphabetical order). Biologic treatment is complicated by a poor response in a minority of people, and this guideline reviewed the literature for the use of a second biological drug.

For most people, psoriasis is managed in primary care, with specialist referral being needed at some point for up to 60% of people. Supra-specialist (level 4) tertiary care is required in the very small minority with especially complex, treatment resistant and/or rare manifestations of psoriasis.

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

This guideline covers people of all ages and aims to provide clear recommendations on the management of all types of psoriasis. The term 'people' is used to encompass all ages. 'Children' refers to those up to 12 years, who become 'young people' thereafter, before merging with the adult population by 18 years of age. The GDG have focused on areas most likely to improve the management and delivery of care for a majority of people affected, where practice is very varied and/or where clear consensus or guidelines on treatments are lacking. It is hoped that this guideline will facilitate the delivery of high-quality healthcare and improved outcomes for people with psoriasis.

Hello! I just found you today on the internet and have joined up! I am a 59 year old female who has had psoriasis since age 6, showing up about 2 weeks after I had chicken pox. I was given many difference treatments as a child (including eating turkey every day for a month) most of which did not make a great difference. After reaching my mid-twenties, I just quit seeking treatment and have lived with it, feeling fortunate that I did not have it as bad as some people did.

However, late last week, I discovered a small balding spot on my head. I went to the Dermatologist who diagnosed it as Alopecia. That caused me to begin to research on the internet to see if there was any link with it and Psoriasis. So, I am wondering if anyone in the club has dealt with this and I am wondering if anyone out there has scarring from Psoriasis?

I'm Barbi C, I found out I have Pustular Psoriasis on my foot in the spring, when I went to the doctor, its been appearing for the past 5 years+.... & I thought it was veruca's or athletes foot.... ok should have gone earlier

dr asked me what had I got to be stressed about??? I could start a book!! mainly building a house with no budget, but don;t get me started. its seriously flared up at present, as we have my husbands ex staying with us.... and I am letting her get to me!

Today it has been so bad it woke me up, and by the end of today I need to have delivered around a 1000 poll cards for this police commisionar election which is what I was doing yesterday, walking on flaring psoriasis is a total pain.... sure I don;t need to say that here however!! So how did I get here?? I decided to google psoriasis to see what I could do to ease it, as I'm hobling big time. & I found you - what a wonderful find!! I don;t feel so alone, and I realise that some of my other complaints are either linked or are a likely stimuli. Mind if my foot is giving me a lot of grief at least it takes my mind off my digestion.....

right back to bed! I have an hour before I need to be up & at it, and to prove J (the ex) that I can get up & out before 9am.....

ps I'm really a happy person, just lately let things get on top, that makes my psoriasis flare that me me miserable.... and round we go! etc etc

Big hugs to everyone and thanks for being there, I've already found stuff that is useful & gives me hope that I will not end up cutting my foot off.....

Hello, I am new to all of this, my dermatologist suggested this to me so I have someone to talk to, as right now it feels like I am the only one, as psoriasis is sch a taboo subject. I am 19 years old, and have had psoriasis since i was 14, and I have it quite severly now. There isn't a part of my body that doesn't have patches on it. I'm wondering how other people cope with the pressures of every day life? being a young woman, i feel like i have been stripped of my femininity, and my ability to even feel like a woman. I never wear dresses, or anything that reveals any part of my skin. I feel depressed all of the time, and whenever i see pretty women, who are able to wear what they want and are confident it makes me want to break down. I have a wonderful boyfriend who supports me, but I can't feel confident, even though he tells me he thinks i am beautiful, i don't believe him. i trust him more than anything but there is always a voice in my head telling me he wishes i looked 'normal'. I am so fed up feeling like this and need someone to talk to who knows what it feels like to constantly be uncomfortable in their own skin.

Hi everyone,
new to the forum and hoping to hear some positive stories about how you manage to look after your skin.
im trying a special diet at the moment and hoping it will help me heal...
i have also started an e-petition as psoriasis can be a debilitating condition and believe we need more support. Feel free to read it and sign it if you wish
*Old link removed as it's not secure
kind regards
pina

More evidence has been posted about the link of Diabetes with Psoriasis. I first reported about it here: Psoriasis and Diabetes

Objective: 
To compare the prevalence and incidence of type 2 diabetes mellitus between patients with psoriasis and those without psoriasis.

Data Sources: 
MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews between January 1, 1980, and January 1, 2012.

Study Selection: 
Observational (cohort, case-control, and cross-sectional) studies published in English that compared the prevalence or incidence of diabetes among patients with psoriasis with individuals serving as controls.

Data Extraction: 
Two independent investigators extracted the data. The quality of evidence was assessed using a 6-point scale.

Data Synthesis: 
Among 142 identified publications, 27 observational studies were included in the meta-analysis. Five of these studies assessed the incidence of diabetes in patients with psoriasis and were analyzed separately. Among studies assessing the prevalence, psoriasis was associated with an odds ratio (OR) of 1.59 (95% CI, 1.38-1.83) for diabetes. The pooled OR was 1.53 (95% CI, 1.16-2.04) for mild psoriasis and 1.97 (1.48-2.62) for severe psoriasis. Meta-regression of prespecified potential sources of heterogeneity revealed a nonsignificant difference (P = .10) of increased reported strength of association among studies that used medical record review (OR, 1.52 [95% CI, 1.31-1.77]) or patients' report of diabetes (2.79 [1.42-5.48]) compared with studies that used billing data (1.46 [1.01-2.09]). Among studies that assessed incidence, psoriasis was associated with a relative risk of 1.27 (95% CI, 1.16-1.40) for developing diabetes.

Conclusions: 
Psoriasis is associated with an increased prevalence and incidence of diabetes. The association of psoriasis with diabetes may be strongest among patients with severe psoriasis.

Source: jamanetwork.com

If you don’t have psoriatic arthritis, I hope you never get it. Today has been a terrible day. It started in the early hours of the morning; I woke up in a tight ball and felt like I had been stuffed in a jam jar!

I had to get up early too, as the nurse was coming for a blood test. It took me a while to roll out of bed and shuffle off to the bathroom, shower and drying was difficult as my bones just wouldn’t wake up. Usually I can get them working after an hour or so, but today it’s been like someone has come along and tightened all my joints up with a monkey wrench.

Hobbled around all-day in a grumpy mood and it’s not even a Full Moon. Time for another glass of red I think to help with the numbness, no not to get rid of the numbness but to bring it on.

Night Night

Greetings, mates!

I have had psoriasis since age 6-used a variety of treatments-cortisone, Hobson's DermaZema-a mix of pine tar and zinc oxide-worked but STUNK and stained things badly! It's no longer manufactured....last April my brother took me to a homeopathic chiropractor who practices Traditional Chinese Medicine and is also a Reiki master. He tested me and said my liver was dystunctional due to many years of using petrochemicals from creams, lotions and all the drugs I'd taken over the years. As a result of being clogged up, the job of excretion had shifted from my liver to my skin and the psoriasis was the result He put me on a diet with no red meat, no shellfish, little rice and soy abd supplements.

It's better; not gone but better. At times my ankle swells, the rash iteches and burns and then it's better. I believe it's genetic; Dad had it so bad he was fired from a job because it covered the top of his hands and he had a large bandaid on them.

Prior to starting my treatment with Dr. Rob, I'd been using coal tar without any visible results. My insurance didn't cover it and THE DARN STUFF COST ME $14.95 USD! Not happy with that.

Any thoughts on other holistic treatments?

Objective: 
To compare the efficacy of Stelara (ustekinumab) with that of other biological agents using the Psoriasis Area and Severity Index (PASI) among adult patients with moderate to severe plaque psoriasis.

Data Sources: 
We conducted a systematic search of the period January 31, 1992, to February 1, 2012, using MEDLINE (pub med), Embase, the Cochrane Library, and clinicaltrials.gov.

Study Selection: 
We included randomized controlled trials of biological agents compared with placebo or other biological agents using the PASI in patients who had moderate to severe plaque psoriasis.

Data Extraction: 
Study data were extracted independently by 2 of us, with disagreement resolved by consensus. Data extracted included the size of the trial, follow-up period, age range of patients, disease duration, body surface area involvement, baseline PASI, PASI response, and previous treatment with biological agents.

Data Synthesis: 
A Bayesian network meta-analysis was performed by fitting 3 regression models: a fixed-effects model, a random-effects model, and a random-effects model with meta-regression coefficients. The random-effects model achieved the best fit for these data. In pairwise comparisons, ustekinumab use was associated with statistically significantly higher odds for achieving a 75% reduction in the PASI compared with adalimumab use (odds ratio [OR], 1.84; 95% credible interval [CrI], 1.01-3.54), alefacept use (OR, 10.38; CrI, 3.44-27.62), and etanercept use (OR, 2.07; 95% CrI, 1.42-3.06) but was associated with lower odds compared with infliximab use (OR, 0.36; 95% CrI, 0.14-0.82) . In the therapeutic class comparison, the interleukin-12/23 inhibitor had the highest odds for achieving a 75% reduction in the PASI compared with placebo (OR, 69.48; 95% CrI, 36.89-136.46), followed by tumor necrosis factor inhibitors (OR, 42.22; 95% CrI, 27.94-69.34) and the T-cell inhibitor (OR, 5.63; 95% CrI, 1.35-24.24).

Conclusion: 
For the treatment of moderate to severe plaque psoriasis, Stelara (ustekinumab) may be more efficacious than Humira (adalimumab), and Enbrel (etanercept), but not Remicade (infliximab).

Source: jamanetwork.com

XBiotech, a privately held biotechnology company, announced positive preliminary results today from their Phase II study using a True Human™ monoclonal antibody (MABp1) in patients with moderate to severe psoriasis. Data from the trial indicate a relatively rapid response in skin lesion severity following an initial subcutaneous injection, and continued improvement over 70 days with a maximum of three injections. Preliminary results demonstrated a 30 percent improvement in Psoriasis Area and Severity Index (PASI) scores within three weeks of receiving the initial subcutaneous dose. Full data from the study will be submitted to a peer-reviewed journal for future publication.

“What I was most impressed by was the immediate decrease in redness in skin lesions,” said Kyle M. Coleman, M.D., American Academy of Dermatology (ADA), and American Society for Dermatologic Surgery (ASDS) member and a lead clinical investigator in the Phase II study from Westlake Dermatology, Austin, Texas. “Inflammation is a driving force in psoriasis, but other therapies aren’t directed at addressing the underlying cause first. Most address skin thickness initially, with resolution in inflammation and redness occurring as a last result. This is a whole new approach that appears to provide a well tolerated therapy with significant patient benefit.”

"IL-1α is a master regulator of chronic inflammation that plays a pivotal role in triggering and sustaining the inflammatory process in a variety of disease indications,” said John Simard, president and CEO, XBiotech. “Based on data being generated in our clinical trials, we believe that targeting IL-1α holds significant promise as a unique therapeutic option for psoriasis and a variety of other diseases. We are pleased to continue to advance a new medial paradigm for treatments that block chronic inflammation, and to develop therapies that represent a breakthrough in safety and efficacy for patients.”

True Human™ antibodies represent the next generation of therapeutic antibodies. These antibodies are identified using the Company’s proprietary platform technology to ensure faithful reproduction of the original human antibody gene. True Human™ antibodies are “invisible” to the body’s immune system and thus have the potential for better safety, efficacy and patient tolerability compared to earlier generation antibody therapeutics.

XBiotech is pioneering breakthrough therapies that improve the safety and efficacy of antibody therapeutics. The Company’s lead product candidate inhibits chronic sterile inflammation by targeting IL-1α, a master regulator of inflammation. The clinical development program addresses tremendous unmet medical need in multiple disease indications including, acne, psoriasis, cachexia, cancer, type 2 diabetes and cardiovascular disease. XBiotech is also revolutionizing scalable, flexible manufacturing systems for the production of biological therapies. Using minimal infrastructure and disposable bioreactor technology – to dramatically reduce capital requirements, operating complexity, and lead times - the Company has established a compelling commercialization path for its True Human™ antibody platform.

Source: xbiotech.com

I am 48 years of age and have been suffering from Ps since I was about 27 just came on when very stressful time in my life. It has gone completely when pregnant . when bad in early 90's and early 2000 did have uvb treatment which worked really well and managed to keep under control. It has just flared up over the last two weeks but seem to be settling down with use of pine tar soap and salcura spray .

I've added a new thingy to the forum that will show a few words from a threads first post. It also shows a few words from the latest reply. See Red Arrows in photo!



Just hover your mouse to make it work, any problems let me know.

Objective:
To determine the “real-world” clinical effectiveness and safety of leflunomide (Arava) in patients with psoriatic arthritis (PsA).

Methods:
This prospective, multinational 24-week observational study involved adult patients with active PsA who initiated treatment with leflunomide.Patients were evaluated at baseline, 12 weeks, and 24 weeks.The primary outcome was response as assessed by Psoriatic Arthritis Response Criteria (PsARC) in patients with pre- and post-treatment data.A modified PsARC response analysis included patients with joint counts, but no severity scores.Other effectivenessevaluations included global assessments, fatigue, pain, skin disease, dactylitis, and nail lesions.All patients were evaluated for safety.

Results:
A total of 514 patients were enrolled in this study (mean age, 50.7 years; mean disease duration,6.1 years). In the primary effectivenessanalysis, 380 of 440patients (86.4%; 95% confidence interval 82.8% – 89.4%) achieved a PsARC response at 24 weeks. Significant improvements were observed in tender and swollen joint scores and counts, patient and physician global assessments, fatigue, pain, skin disease, dactylitis, and nail lesions.The discontinuation rate was 12.3%.Ninety-eight adverse drug reactions occurred in 62 (12.1%) patients; 3 were serious (2 increased liver enzymes, 1 hypertensive crisis).

Conclusion:
Leflunomide is an effective and well tolerated option for PsA in daily clinical practice, with beneficial effects on peripheral arthritis and on other PsA manifestations, including pain, fatigue, dactylitis, and skin disease. © 2012 by the American College of Rheumatology

Source: onlinelibrary.wiley.com