Hi everyone, like my username says, I'm just a farmboy from Canada My question to the forum is this: How genetically heritable is psoriasis? My mom has it on her elbows, neck, back and knees, and she is in a quite a bit of discomfort all the time.

Sandoz launches first-to-file calcipotriene cream, the first generic.

Sandoz, a Division of the Novartis group, is the second-largest generic pharmaceuticals company globally, offering a broad range of about 1000 high-quality, affordable products that are no longer protected by patents. announces the introduction of its first-to-file calcipotriene cream, the first generic version of LEO Pharma Inc.’s Dovonex® Cream, 0.005% in the US.

"Sandoz is proud to be both the first company to file for and the first to launch this important new generic dermatology medicine, which further strengthens Sandoz’s #1 position in generic dermatology medicines in the US and globally,” said Don DeGolyer, President of Sandoz US. “The launch of calcipotriene cream further demonstrates our commitment to improving patient access to high-quality, affordable medicines.”

According to IMS Health, US sales for the branded version of calcipotriene cream were approximately USD 118.8 million for the 12 months ending in May 2012. Sandoz is marketing calcipotriene in the 0.005% strength, the same strength that is marketed as Dovonex® Cream, 0.005%.

Currently Sandoz has a total of 172 ANDAs (Abbreviated New Drug Applications) pending approval with the US FDA, including 40 confirmed first-to-file opportunities.

Source: sandoz.com

Can-Fite BioPharma expects to publish positive data at the end of the third quarter regarding the safety and efficacy of its CF101 drug under development for the treatment of psoriasis, the Israeli company's acting CEO said on today.

CF101, a small molecule oral drug, is in advanced clinical development for the treatment of autoimmune inflammatory diseases such as psoriasis, and rheumatoid arthritis.

Can-Fite acting CEO and founder Pnina Fishman said the company was conducting a Phase II/III clinical study involving 300 patients in the United States, Europe and Israel.

"We are going to have the interim analysis clinical data towards the end of the third quarter," Fishman told Reuters. "The data is positive ... in terms of safety and efficacy."

Shares in Can-Fite were up 3.8 percent in midday Tel Aviv trade after the clinical trial's investigators presented their findings to investors.

The most effective treatments for psoriasis on the market are biological drugs focused on blocking the inflammatory factor in the body that causes the disease.

Though the drugs are effective, patients may suffer from adverse events that can cause inflammatory conditions as well as depression and sepsis, Fishman said. The cost of treatment per patient is about $20,000 a year and over time patients can stop responding to the drugs.

"There is a need for another type of drug that won't be so expensive and will not induce adverse events," Fishman said.

CF101 is administered as a tablet twice daily while the biological drugs must be administered intravenously.

"We will position it in the market so that the margin of profit will be high for the company but the cost will be much, much lower than for the biological drugs," Fishman said.

Can-Fite will need to conduct a Phase III study in addition to the Phase II/III study underway to obtain approval from the U.S. Food and Drug Administration. Fishman estimated it would take three to four years to register the drug.

About 2 percent of the world's population suffers from psoriasis and the market for treatment of the disease is valued at $3.6 billion a year worldwide. This is estimated to grow to $8.5 billion by 2017.

Can-Fite has licensed CF101 for the treatment of autoimmune diseases to Seikagaku Corp in Japan and for rheumatoid arthritis to Kwang Dong in South Korea. Can-Fite so far has received $8.5 million in upfront payments.

"There never will be a cure for psoriasis but we would like to turn it into a disease where the clinical manifestations will be minimal," Fishman said.

Source: reuters.com

Hi I,m new here, so hello everyone. I have psoriatic arthritis with psoriasis. 7 weeks ago my legs were burning so bad and I assumed I was just having a flare up, but that night when I got home and removed my compression stockings, my legs were swollen, sore and bright pink from the feet to my knees on both legs. I went straight to the ER where I received an IV with antibiotics. Diagnosis, Cellulitis with the psoriasis. It has been 7 weeks and I am still on the antibiotics. A nurse comes to my home and administers antibiotic IV drip each morning. Having psoriasis of the legs I don't know what is now the psoriasis and what is the cellulitis. I wondered if anyone on the forum has ever had cellutitis and if so could the please give me a little info on how long they were on the antibiotics and so on. My legs are still pink and burning, the feeling reminds me of when I have a flare up with my psoriasis, I'm feeling so depressed and don't see much difference in 7 weeks.

Sorry my post is so long, would appreciate if anyone has any info. All these years I thought that having psoriasis is bad, but this is the worst.

Liz.

Horizon Pharma, Inc announced today that the U.S. Food and Drug Administration (FDA) has approved RAYOS® known as LODOTRA® in Europe (prednisone) delayed-release tablets (1 mg, 2 mg and 5 mg) to treat a broad range of diseases including rheumatoid arthritis (RA), polymyalgia rheumatica (PMR), psoriatic arthritis (PsA), ankylosing spondylitis (AS), asthma and chronic obstructive pulmonary disease (COPD)

"We are extremely pleased the FDA has approved RAYOS for a broad range of indications, including RA and polymyalgia rheumatica,” said Timothy P. Walbert, chairman, president and chief executive officer, Horizon Pharma. “Our initial focus will be on the launch of RAYOS in rheumatologic diseases such as RA and polymyalgia rheumatica in the fourth quarter of this year. Based on the extent of the approved indications, we will be developing a broader commercial strategy to expand the opportunity for RAYOS in key IL-6 mediated diseases, including asthma and COPD."

"Prednisone is a common therapy for patients with various inflammatory diseases, including RA, and the delayed-release enhancement offered with RAYOS is an important treatment advance,” said Michael Schiff, M.D., Clinical Professor of Medicine at the University of Colorado School of Medicine, Rheumatology Division. “RAYOS is engineered to benefit the underlying patterns of inflammatory diseases. RAYOS, as studied in its clinical trials with ten p.m. dosing, reduces the overnight rise of inflammatory mediators, which results in less pain and stiffness for patients as they begin their day."

Important information about RAYOS
Do not use RAYOS if you are allergic to prednisone.

Long-term use of RAYOS can affect how your body responds to stress. Symptoms can include weight gain, severe fatigue, weak muscles, and high blood sugar.

RAYOS can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had.

RAYOS can cause high blood pressure, salt and water retention and low blood potassium.

There is an increased risk of developing holes in the stomach or intestines if you have certain stomach and intestinal disorders.

Behavior and mood changes can occur, including intense excitement or happiness, sleeplessness, mood swings, personality changes or severe depression.

Long-term use of RAYOS can cause decreases in bone density.

RAYOS can cause cataracts, eye infections and glaucoma.

Do not receive a "live" vaccine while taking RAYOS. The vaccine may not work as well during this time, and may not fully protect you from disease.

Taking RAYOS during the first trimester of pregnancy can harm an unborn baby.

Long-term use of RAYOS can slow growth and development in children.

The most common side effects with RAYOS are water retention, high blood sugar, high blood pressure, unusual behaviour and mood changes, increased appetite and weight gain.

Source: horizonpharma.com/

A new study suggests that Methotrexate may not be helping *Synovitis in Psoriatic Arthritis.

Objective:
MTX (Methotrexate) is widely used to treat synovitis in PsA (Psoriatic Arthritis) without supporting trial evidence. The aim of our study was to test the value of MTX in the first large randomized placebo-controlled trial (RCT) in PsA.

Methods:
A 6-month double-blind RCT compared MTX (15 mg/week) with placebo in active PsA. The primary outcome was PsA response criteria (PsARC). Other outcomes included ACR20, DAS-28 and their individual components. Missing data were imputed using multiple imputation methods. Treatments were compared using logistic regression analysis (adjusted for age, sex, disease duration and, where appropriate, individual baseline scores).

Results: Four hundred and sixty-two patients were screened and 221 recruited. One hundred and nine patients received MTX and 112 received placebo. Forty-four patients were lost to follow-up (21 MTX, 23 placebo). Twenty-six patients discontinued treatment (14 MTX, 12 placebo). Comparing MTX with placebo in all randomized patients at 6 months showed no significant effect on PsARC [odds ratio (OR) 1.77, 95% CI 0.97, 3.23], ACR20 (OR 2.00, 95% CI 0.65, 6.22) or DAS-28 (OR 1.70, 95% CI 0.90, 3.17). There were also no significant treatment effects on tender and swollen joint counts, ESR, CRP, HAQ and pain. The only benefits of MTX were reductions in patient and assessor global scores and skin scores at 6 months (P = 0.03, P < 0.001 and P = 0.02, respectively). There were no unexpected adverse events.

Conclusions:
This trial of active PsA found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in PsA.

Source: nih.gov

*Synovitis is the medical term for inflammation of the synovial membrane. This membrane lines joints which possess cavities, known as synovial joints. The condition is usually painful, particularly when the joint is moved. The joint usually swells due to synovial fluid collection.

Sunbeds are often used by people with psoriasis so I thought this study could be of interest.

Cutaneous *Melanoma attributable to sunbed use:

Objective:
To estimate the burden of melanoma resulting from sunbed use in western Europe.

Design:
Systematic review and meta-analysis.

Data sources:
pub med, ISI Web of Science (Science Citation Index Expanded), Embase, Pascal, Cochrane Library, LILACS, and MedCarib, along with published surveys reporting prevalence of sunbed use at national level in Europe.

Study selection:
Observational studies reporting a measure of risk for skin cancer (cutaneous melanoma, squamous cell carcinoma, basal cell carcinoma) associated with ever use of sunbeds.

Results:
Based on 27 studies ever use of sunbeds was associated with a summary relative risk of 1.20 (95% confidence interval 1.08 to 1.34). Publication bias was not evident. Restricting the analysis to cohorts and population based studies, the summary relative risk was 1.25 (1.09 to 1.43). Calculations for dose-response showed a 1.8% (95% confidence interval 0% to 3.8%) increase in risk of melanoma for each additional session of sunbed use per year. Based on 13 informative studies, first use of sunbeds before age 35 years was associated with a summary relative risk of 1.87 (1.41 to 2.48), with no indication of heterogeneity between studies. By using prevalence data from surveys and data from GLOBOCAN 2008, in 2008 in the 15 original member countries of the European Community plus three countries that were members of the European Free Trade Association, an estimated 3438 cases of melanoma could be attributable to sunbed use, most (n=2341) occurring among women.

Conclusions:
Sunbed use is associated with a significant increase in risk of melanoma. This risk increases with number of sunbed sessions and with initial usage at a young age (<35 years). The cancerous damage associated with sunbed use is substantial and could be avoided by strict regulations.

Source: bmj.com

*Melanoma is less common than other skin cancers. However, it is much more dangerous if it is not found early. It causes the majority (75%) of deaths related to skin cancer. According to a WHO report, about 48,000 melanoma related deaths occur worldwide per year. The treatment includes surgical removal of the tumor. If melanoma is found early, while it is still small and thin, and if it is completely removed, then the chance of cure is high.

*Subclinical Enthesitis Is More Common in Psoriatic Arthritis

Subclinical enthesitis occurs more commonly in patients with psoriatic arthritis than in those with psoriasis, possibly as a result of age and obesity rather than disease severity, to judge from the findings of a cross-sectional study conducted by investigators at Toronto Western Hospital.

The investigators used ultrasound as well as clinical examination to assess the extent, if any, of enthesitis in study participants, who were 59 patients with psoriatic arthritis and 79 patients with psoriasis. Study participants were recruited from longitudinal cohorts. The control group was made up of 60 healthy volunteers who did not have any personal or family history of spondyloarthropathy. They were evaluated for enthesitis at sites in the calcaneus, knee, and olecranon.

Findings on ultrasound – any enthesophytes, bony erosions, tendon thickness, and bursitis, within tendons – were scored using GUESS (Glasgow Ultrasound Enthesitis Scoring System), which reflects the overall burden bilaterally of enthesitis from abnormalities in five lower limb sites, and the MASEI (Madrid Sonography Enthesitis Index), which additionally includes calcifications and Doppler signals as elemental lesions as well as abnormalities of the olecranon tuberosity enthesis.

The average ages were 52, 53, and 42 years in the psoriasis, psoriatic arthritis, and healthy volunteer groups, respectively, and men accounted for 64%, 57%, and 32% of participants. Corresponding mean body mass indices were 27, 30, and 26 kg/m2, respectively.

In all, 12 anatomical sites were assessed. The mean number showing ultrasonographic enthesitis differed significantly across groups, reported study coauthor Jai P. Jayakar at the annual meeting of the Canadian Rheumatology Association. The number of anatomical sites that showed enthesitis was highest in the psoriatic arthritis group (7.1), intermediate in the psoriasis group (5), and lowest in healthy volunteers (4).

There was also a significant, graded difference across groups in GUESS scores (8.9, 5.6, and 4.4 out of a possible 36, respectively, for psoriatic arthritis, psoriasis, and healthy controls) and in MASEI scores (18.5, 9.9, and 7.7 respectively for psoriatic arthritis, psoriasis, and healthy controls out of a possible 136). However, in multivariate analyses, disease status was not associated with these scores; only increasing age and BMI showed significant associations.

"Our study is one of the first comparative assessments of subclinical enthesitis in psoriasis vs. psoriatic arthritis," noted Mr. Jayakar. "Our results reveal that the prevalence of ultrasonographic entheseal abnormalities and indices of entheseal burden ... are greater in psoriatic arthritis than in psoriasis; however, this relationship may be modulated in a multifactorial manner by factors other than disease status, such as age and body mass index.

"Now, it is possible that enthesitis could be of predictive value in specific patient subgroups – for example, age- or obesity-stratified subgroups," he added. "However, larger studies are needed to confirm the utility of subclinical enthesitis as a predictive factor for the development of psoriatic arthritis in patients with psoriasis."

How could the investigators be certain, a session attendee asked, that they were detecting disease-related enthesitis and not simply mechanical tendonitis?

That is a valid concern, given the lack of consensus among rheumatologists as to which ultrasonographic abnormalities result from degeneration, inflammation, mechanical stress, or other etiologies, acknowledged Mr. Jayakar, a medical student at the University of Western Ontario, London. Large cohorts with well-defined disease status would be required to investigate this further, he said.

"One direction in which we could move forward is if we can find specific elemental lesions – or aggregates of elemental lesions – that are of predictive value, then perhaps those could be used pragmatically to help us in our clinical management," he noted. "But as of now, the pathophysiological underpinnings of these abnormalities are not very well described."

Source: skinandallergynews.com

*Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. Symptoms include multiple points of tenderness at the heel, tibial tuberosity, iliac crest, and other tendon insertion sites.

Following on from my old thread about Stelara which you can find here Stelara 16 Months On. I thought I would start a new one in case it helps someone and also so I can monitor my results.

I have used Stelara before for 2 years see the old thread, and was about to go on to a new trial. however I was not suitable in the end to start the trial, so it's back on to Stelara for the moment as my skin is going crazy. the psoriatic arthritis is not to bad, but I desperately want that feeling of clear skin again.

So here goes, I have just taken my first shot and will be having another in 8 weeks followed by another visit with my dermatologist. My psoriasis score is 33 today, and here is a photo of my left leg showing between my ankle and knee. I had got the scaling down using Cold Cream, and I will carry on using that for the moment.



I will give updates on this thread as I go on through the treatment, and if you have any questions or comments please post here so I can keep it all together or PM me.

Anyone else had a swollen ankle with psoriasis? I have never had this before, I do have a very bad flare up from my ankles to my knees at the moment and the left one is worse than the right.

The left one is slightly swollen, it's not painful and I'm thinking it's fluid retention due to the inflammation of the psoriasis.

Any thoughts?

Hi im new to this and a little shy i have had P for many years and at my wits end im thinking of going on methotrexate (my dermo recommends ) any advice?

The Effects of Chronic Periodontitis and Its Treatment on the Subsequent Risk of Psoriasis

Background: 
Although psoriasis and *chronic periodontitis (CP) may share an underlying immune dysregulation as part of their pathologies, only one small-scaled cross-sectional pilot study has investigated the potential association between CP and psoriasis to date.

Objective: 
This study aimed to investigate the subsequent risk for psoriasis following a diagnosis with CP by utilizing a cohort study design and population-based dataset in Taiwan.

Methods: 
In total, 115,365 patients with CP were included in the study cohort and 115,365 patients without CP were included in the comparison cohort. We individually tracked each patient for a five-year period to identify those who had subsequently received a diagnosis of psoriasis. A Cox proportional hazards regression was performed to compute the five-year risk of subsequent psoriasis following a diagnosis of CP.

Results: 
We found that the incidence rate of psoriasis during the five-year follow-up period was 1.88 (95% CI=1.77-1.99) per 1,000 person-years in patients with CP and 1.22 (95% CI=1.14-1.32) per 1,000 person-years in comparison patients. After censoring those who died during the follow-up period, and adjusting for monthly income and geographic region, compared with comparison patients, the HR of psoriasis for patients with CP was 1.52 (95% CI=1.38-1.70). Furthermore, the study subjects who had undergone a gingivectomy or periodontal flap operation only had a slightly higher adjusted risk of psoriasis than comparison patients (HR=1.26).

Conclusions: 
This study detected an increased risk for psoriasis among patients suffering from CP. Treatment for CP attenuated, but did not nullify, the risk for subsequent psoriasis.

Source: onlinelibrary.wiley.com

*Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues.
Symptoms may include: Redness or bleeding of gums while brushing teeth, Gum swelling that recurs, Halitosis, Gingival recession, Deep pockets between the teeth and the gums, Loose teeth.

So I'm currently covered in psoriasis from head to toe it is easier to tell you that I don't have it on 7 out of 10 fingers and 8 out of 10 toes!!! 
Being pregnant means I'm rather limited on what treatments are open to me and most creams come with risks to the baby.

I was in the pharmacy the other day and noticed a product which I toyed with the idea of using before but chose to try forever living aloe products, the kind lady in the pharmacy gave me some trial samples and a leaflet. I checked it's all safe to use while pregnant so on saturday I purchased my first lot, I had to buy more today from the pharmacy where I got given the samples and another lady asked how I was getting on with it a a few people have tried the product and gone back singing it's praises.

Since starting it I do feel more moisturised and far less itchy and my flakey-ness decreased loads, I ran out of the product yesterday so had to use my epaderm moisture cream, itchiness came back and lots of flakes!!

So here's my plan, I'm giving this product 6 weeks hopefully without running out again. I will try and update on here a much as possible, and hopefully with positive results.
If this doesn't work I may bite the bullet and have more UVB.

I'm not naming what I'm using just yet as I want to see results from my own trial first. But if you really want to know PM me as the company is doing sample products that you need to pay £2 p&p for (uk) 

Hello everyone, I'm Keesha!
I'm 22 now, and ive known about my psoriasis since I was 8. I know a lot of you have had it longer than me and a lot of you have a very serious case of it.  Run down of my story.... my psoriasis started behind my ears, my mom thought I wasn't washing behind them when I showered. Lol.  But when it started to build up, and when my mom would pull my ear forward and the back would split and hurt really bad then bleed she took me to the doctors.. and they sent me to the dermatologist, and that's how I found out.  So creams it was, and they worked for years.... actually my breakouts stopped for a while... when I got pregnant they started showing back up, and after I had my baby it got really bad.. I was using a breast pump but then my chest area got covered and I had to stop.  I started on humira injections and it was working great.. but the more injections I got, the bigger my injection sites would irritate. So they took me off.. I was back to creams for a while, and some dermal smooth for my scalp.  But my back, stomach, chest and scalp started getting bad again... at the point where I couldn't do anything with my hair and I hated going out. See I have very dark hair, and everytime I brush these white flakes go everywhere..
well story already long... I stared stelara in march.. second dose in April, and do for my third injection next week. Its been working good so far, but I went to get my blood work done on Friday and my doctors official called me and said I have to get it done again because my liver levels were high.. what does that mean? They also said if it comes back high again I cant get my third injection... this has me kinda. Dummed

Hi Folks,
I'm on Fumaderm for the first time and got to the Blue tabs, 3 times a day, without any problems, then boom! Omg! Stomach cramps and the runs, has anyone come across anything that alleviates either of these issues?

I have suffered with psoriasis for over 20 yrs. first the itching I use Germ x hand sanitizer. I have recently started to use petroleum jelly for the plaque, i had about 30% of my body covered in plaque.

I'm glad to report about a 15 yr reversal in my condition. I no longer have any significant plaque anywhere. This is almost a miracle, well who am I kidding it is a miracle. I could not go out in public, I had to where as much clothing as possible. I felt like a freak I had so much plaque, not anymore. 20 yrs of Dovonex treatments failed.

Then i tried a simple petroleum gel coating to relive the dryness, now after 3 months I'm almost completely free of plaque. No more vacuuming the floor everyday. No more constant scratching and shedding skin. I hope this helps you and others, please tell your friends.

Edwin & Debbie

Now my psoriasis is flaring up again, I was noticing how symmetrical it is.

Symmetrical I have

• Above my left and right ear.
  
• Both armpits.
  
• Both undersides of my lower arms.
  
• Both thumbnails are lifting.
  
• Left and right toenails look the same.
  
• Left and right front lower legs are the worse, and look much the same.
  
• I suppose you could class as symmetrical, my lips and genital area are both flaring up.
  

• One small patch on my right torso.
  
• My right hand outside upper leg.
  
• Right hand toes.
  

Celgene today announced top-line results from the PALACE-1 study, the first of three pivotal phase III, randomized, placebo-controlled studies evaluating the Company’s novel, oral small-molecule inhibitor of phosphodiesterase 4 (PDE4) in patients with psoriatic arthritis who had received an oral disease-modifying antirheumatic drug (DMARD), biologic therapy or had failed on an anti-tumor necrosis factor (TNF) agent. *Apremilast treatment in this study was used alone or in combination with an oral DMARD.

In the study, statistical significance for the primary endpoint of ACR20 was achieved for patients receiving apremilast. Patients in the active treatment arms also maintained significant improvements in arthritis-related endpoints, including ACR50 and ACR70 through week 24. Significant and sustained improvements in various measures of physical function were also observed in apremilast-treated patients.

The overall safety profile was consistent with previous experiences in the phase II program and tolerability was improved. Common side effects for PDE4 inhibitors have been gastrointestinal in nature. In the PALACE-1 study, gastrointestinal adverse events, upper respiratory tract infections, as well as headache, were no more common in apremilast-treated patients than in those receiving placebo.

The PALACE-1 study is ongoing and the study extension remains blinded until all patients complete week 52. Full data from this phase III study will be submitted for presentation at appropriate medical meetings.

Source: celgene.com

*Apremilast is an oral small-molecule inhibitor of phosphodiesterase 4 (PDE4), works intracellularly to modulate a network of pro-inflammatory and anti-inflammatory mediators. PDE4 is a cyclic adenosine monophosphate (cAMP)-specific PDE and the dominant PDE in inflammatory cells. PDE4 inhibition elevates intracellular cAMP levels, which in turn down-regulates the inflammatory response by modulating the expression of TNF-α, IL-23, and other inflammatory cytokines. Elevation of cAMP also increases anti-inflammatory cytokines such as IL-10.

Hello,

First post, suffered with P for 25 years, Im only 29. tuff life as everybody knows. I used to get this stuff skin cap. Cleared my skin in 2 days. It worked great. Now its been banned. Im broken out, no insurance, and have been looking on internet for skin cap and I heard about Psor Val that is supposedly same ingrediant and works better. I want to order this immediately since it worked so well. Has anybody else tried doing that, or have heard of Psor Val, or even if the skin cap on the web still works, it says its by the same corporation. Please let me know if anybody else has tried or heard about these two products. Skin cap was the best and I hope its still the same as a couple years ago before it was banned. Thanx for all your help, and Im glad Im not alone having to deal with this. I wish all of you the best. Thanx for any feed back on my question!!!!

Following on from the introduction of Simponi (golimumab) by NICE in April 2011 for England. Scotland has now followed suit, But its use is restricted to patients in whom treatment with at least two other disease-modifying antirheumatic drugs (DMARDs) or NSAIDs has failed to alleviate symptoms. And doses must be restricted to 50mg.

The Scottish Medicines Consortium ruled that the drug can be used alone or in combination with methotrexate. Evidence reviewed by the watchdog found golimumab was cost effective at this dose. A study showed it outperformed placebo at reducing symptoms. Side-effects were similar to placebo and included nasopharyngitis and URTI.

Source: scottishmedicines.org.uk

More on Simponi here: https://psoriasisclub.org/showthread.php...169#pid169