Hello, thought I would check out a forum as I am starting a new med.

First I will recap my journey to this point:

I was diagnosed as having Psoriatic arthritis around 1992.

I was told that by the time I was 55 I would be in a wheelchair.  I took just about everything imaginable between then and 1998.  Methotrexate, sulfa, don’e even remember it all.  Nothing made any difference.

In 1998 I was ready to give up and my primary care Dr recommended a hand specialist in the area that had done surgery on people from all over.  I told him I was at the end of my rope.  He said “There’s a new med out called enbrel, let’s try that”.  I started enbrel and it saved my life.  A miracle drug.

In 2011 we moved to mexico.  I stopped the enbrel as my insurance would not cover it there.  It took several years for it to wear off.  When it did both the psoriasis and arthritis came back with a vengance.

In 2018 we moved back to the us and started enbrel again.  Much better but not as effective as it once was.  They switched me to humira.  It did nothing.  Just recently I was switched to otezla.  Bad trip.  Stomach problems, nausea,  diarrhea, nausia, migraine, trembling inside and out.

Now they are going to send me taltz.  I am curious of experiences people have had with it.

So thanks for having me.  Should I have posted this in the pa forum?

AbbVie today announced that it has submitted applications for a new indication to the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) for RINVOQ (upadacitinib; 15 mg, once daily), a selective and reversible JAK inhibitor, for the treatment of adult patients with active psoriatic arthritis.

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"Psoriatic arthritis is a complex heterogeneous disease with manifestations across multiple domains, including joints and skin, causing daily pain, fatigue and stiffness," said Michael Severino, M.D., vice chairman and president, AbbVie. "We look forward to working with regulatory authorities and hope to bring RINVOQ to people living with this debilitating disease as quickly as possible."

The applications are supported by data from two Phase 3 studies across a broad range of more than 2,000 patients with active psoriatic arthritis.1,2 In both studies, RINVOQ met the primary endpoint of ACR20 response at week 12 versus placebo.1,2 RINVOQ 15 mg also achieved non-inferiority versus adalimumab in terms of ACR20 response at week 12.1 Patients receiving RINVOQ also experienced greater improvements in physical function (HAQ-DI) and skin symptoms (PASI 75), and a greater proportion achieved minimal disease activity.* Overall, the safety profile of RINVOQ in psoriatic arthritis was consistent with previously reported results across the Phase 3 rheumatoid arthritis clinical trial program, with no new significant safety risks detected.

*Physical function was measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). Skin symptoms were measured by a 75 percent improvement in the Psoriasis Area Severity Index (PASI 75). Minimal disease activity is defined as the fulfillment of five of seven outcome measures: Tender joint count ≤1; swollen joint count ≤1; PASI ≤1 or body surface area-psoriasis ≤3 percent; Patient's Assessment of Pain Numerical Rating Scale (NRS) ≤1.5; Patient Global Assessment-Disease Activity NRS ≤2.0; HAQ-DI score ≤0.5; and Leeds Enthesitis Index ≤1.

About RINVOQ™ (upadacitinib)

Discovered and developed by AbbVie scientists, RINVOQ is a selective and reversible JAK inhibitor that is being studied in several immune-mediated inflammatory diseases. In August 2019, RINVOQ received U.S. FDA approval for adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate. In December 2019, RINVOQ was approved by the European Commission for the treatment of adult patients with moderate to severe active rheumatoid arthritis who have responded inadequately to, or who are intolerant to one or more disease-modifying anti-rheumatic drugs. The approved dose for RINVOQ in rheumatoid arthritis is 15 mg. Phase 3 trials of RINVOQ in psoriatic arthritis, rheumatoid arthritis, axial spondyloarthritis, Crohn's disease, atopic dermatitis, ulcerative colitis and giant cell arteritis are ongoing. Use of RINVOQ in psoriatic arthritis is not approved and its safety and efficacy have not been established by regulatory authorities.

Started getting eye problems after a few weeks on Taltz.
Eyes aching like I was punched in them. It then changed to when I wore glasses to see the PC screen. (quite a lot)
Its now very sunny in the Uk and I have slight head ache and eye ache. I had my last injection 18th April and was about to take it monthly. I missed my last injection, so now just over 5 weeks ago.
I am wanting it out of my system so I know if its Taltz that's causing it.
Opticians tested my eyes in January. They had another look when I started with problems. They couldn't find anything major. My eyes were very slightly dry and my distance vision had deteriorated a little.
I phoned dermatologist personal receptionist and asked if it was ok to stop temporary. Also with the Virus about. She said she had heard of someone else with the same problem.
Got call back with the Ok to stop and see her on review date.


My question is....How long before Taltz is out of my system

This study compared Humira (adalimumab) and Fumaric Acid Esters (FAE) on cardiovascular disease markers in psoriasis patients.

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Background:
The effect of adalimumab and fumaric acid esters (FAE) on the cardiovascular risk associated with psoriasis has only been investigated scarcely in randomized controlled studies.

Objective:
The aim of this prospective, randomized controlled head‐to‐head trial was to compare the influence of adalimumab and FAE on cardiovascular disease markers in psoriasis patients.

Methods:
65 patients with moderate to severe plaque psoriasis were randomly assigned to adalimumab or FAE treatment for 6 months. Cardiovascular hemodynamic parameters (flow mediated dilation (FMD), nitro‐glycerine mediated dilation (NMD) and carotid intima media thickness (CIMT), blood pressure) were assessed at baseline(v0) and after 6 months(v6). Cutaneous disease severity, inflammatory and lipid cardiovascular risk markers were analysed at baseline(v0), after three(v3) and six months(v6).

Results:
After 6 months of treatment FMD in the adalimumab group increased significantly (v0 5,9% (6,4% S.D), v6 8,0% (4,8% S.D.), p=0,048) but not in the FAE group. (v0 7,0% (4,1% S.D), v6 8,4% (6,1% S.D.), p=0,753) This was paralleled by a significant decrease of hsCRP in the adalimumab group in comparison to the FAE group (v0: 0,39 mg/dl (0,38 S.D.), v6: 0,39mg/dl (0,48 S.D.), p=0,043). No significant changes were observed in any other hemodynamic parameters. FAE, however, additionally decreased total cholesterol (p=0,046) and apolipoprotein B (p=0,041) levels compared to adalimumab. Mean PASI (psoriasis area severity score) reduction was greater but not significant (p=0,116) under adalimumab treatment compared to FAE treatment ( ‐71,1% (29,9 S.D) vs. ‐54,6% (45,7%)).

Conclusion:
In our study both treatments were documented to exert effects on the cardiovascular system. While adalimumab showed anti‐inflammatory effects and improved FMD, FAE interacted favourably with the cholesterol metabolism.

This study suggests Cosentyx (secukinumab) resulted in complete normalization of quality of life (QoL) in a substantial proportion of psoriasis patients, and their families, regardless of their prior treatment history.

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Introduction:
Psoriatic disease is associated with considerable impairment of Quality of life (QoL). The PROSE study (NCT02752776) investigated the impact of secukinumab treatment on patient‐reported outcomes (PRO) in patients with moderate‐to‐severe psoriasis stratified by their treatment history.

Methods:
PROSE was a prospective, non‐randomised, multicentre study. Patients were categorized at baseline according to treatment history as naïve (naïve to any systemic therapy [N=663]), conventional systemic (previously exposed to ≥1 conventional systemic (CS) therapy [N=673]), and biologics (previously exposed to ≥1 biologic therapy [N=324]). QoL PROs, efficacy and safety of secukinumab 300 mg were assessed for a period of 52 weeks.

Results:
The primary objective was met with 70.8% patients achieving a Dermatology Life Quality Index (DLQI) 0/1 response at Week 16 (naϊve, 74.7%; CS, 71.3%; biologic, 61.7%), with effects sustained up to Week 52. Mean Family‐DLQI (FDLQI) score decreased from 11.5 at baseline (naϊve, 11.3; CS, 11.4; biologic, 12.1) to 2.5 at Week 16 (naϊve, 2.5; CS, 2.3; biologic: 3.5). Substantial improvements in EuroQoL 5‐Dimension Health Questionnaire, Numeric Rating Scale for pain, itching and scaling, Health Assessment Questionnaire‐Disability Index, Treatment Satisfaction Questionnaire for Medication, and Patient Benefit Index were also observed at Week 16. The QoL gains were associated with substantial improvements in Psoriasis Area and Severity Index and Investigator Global Assessment mod 2011 0/1 response. No meaningful difference was observed in the efficacy or QoL improvements across patient subpopulations. All QoL and efficacy parameter improvements were sustained up to Week 52. Secukinumab treatment was well‐tolerated, and no new safety signals were observed.

Conclusion:
Secukinumab treatment resulted in complete normalization of QoL in a substantial proportion of psoriasis patients, and their families, regardless of their prior treatment history.

Has anyone else using Tremfya noticed an increase in eye light sensitivity ?

It has been said that people with psoriasis can suffer with increased light sensitivity and I remember Stelara made my eyes more sensitive to sunlight.

I'm finding now we are getting a lot more brighter sunshine my eyes start to feel more sensitive and get very dry and I keep squinting, after coming back inside it starts to wear off and after a couple of hours my eyes are back to normal.

I think I will go back to putting sunglasses on when going out in the garden as I used to with Stelara, but was wondering if anyone else has noticed an increase in eye light sensitivity with Tremfya ?

This study set out to confirm the effectiveness and safety of Cimzia (certolizumab) in patients with psoriasis and psoriatic arthritis in routine clinical practice.

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Background:
Certolizumab, a pegylated tumour necrosis factor‐α inhibitor, reduced disease activity in randomised trials of patients with psoriasis and psoriatic arthritis. Real‐life data are missing.

Objective:
To confirm the effectiveness and safety of certolizumab in patients with psoriasis and psoriatic arthritis in routine clinical practice.

Methods:
In this retrospective study involving 11 Italian sites, patients with psoriasis and psoriatic arthritis received subcutaneous certolizumab (400 mg loading dose at 0, 2 and 4 weeks, followed by 200 mg every 2 weeks) for up to 52 weeks. Primary outcomes included mean change from baseline in Psoriasis Area and Severity Index (PASI) and modified Nail Psoriasis Severity Index (mNAPSI) scores, and the proportion of patients achieving a 75%, 90% or 100% reduction in PASI score. Other endpoints included Disease Activity Score computed on 44 joints correlated to the erythrocyte sedimentation rate during the first hour (DAS44‐ESR), Tender Joint Count (TJC), Swollen Joint Count (SJC), pain (visual analogue scale [VAS] score), inflammatory markers and quality of life (QOL).

Results:
In the study were enrolled 153 patients (mean age: 55 years). Certolizumab reduced the mean PASI score from baseline by 4.45, 6.30 and 7.58 at weeks 12, 24 and 52, respectively (p<0.001 for all). At weeks 24 and 52, 69.6% and 83.3% of patients had a PASI score ≤3. DAS44‐ESR, TJC, SJC and mNAPSI scores, and pain‐VAS were also all significantly improved from baseline at each time point. C‐reactive protein levels decreased during treatment, being significant at week 24. On multivariate analysis, psoriasis duration, baseline PASI, mNAPSI and pain‐VAS scores were found to be predictive of the improvement in PASI score at week 12.

Conclusion:
Certolizumab displayed also in the real‐life encouraging results in both psoriasis and psoriatic arthritis patients

This study suggests there is still an unmet need for more efficacious biologics for patients with psoriasis.

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Background:
Anti‐tumour necrosis factor (TNF) and anti‐interleukin (IL)‐12/23 biologics revolutionized plaque psoriasis treatment by enabling ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) in clinical trials. Modern biologics are now reported to achieve PASI 100 (complete skin clearance) in clinical trials. However, real‐world evidence of skin clearance rates with biologics is limited. PSO‐BIO‐REAL was conducted to understand the real‐world burden of plaque psoriasis.

Objective:
The primary objective of this observational study was to estimate the proportion of patients who achieved complete skin clearance at 6 months. Secondary objectives included maintenance of response and evaluation of complete skin clearance at 12 months.

Methods:
PSO‐BIO‐REAL was a multinational, prospective, real‐world, non‐interventional study of skin clearance and patient‐reported outcomes (PROs) with biologics. A total of 846 patients from the United States (32%), France (28%), Italy (22%), the United Kingdom (11%), and Germany (8%) were enrolled and followed for one year. Eligible patients were aged ≥18 years with moderate‐to‐severe plaque psoriasis who had initiated a biologic for plaque psoriasis. Patients could be biologic‐naïve or switching biologics (biologic‐experienced). Assessments were made at baseline and at Months 6 and 12.

Results:
At 6 and 12 months, 23% and 26% of patients achieved complete skin clearance, respectively. Prior to study entry, 60% were biologic‐naïve. The proportion of patients achieving complete skin clearance was lower among biologic‐experienced patients (20% at both Months 6 and 12) compared with biologic‐naïve patients (25% at Month 6, 30% at Month 12). The rate of complete skin clearance decreased as the number of prior biologics and baseline comorbidities increased.

Conclusion:
Only one in four patients achieved complete skin clearance after 6 months of treatment with biologics. The study indicates there still is an unmet need for more efficacious biologics for patients with psoriasis.

Results of a 52 week efficacy and safety study of Cosentyx v Stelara

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Background:
Secukinumab demonstrated superior efficacy over ustekinumab in the treatment of moderate to severe plaque psoriasis over 16 weeks in the CLARITY study and over 52 weeks in the CLEAR study.

Objective:
To compare the efficacy and safety of secukinumab vs ustekinumab over 52 weeks in CLARITY.

Methods:
Analysis of 52‐week data from CLARITY (NCT02826603), a phase 3b study in which patients were randomized to receive secukinumab 300 mg (n = 550) or ustekinumab 45/90 mg (n = 552) per label.

Results:
At week 52, secukinumab was superior to ustekinumab in the proportion of patients who achieved ≥90% improvement in Psoriasis Area and Severity Index (73.2% vs 59.8%; odds ratio [OR], 1.84 [95% CI, 1.41‐2.41]; P < .0001), Investigator’s Global Assessment modified 2011 responses of clear (0) or almost clear (1) skin (76.0% vs 60.2%; OR, 2.12 [95% CI, 1.61‐2.79]; P < .0001), and Dermatology Life Quality Index response of no effect (0/1) (69.9% vs 61.2%; P = .0028). Proportions of patients with any adverse events were comparable between treatment arms.

Conclusions:
This second head‐to‐head study confirmed the superior efficacy of secukinumab over ustekinumab in skin clearance and quality of life through 52 weeks, with safety comparable to that reported in previous trials.

This study compared clobetasol cream and calcipotriol/betamethasone dipropionate foam (Cal/BD‐foam)

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Background:
Treatment response for psoriasis is typically evaluated using clinical scores. However, patients can relapse after clinical clearance, suggesting persistent inflammation. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) can non‐invasively improve treatment response assessment.

Objectives:
To compare the clinical and non‐invasive microscopic features in a psoriatic target lesion treated with clobetasol cream or calcipotriol/betamethasone dipropionate foam (Cal/BD‐foam)

Methods:
Prospective, unicentric, open, randomized clinical trial comparing clinical data (total clinical score [TCS]) and microscopic data (dermoscopy, RCM, OCT) in psoriasis patients treated with clobetasol or Cal/BD‐foam.

Results:
We included 36 adult patients (22 men). At week 4, more patients treated with Cal/BD foam achieved TCS≤1 than with clobetasol (63.2% vs 18.8%, p=0.016). Treatment satisfaction was higher with Cal/BD‐foam (p<0.03). Microscopically, Cal/BD‐foam induced more reduction of epidermal thickness at week 4 (p<0.049). Dilated horizontal blood vessels were more common with clobetasol than with Cal/BD‐foam at week 8 (69.2% vs 31.2%, p=0.159). If epidermal hyperplasia was noted at baseline, the response was poorer with clobetasol (p=0.029).

Limitations:
Small sample size, open study, imaging sampling bias.

Conclusion:
Cal/BD‐foam is more effective than clobetasol, has better patient satisfaction and induces greater reduction of the hyperkeratosis/acanthosis, regardless of baseline epidermal hyperplasia.

This study looked at the usefulness and reliability of insurance databases in psoriasis studies.

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Background:
Psoriasis is one of the most frequent chronic inflammatory dermatoses in the world. Data on the prevalence of psoriasis in adults differ depending on the study.

Objective:
To estimate the prevalence of patients with treatment for psoriasis in France and to identify and characterize patients receiving systemic treatments.

Methods:
This was a French, nationwide cohort study based on health administrative data from the French national health insurance scheme linked to the national hospital discharge database (SNDS‐PMSI). All adults with psoriasis registered in the SNDS between January 1, 2008 and December 31, 2016 were eligible for inclusion. All patients with a new prescription for a systemic treatment for psoriasis were included.

Results:
A total of 874,549 patients were identified as having psoriasis (mean±SD age 53.8±17 years; 52.4% males); 112,969 (13%) had filled at least one prescription for a systemic medication used to treat psoriasis. The prevalence of patients with treatment for psoriasis was estimated at 1.3%. Overall, 73,168 and 16,545 were new users of conventional systemic treatments and biologics, respectively. The most frequent comorbidities associated with psoriasis were hypertension, dyslipidemia, diabetes and chronic obstructive pulmonary disease.

Conclusion:
The prevalence of psoriasis we found was lower than in other studies. It was probably underestimated because we identified only patients with treatment for psoriasis. Our results concerning comorbidities associated with psoriasis patients requiring systemic treatment were similar to those from other published studies using other data sources, highlighting our ability to catch moderate‐to‐severe psoriasis. This study highlights the usefulness and reliability of the use of insurance databases in studies, because they allow for a better application to the general population.

This study looked at heterogenicity using gene expression profiles of lesional skin biopsy specimens in Chinese psoriasis patients.

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Background:
Psoriasis is an immune‐mediated, chronic inflammatory disease with diverse phenotypes. However, its biological diversity has not been well‐characterized in Chinese psoriasis population.

Objectives:
To characterize psoriasis biological heterogenicity using gene expression profiles of lesional skin biopsy specimens in a Chinese psoriasis population.

Methods:
Lesional tissues and blood samples from Chinese psoriasis patients (n = 40), atopic dermatitis (AD) patients (n = 25) and age‐matched healthy controls (n = 19) were investigated by using Real‐Time PCR Array, histological evaluation and flow cytometry. Unsupervised hierarchical clustering was performed using gene expression profiles of patients with psoriasis.

Results:
Two distinct psoriasis clusters were identified. Both clusters indicated high TH17 activation. One cluster (n = 6 of 40 consecutive psoriasis patients) indicated a strong TH2 component in skin lesions, with early onset and low peripheral blood eosinophil level. Significantly higher IL‐4, IL‐13, IL‐25, IL‐31 and TSLP gene induction typified this cluster of psoriasis patients, even compared with AD patients. Both psoriasis clusters were characterized by neutrophilic microabscess formation. Histologically, the TH2 high psoriasis cluster indicated a low percentage of perivascular eosinophils.

Conclusions:
Two distinct psoriasis clusters were identified. One presented early onset and a low eosinophil level, indicating TH17 polarization and a strong TH2 component. These results laid the foundation for further demonstrating the pathogenesis of psoriasis in Chinese population.

Hi I'm new here, just got what turned out to be guttate after a bad strep infection in March. What started out as brown discoloration on my legs turned into tiny red dots all over my legs. I didn't pay much attention until it showed up on my chest. That's when i went to a dermatologist and got a biopsy. My doctor put me on betamethasone, however it doesn't seem to have lasting effect. I started out with tiny dots, now after 3 rounds of topical steroid, it spreads to other areas of my body. It does seem to reduce the inflammation and redness during my 2 weeks treatment, however as soon as i stop, the spots come back with a vengeance. Some spots even joined together and formed a 1inch leisons

I'm hesitantly carrying on with my current round of betamethasone as i know it will get worse and then have to go back to square one again. I heard people saying weening off steroid is the same as quitting cold turkey, since the lest you put on your body the easier it is to quit. I'm tempting to manage my guttate with dietary change and natural sunlight.

People often say that guttate goes away in a couple months. Does that mean I have to keep up with topical steroid until it fades? From my own experience, last time most of my spots seemed to fade, with only some white discoloration but then after a week, they come back redder and more raised and showed up at other places in my body as well. If you have succeed treating your guttate with topical steroid, do you still have to use it for maintenance during remission?

Hi again. After a few years of bad side effects from oral treatment and then starting biological treatments. I am now on My 2nd attempt with injections. I am now on Taltz.
I have just had my 5th injection. My skin is well on the way to perfect. Just my lower legs to clear. Still early days.
No horrendous side effects the all other treatments. There is 2 side effects, 1 of which is listed a lot.
1. Injection site goes red. I mean a large circle if I inject my tummy and lumpy under the skin. It lasts between 1 and 2 weeks. Doesn't bother me.
2. My eyes have ached really badly on 2 occasions. The first time it came on rapidly with gritty eyes. I assumed it was allergy's and just put in eye drops. It was on and off for 1 week but only bad for 1 evening. Didn't think anything of it. Then it happened again 3 weeks later. 
I phoned my GP and she said take anti histamine tablets as allergies can make them also ache. If still bothering me in 24 hours book with opticians as she cant see in the eye.
I phoned the opticians anyway. They said come in and they will look. 
The next day my eyes were fine. The day after I had appointment at opticians.
Note I only have 1 good eye!!
Opticians said he couldn't find anything wrong other than the ware very slightly dry. Also needed prescription for distance. Even though I had them tested 2 month prior. This he found "interesting" As I write this, my eyes feel fine.

Most sites don't list eye problems but some sites do. In total it lists, redness, pain, selling of the eye or inner lining.

Obviously I will be talking to my dermatologist but I know all she will say is "do you want to continue on it"
I will now be  taking the injection every month instead of every 2 weeks. So if it is Taltz I will soon find out.

HAS ANYONE ELSE HAD EYE ACHE USING TALTZ !! 

Sorry for ranting on. Its just I was so pleased to have found something that works without side effects after all this time 
Duncan

I am new to the Board; I’m 70 and live in California. I first broke out with Psoriasis at age 31 when my dad got Cancer at age 52; I broke out over 80% of my body almost everywhere but my face, hands, and feet. After my father passed at age 55 my psoriasis cleared mainly except for a few spots of my lower legs and an occasional spot here and there. I would say less than 2% of body.

I quit smoking 35 years ago and drink a bit of alcohol albeit know more than 7-8 drinks per week. I exercise 2x per week playing ? tennis. I take several supplements including Turmeric, D 3, Vitamin C, Vitamin E, etc

I’m concerned about possibly getting cancer which is my greatest fear but I understand if we have Psoriasis are likelihood is increased!! There are many studies that indicate this.

Anyone know of anything we can do to lower the probability?

hello, everyone

after 50 years of suffering with psoriasis, I was eventually put on  Methotrexate and it really works.       over the years,  I tried so many steroid ointments, nothing worked.  hope this is useful

This study looked at the impacts of gene polymorphisms on Methotrexate in Chinese psoriasis patients.

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Background:
Methotrexate (MTX) is the first‐line treatment for psoriasis in China. The metabolic processes of MTX include various proteins and genes. Previous studies have shown that gene polymorphisms had significant impacts on the efficacy of MTX. However, the influence of gene polymorphisms has not been reported in the Chinese psoriatic patients.

Objective:
The aim of this study was to verify the impacts of candidate genes polymorphisms on the effectiveness of MTX in a Chinese psoriatic population.

Methods:
In this study, we enrolled 259 psoriasis patients from two clinical centres. Each of them received MTX treatment at 7.5‐15 mg/week for at least 8 weeks. Patients were stratified as responders and nonresponders according to whether the Psoriasis Area and Severity Index score declined more than 75% (PASI75). According to previous reports, 16 single‐nucleotide polymorphisms (SNPs) were selected and genotyped for each patient using the Sequenom platform. Fisher’s exact test, the χ2 test, Mann‐Whitney tests, and ANOVA analyses were used for statistical analysis.

Results:
Among 259 patients, there were 182 males and 77 females, 63 patients with psoriatic arthritis and 196 patients without arthritis phenotype, and the age of all patients ranged from 19 to 70 years (49.7±13.6). The baseline PASI value of patients was 13.8±8.5, and 33.2% of patients achieved a PASI75 response after MTX treatment. Patients carrying the ATP‐binding cassette subfamily B member 1 gene (ABCB1) rs1045642 TT genotype were associated with more severe psoriasis skin lesion (P=0.032). Furthermore, the ABCB1 rs1045642 TT genotype was found to be more frequent in nonresponders (P=0.017), especially in moderate‐to‐severe patients (P=0.002) and patients without psoriatic arthritis (P=0.026) after MTX treatment.

Conclusion:
We have demonstrated for the first time that polymorphism of the ABCB1 rs1045642 TT genotype is predictive of a worse clinical response of skin lesions to MTX therapy in a Chinese psoriatic population.

This study evaluated the effectiveness, safety, and drug survival of Otezla (apremilast) at 52 weeks in patients with moderate to severe plaque psoriasis or palmoplantar psoriasis in routine clinical practice.

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Background:
Little has been published on the real‐world effectiveness and safety of apremilast in psoriasis.

Objectives:
To evaluate the effectiveness, safety, and drug survival of apremilast at 52 weeks in patients with moderate to severe plaque psoriasis or palmoplantar psoriasis in routine clinical practice.

Methods:
Retrospective, multicenter study of adult patients with moderate to severe plaque psoriasis or palmoplantar psoriasis treated with apremilast from March 2016 to March 2018.

Results:
We studied 292 patients with plaque psoriasis and 85 patients with palmoplantar psoriasis. The mean (SD) Psoriasis Area and Severity Index (PASI) score was 10.7 (7.0) at baseline and 3.0 (4.2) at 52 weeks. After 12 months of treatment, 73.6% of patients had a PASI score of 3 or less. In terms of relative improvement by week 52, 49.7% of patients achieved PASI‐75 (≥ 75% reduction in PASI score) and 26.5% achieved PASI‐90. The mean physician global assessment score for palmoplantar psoriasis fell from 4.2 (5.2) at baseline to 1.3 (1.3) at week 52. Overall drug survival after 1 year of treatment with apremilast was 54.9 %. The main reasons for treatment discontinuation were loss of efficacy (23.9%) and adverse events (15.9%). Almost half of the patients in our series (47%) experienced at least one adverse event. The most common events were gastrointestinal problems.

Conclusions:
Apremilast may be a suitable alternative for the treatment of moderate to severe psoriasis and palmoplantar psoriasis. Although the drug has a good safety profile, adverse gastrointestinal effects are common.

I’ll be taking my third dose tonight and just wondering when I could be seeing results? Pretty sure my dermatologist said it could take 3 months but obviously I want instant results (yes I’m impatient!). Luckily I’ve had no side effects. My slight concern is my GP may not do my 4 week blood test due to the coronavirus but guess have to see when the time comes.

Taltz is now approved by the FDA (U.S. Food and Drug Administration) for use in children over 6 years.

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Eli Lilly announced today the U.S. Food and Drug Administration (FDA) has approved a supplemental Biologics License Application (sBLA) for Taltz® (ixekizumab) injection, 80 mg/mL for the treatment of pediatric patients (ages 6 to under 18) with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.