Howdy y'all,

A real quick rundown of my dose of Methotrexate. Also, note that my dermatologist is a man. But I interact more with the resident under him, who is a woman. So if I get gender-confused, that's why haha

My dermatologist had me start a daily regimen of folic acid 2 days before she had me start the MTX (that I skip on the days I take MTX). I was taking the MTX on Tuesday's. But because of the required labs and the clashing with my job, I had to move the dose to Wednesday. 


1. I started a 2-pill dose on April 23. 

• The first labs came back normal. I discovered I am anemic based on my lab results. I didn't know but had an idea that I am. 
  
• I also had serious heartburn. There was also occasional pressure under my sternum like gallstones. I had experienced gallstones 15 years ago after having my son. Never had that issue resolved but the pain stopped after a couple of years. I emailed my dermatologist about this symptom and she says it is not related to the MTX and to contact my primary. 
  
• No change in psoriasis
  

• Labs again were normal. But I've started having issues with my job. I couldn't concentrate. Distractibility was high. 
  
• 2 days after this dose, I had a full-blown gallstone attack that had me down and out for a couple of hours. Then again another attack the next day. No clue what triggered the attack
  
• A small change in psoriasis.
  

• Labs were normal so dr upped the dosage. 
  
• Emailed my dr about the fatigue, distractibility and how it affects my very unique job. 
  
• Inverse psoriasis has begun to clear up.
  

• Fatigue has been kicking my butt. My boss has given me permission to take off early if I can't work with a clear head, providing I have the vacation/sick hours to cover.
  
• Distractability wasn't an issue until today (5 days post-dose). 
  
• I feel like my mind goes blank sometimes. I'll be doing something and stop and just think "what was I doing?" That actually happened while I was creating this thread.
  
• The inverse psoriasis was almost cleared up but seems to be making a come-back.
  
• Plaques/guttate has started clearing up on the larger areas but itches like hell. Anytime I scratch, I bleed all over the place.
  
• Psoriasis had started moving down my legs more but seems to have stopped progressing.
  

Hi all,

I have joined this board in hopes of finding some info on the treatments for psoriasis.

I first experienced psoriasis when I was a teen. At the time, I didn't realize what it was. I just itched a lot on my arms and legs and didn't know why. After a change in detergents, it went away. I've had various short episodes since then. Most of the time my flare-ups are triggered by an allergic reaction to detergents or fabric softeners. That alone has limited me to using only All Free & Clear to wash my clothes.  I have a reaction to ALL box soaps and anything scented. Recently, All released their new Free & Clear softener and I was hoping I could use that since I pretty much live off the detergent. That was a big fat NOPE. It resulted in a flare-up that I'm currently dealing with.

How do I know it was psoriasis you ask? Besides a Dr's diagnosis, my mother is a lifetime psoriasis sufferer as well. We have worked through this fight together to find out what works and what doesn't. I also have an aunt and an uncle on my dad's side who has psoriasis but I don't interact with them very much. 

I have had inverse psoriasis most of my life. I live in Texas and the heat (sweating) makes it worse. Sweating, in general, makes it worse. It makes me miserable, unhappy, and in a lot of pain. So I tend to avoid exercise because sweat = pain. When I say I have had a flare up I'm referring to plaque and guttate psoriasis. The inverse is ever-present in my life and quickly rears it's head if I sweat too much. 

With this new and most recent flare-up, I was finally able to get a real dermatology referral. Past dermatology experiences have had me doing creams only. A few times, I had done light therapy. With my current schedule of kids, being a full-time student, and a full-time job, light therapy isn't an option. So, I am now on methotrexate as the "first step" towards biologics. I feel like I am struggling with this medication and so here I am hoping to find support.

This study suggest that patients over 90 kg could benefit from moving to a two week between shots regime with Cosentyx (secukinumab).

Quote:

---

Background:
Secukinumab is a fully human monoclonal antibody that selectively binds to and neutralises interleukin‐17A.

Objective:
To assess the efficacy and safety of different maintenance‐dosing regimens of secukinumab 300 mg based on PASI response at Week 24 in patients with moderate to severe plaque psoriasis.

Methods:
OPTIMISE was a randomised, open‐label, rater‐blinded Phase 3b study. Subjects (n=1,647) received secukinumab 300 mg at baseline, Weeks 1, 2, 3, and 4, and every 4 weeks (q4w) to Week 24. At Week 24, PASI 90 responders (n=1306) were randomised to secukinumab 300 mg q4w (n=644) or every 6 weeks (q6w, n=662) regimen to Week 52; PASI ≥75 to <90 responders (n= 206) were randomised to secukinumab 300 mg q4w (n=114) or every 2 weeks (q2w, n=92) regimen to Week 52.

Results:
PASI 90 response was maintained at Week 52 by 85.7% subjects with q4w dosing vs 74.9% with q6w dosing; odds ratio 1.91 (95% confidence interval 1.44, 2.55). The primary endpoint, non‐inferiority of q6w vs q4w dosing, was not met. In PASI ≥75 to <90 responders, the proportion of subjects with PASI 90 response at Week 52 was numerically higher in q2w vs. q4w group (56.5% vs. 46.5%, respectively; P=0.1013). Heavier subjects (≥90 kg) demonstrated numerically higher PASI 90 response with q2w (57.1%) vs q4w regimen (39.6%, P=0.1053).

Conclusion:
Standard q4w dosing of secukinumab 300 mg is the optimal dosing regimen to achieve and maintain clear or almost clear skin. Subjects with body weight ≥90 kg not achieving PASI 90 at Week 24 may benefit from the q2w dosing regimen.

Hi All,

I just had my first real experience with arthritis this morning (aside from the ache in my hips). I awoke with my knuckle swollen, hand disfigured and experiencing dull pain. Any remedy aside from the Cosentyx that I am currently taking?

Thanks!
Kevin

I was just reading Kat's post RE: Cosentyx - Kat's journey and it got me thinking.

Are there any of our members using Cosentyx that got completely clear and staying that way ?

For me it started off well, but now I find I still get the occasional flare up and have to resort to using some Diprosone with it. This usually happens if I get wound up about something, but I have also noticed it happens around week three.

What about you, anyone staying clear with just Cosentyx ?

Hi All:

I've been on Cosentyx for about three months now and it is not getting any better. Lesions are all over and more are appearing in inconspicuous locations. Curious if there are best practices concerning administering the shot (i.e. time of day, location, etc.)?

Any help would be appreciated.

Thanks.

Kevin

Hey all, it may be obvious by now that as a new member I am posting my biggest questions here and there.

For this thread my question is if anyone has tips about the best way to dry long (no idea if length is relevant) hair after a shower with scalp psoriasis. I typically let my hair air dry or towel dry but sometimes I blow dry for expediency. I was wondering if anyone knew if there was a "best" way to keep my scalp healthier. Is the heat from a blowdryer bad? is a cool setting better? is towel drying best? what are your thoughts?

and one more question: I love hot showers! They are the most relaxing thing to me, especially after a long day, is that bad for my scalp psoriasis? I don't think I can give up hot showers even if it is, but I think I should know for reference.

Hello, new member here who was just put on otezla by my dermatologist.

The doctor put me on a tapered dose to start and I just started taking twice a day pills at 10mg each yesterday, I will slowly be working up to the twice a day 30mg pills (6omg total).

I have been concerned about the side affects specifically nausea and migraines hurting my ability to study and carry on with life stuff so I wanted to ask peeps here how they have done/are doing on otezla? And specifically, when did you experience side affects? Immediately, or did it take longer (and/or until you were up to the full 60mg)? and how long did the side affects last for you?

I know everyone is different and my experience may not be the same, but I am just looking for some kind of reference of what I might be able to expect.

Hi, I have just recently in the past week, been diagnosed with psoriasis and found this group while searching for a community that I could feel safe discussing this condition with. I am 30, female.

I mainly have scalp psoriasis but also have it on other parts of my body. Before my dermatologist's appointment I had no idea what this was and thought it was just a rash or fungal infection! I was so embarrassed because my scalp started shedding and I am a student and an intern studying to be a teacher and it just has been hammered into me that I need to professional all the time in everything! I am a bit relieved to know the cause because I was trying to treat it on my own and nothing was working!! But I am still a little concerned about scalp shedding in my chosen profession. I am worried my supervisor or a principal or mentor will think it is unprofessional and I have been contemplating telling my professors about my condition before someone says something, but it is a bit private and I'm not sure I should say anything. I have mostly been hiding it now by always braiding my hair.

Anyway, I finally went to a dermatologist and was given a month's supply of otezla (which I am not sure I will qualify for the free service in the future, but my doctor wants me to try). As well as some prescription topicals. She also suggested I use tgel shampoo.

I am now on a tapered dose of otezla and started with one ten mg dose in the morning and moving up to 20 taken in two 10mg pills twice a day today, and slowly building to the 30mg twice a day. I haven't noticed any side affects so far, but maybe it takes until you are on a higher dose?

I don't know much about psoriasis treatment, medications or anything, so any tips for a beginner would be nice.

The Food and Drug Administration (FDA) has approved Skyrizi (risankizumab-rzaa), an interleukin-23 (IL-23) inhibitor, for the treatment of moderate to severe plaque psoriasis in adults.

Quote:

---

AbbVie today announced that the U.S. Food and Drug Administration (FDA) approved SKYRIZI™ (risankizumab-rzaa), an interleukin-23 (IL-23) inhibitor, for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.3 In clinical trials, SKYRIZI produced high rates of durable skin clearance – most people (82 and 81 percent) treated with SKYRIZI achieved 90 percent skin clearance (PASI 90) at one year, with the majority (56 and 60 percent) achieving complete skin clearance (PASI 100).

"The complex nature of psoriasis and the variability or loss of treatment response over time can prevent some patients from achieving their treatment goals," said Kenneth B. Gordon, M.D., a principal investigator for the ultIMMa-1 pivotal trial and professor and chair of dermatology at the Medical College of Wisconsin. "In clinical trials, risankizumab demonstrated high levels of skin clearance that persisted through one year. I'm pleased the dermatology community now has a new option that can help patients achieve and maintain a high level of treatment response."

The recommended dose for SKYRIZI is 150mg – administered by two subcutaneous injections every 12 weeks following two initiation doses at week 0 and 4. SKYRIZI can be administered in-office or by self-injection after training.

"The approval of SKYRIZI is an important advance in the treatment of adults with plaque psoriasis who are seeking high levels of durable skin clearance that can be maintained over time," said Michael Severino, M.D., vice chairman and president, AbbVie. "SKYRIZI builds on AbbVie's legacy in immunology, expanding our portfolio to help meet the evolving needs in psoriatic disease and reinforcing our continued pursuit of innovations that improve care for people living with immune-mediated conditions."

Affecting 7.5 million Americans, psoriasis is the most prevalent autoimmune disease in the U.S.4 It is characterized by over activation of the immune system and widespread inflammation that causes painful, itchy plaques anywhere on the skin.5 People with psoriasis also experience a significant emotional, psychological and social burden that can negatively impact their quality of life.

"People living with plaque psoriasis can be profoundly impacted by their disease both physically and emotionally," said Stacie Bell, Ph.D., vice president of research and medical affairs, National Psoriasis Foundation. "The approval of a new therapy represents an important step forward in the treatment of psoriasis, offering dermatologists another option to help patients achieve their treatment goals."

The approval of SKYRIZI is supported by results from AbbVie's global Phase 3 psoriasis program, which assessed the safety and efficacy of SKYRIZI in adults with moderate to severe plaque psoriasis across four randomized, placebo and/or active-controlled pivotal studies: ultIMMa-1, ultIMMa-2, IMMhance and IMMvent. The co-primary endpoints of these studies were Psoriasis Area and Severity Index (PASI 90) and static Physician Global Assessment [sPGA] score of clear or almost clear [sPGA 0/1] at 16 weeks versus placebo.

This study suggests immunogenicity incidence over 5 years of treatment was consistently below 1% in psoriasis patients treated with Cosentyx (secukinumab)

Quote:

---

Background:
Secukinumab is a fully human monoclonal antibody that selectively neutralizes IL‐17A, a key cytokine involved in psoriasis (PsO) and psoriatic arthritis (PsA) development, and has shown rapid and long lasting efficacy and safety in the complete spectrum of psoriasis manifestations. Monoclonal antibody therapies may be associated with the production of treatment‐emergent anti‐drug antibodies (TE‐ADA) that can affect drug pharmacokinetics, diminish clinical responses via inhibition of target binding, or cause hypersensitivity reactions. Secukinumab exhibited minimal immunogenicity up to 52 weeks in patients with moderate‐to‐severe plaque psoriasis, as evidenced by TE‐ADA in <1% patients.

Objective:
To investigate the immunogenicity of secukinumab treatment up to 5 years in two phase 3 extension studies (NCT01640951 and NCT01365455) in patients with moderate‐to‐severe plaque psoriasis.

Methods:
Immunogenicity was evaluated up to Week 268 (5 years). TE‐ADA were defined as positive anti‐drug antibody (ADA) signals detected in post‐treatment samples from patients with negative baseline signals. Confirmed positive samples were further analysed for their neutralizing potential.

Results:
In total, 1821 patients entered the extension studies. Among patients receiving secukinumab and evaluated for ADAs (n = 1636), 32 developed TE‐ADA, which resulted in an incidence of new TE‐ADA cases below 1% per year. Neutralizing antibodies were detected in 9/32 (28%) patients with TE‐ADA. Half of ADA‐positive cases were transient. Among pharmacokinetic samples measured at the times of immunogenicity determination (n = 9992), 544 (5.4%) had secukinumab concentrations higher than the drug tolerance level of 53.8 μg/mL. There was no effect of TE‐ADA, including neutralizing antibodies, on efficacy, safety, or pharmacokinetics of secukinumab.

Conclusion:
The yearly secukinumab immunogenicity incidence over 5 years of treatment was consistently below 1% in patients with moderate‐to‐severe plaque psoriasis. Any TE‐ADA, including neutralizing antibodies, were not associated with loss of secukinumab efficacy or with clinical concerns.

This study suggests that Mental Health Inventory (MHI‐5) is a reliable and valid instrument that can be used to effectively capture psychological distress in psoriasis patients.

Quote:

---

Background:
Patients with psoriasis are at risk of a comorbid diagnosis of depression and/or anxiety. It is therefore essential for dermatologists to have valid and effective instruments that can screen and monitor depression and anxiety symptoms in psoriasis patients.

Objective:
The aim of this study was to validate the Mental Health Inventory (MHI‐5) as a brief measure that can be used to evaluate psychological distress related to anxiety and depression in psoriasis patients.

Methods:
The sample included 76 adult dermatological outpatients diagnosed with psoriasis. Participants completed the MHI‐5, the Hospital Anxiety and Depression Scale (HADS), and six subscales of the Self Compassion Scale (SCS). Confirmatory Factor Analysis (CFA) was applied to examine the factor structure of MHI‐5. Convergent validity was examined by applying correlations among all measures. Discriminant validity was examined by applying hierarchical regression models. Reliability was examined by calculating the Cronbach's alpha coefficient.

Results:
CFA showed that the proposed one‐factor model has a good fit to the data. The MHI‐5 demonstrated satisfactory convergent validity by yielding significant moderate to strong correlations with the HADS and with the positive and negative subscales of the SCS. Discriminant validity was also evident with being at risk for anxiety predicting MHI‐5 scores above and beyond the effect of gender and age. Hierarchical regressions were not performed because a very small number of participants (n = 3) were classified at risk for depression. The MHI‐5 showed high internal consistency (α = 0.84)

Conclusion:
This investigation provided evidence that MHI‐5 is a reliable and valid instrument that can be used to effectively capture psychological distress in psoriasis patients.

This study suggests there is an increased vascular risk in psoriasis patients with depression.

Quote:

---

Background:
Psoriasis is known to confer a higher risk of cardiovascular and cerebrovascular diseases. However, very few studies have investigated whether the development of depression in psoriasis patients may further increase this vascular risk.

Objective:
We investigated the risk of ischaemic heart disease and cerebrovascular disease in Taiwanese psoriasis patients with and without depression.

Methods:
A nationwide population‐based retrospective cohort study was performed using the National Health Insurance Research Database. We included 604 psoriasis patients with depression, who were matched to 2,416 psoriasis patients without depression (1:4 ratio). Relative risks (RR) with 95% confidence intervals (CI) were determined using the Cox proportional hazards regression model, with adjustment for demographic characteristics and comorbidities.

Results:
Compared with psoriasis patients without depression, psoriasis patients with depression had greater risk of developing incident ischaemic heart disease (19.5% versus 8.3%, adjusted RR 1.98, 95% CI 1.57‐2.49), cerebrovascular disease (15.6% versus 5.9%, adjusted RR 2.29, 95% CI 1.76‐2.98), and either ischaemic heart disease or cerebrovascular disease (28.3% versus 12.5%, adjusted RR 1.94, 95% CI 1.60‐2.35). Subgroup analysis showed that in psoriasis patients with depression, a higher risk of incident ischaemic heart disease or cerebrovascular disease was present in age groups 30‐100 years, in both males and females, and in both lower and higher income categories.

Conclusion:
Depression is an independent risk factor for incident ischaemic heart disease and cerebrovascular disease in patients with psoriasis. Therefore, clinicians need to be vigilant for the increased vascular risk in psoriasis patients with depression.

Right, so as i posted in my main thread, i was sick last week and ended up on Antibiotics, so couldn't take my dose of Stelara last thursday like I was supposed to.

Now, i'm going to take it this Thursday, but what i want to know is, should i take my next dose, in 12 weeks, or 11? should i stay on the same schedule, but just take last weeks dose a week late, or should i start a whole new 12 week cycle from this Thursday?

Used Otezla for 5 weeks now. No bad side effects. Had them all very mild and all cleared.
I now have started with a bad rash. Mainly at the top of my legs. I also have it behind my knees, behind my elbows, under arms. Every where my skin folds ( other than top of legs). Didnt bother me at first. Slight itch. Its now a tad irritating, at times. Sometimes its like when you get burnt in the sun. Other times I forget I have it. Had it for about 2 weeks now. Telephoned Hospital and she said to continue if I can. It was the nurse I spoke to.
Today I feel a bit bad. Like mild sun stroke. Then it clears. I can cope with it if I know it will clear. Its listed as a side effect but what I want to know is, Has anyone here had a rash that has cleared?
If my body gets used to it and clears, that's fine. If its a allergic reaction, then not

Another new treatment for psoriasis is in the pipeline.

Quote:

---

DURECT Corporation today announced it has commenced patient dosing in a Phase 2a proof-of-concept trial with topical DUR-928 in patients with mild to moderate plaque psoriasis.  DUR-928, the lead investigational product in the Company's Epigenetic Regulator Program, is an endogenous, first-in-class small molecule, which may have broad applicability in chronic hepatic diseases such as nonalcoholic steatohepatitis (NASH), acute organ injuries such as alcoholic hepatitis (AH) and acute kidney injury (AKI), and in inflammatory skin disorders such as psoriasis and atopic dermatitis.

"As topical agents continue to be the mainstay of treatment for patients suffering from mild to moderate plaque psoriasis, especially localized plaque psoriasis, it is important to investigate a topical agent with a novel mechanism of action," stated Dr. Howard Maibach, Professor of Dermatology at the University of California San Francisco.  "Should the results be positive, DUR-928 should be studied in additional inflammatory skin diseases."

"Commencing patient dosing in this proof-of-concept psoriasis trial is an important milestone in line with our focus for DUR-928 in 2019, which is to produce data with the potential to create significant commercial and partnering value," said James E. Brown, President and CEO of DURECT.

In this Phase 2a, randomized, double-blind, vehicle-controlled proof-of-concept clinical trial, DUR-928 will be applied topically once-daily for four weeks in patients with mild to moderate plaque psoriasis. The trial is being conducted at multiple clinical sites in the U.S.  Twenty patients are planned to be enrolled to obtain approximately 15 evaluable patients. Patients will serve as their own controls, applying DUR-928 to the plaque on one arm and the vehicle to a similar plaque on the other arm. After the treatment period, patients will be followed for an additional four weeks. The primary efficacy endpoint will be change in local psoriasis scores from baseline in the DUR-928-treated plaques compared to that in the vehicle-treated plaques. We expect to announce top line data from this study in the second half of 2019.

DURECT previously conducted an exploratory Phase 1b trial in psoriasis patients (9 evaluable patients) in Australia.  The trial was randomized, double-blinded, placebo and self-controlled, using a micro-plaque assay with intralesional injections of DUR-928.  The results were encouraging and warranted advancing into the current proof-of-concept trial with topically applied DUR-928.

Hi everyone,

Thank you so much for the warm welcome, it is great to finally find somewhere I can discuss Psoriasis with people that understand and have been through the same trials and tribulations.

The great news for me is that I have now completed week 5 of my Cosentyx and the result is amazing. I would say I am now almost 85-90% clear and feel so much better for it.

The injection pens are pretty much painless and  after the second go you get completely used to whole process (which takes seconds) and minor pinch/scratching feeling when administering.

I am due to have my first bloods (which are a little late) to ascertain there is nothing of concern internally. I did feel like I had a little chesty cough but that to me is a minor issue which has pretty much gone. I do plan on relaying any side effects to my consultant when I have the check-ups. I think I have some anxiety around having bloods in case my body isn't tolerating the medication but I recognise this is natural (working in mental health is beneficial) so I don't catastrophise about this.

Sorry to blabber, I will up date again in around a month,

Cheers

Leo Pharma announced they will start a clinical trial of microarray patches for the local intradermal treatment of psoriasis.

Quote:

---

Lohmann Therapie-Systeme AG (LTS), a market leader in transdermal therapeutic systems, and LEO Pharma A/S, a global leader in dermatology, today announced that the companies will start the clinical trial of microarray patches for the local intradermal treatment of psoriasis. The study will start in April 2019 with expected completion later this year and the aim of the study is to document safety and efficacy in patients.

A microarray patch (also known as a microneedle patch) is a polymeric, microscopic array which delivers encapsulated drugs by perforating the outer stratum corneum with numerous microneedles. The needles are biodegradable and will dissolve as they release the drug in the skin.

This is the first time that microarray patch technology is applied to psoriasis treatment, representing a novel dosage form with several potential benefits for patients: The microarray patch enables slow release of the drug (betamethasone and calcipotriol), which means that treatment frequency can potentially be reduced from one or more times daily to once weekly. Furthermore the patch may reduce or potentially eliminate the need for application of topicals such as ointments. Application of the patch is precise due to the small size of the micro needles ensuring that only affected skin is treated.

The micro array patch for psoriasis treatment has been developed jointly between LEO Pharma and LTS’ laboratories and has Good Manufacturing Practice (GMP) status. The project is the first result of a partnership agreement which the two companies entered in 2016.

"After a successful preclinical development in the last two years, initiating a human study in corporation with LEO Pharma is the next major milestone. Our Micro Array Patch (MAP) platform allows the active ingredient to be released directly into the skin MAP innovation is driven by a productive and constructive cooperation using core competences of LEO Pharma and LTS," said Stefan Henke, Head of LTS‘s Innovative Injection Systems Unit.

"Our alliance with LTS is a great example of LEO Pharma’s innovative approach to psoriasis treatment and how we collaborate to improve and extend what’s possible for the benefit of patients. The microarray patch represents a new treatment method, which we believe has the potential to improve both treatment compliance and convenience – thus helping even more patients achieve healthy skin," said Kim Kjøller, Executive Vice President, LEO Pharma Research & Development.

This study looked at the three biological treatments available for children with psoriasis.

Quote:

---

Background:
Three biotherapies – etanercept, adalimumab, and ustekinumab – are licensed in childhood psoriasis. The few data available on their efficacy and tolerance are mainly derived from industry trials. However, biological drug survival impacts long‐term performance in real‐life settings.

Objective:
The objective of this study was to evaluate the survival rates of biological therapies in children with psoriasis in real‐life conditions. Secondary objectives were to evaluate the factors associated with the choice of the biological therapy and to report severe adverse events.

Materials and methods:
This study was an observational retrospective study. Data were extracted from the clinical records of 134 children. Kaplan–Meier estimates were used to analyse drug survival overall and in subgroups of plaque psoriasis, bio‐naïve, and non‐naïve patients.

Results:
We analysed 184 treatment courses: 70 with etanercept, 68 with adalimumab, and 46 with ustekinumab. Factors associated with the choice of first‐line biological agent were age at initiation (younger for adalimumab, p<0.0001), age at onset of psoriasis (younger for adalimumab and etanercept, p=0.03), and baseline PASI and PGA (both higher for adalimumab, p<0.001). Drug survival rates were higher for ustekinumab than for adalimumab and etanercept (p<0.0001) for all treatment and all psoriasis types, plaque‐type psoriasis (p=0.0003), patients naïve for biological agents (p=0.0007), and non‐naïve patients (p=0.007). We reported eight SAEs: severe infections (n=3), significant weight gain (n=2), psoriasis flare (n=1), and malaise (n=1). Biological therapy was discontinued in three children (one with psoriasis flare and two with weight gain). Only the two cases of weight gain resulted in an unfavourable outcome.

Conclusions:
Our real‐life comparative study found that UST had the best drug survival outcome. The profile of SAEs in children was comparable to that in adults. These results will assist dermatologists in the decision‐making process when choosing treatment options for children with psoriasis in daily practice.

I'm still waiting for everything to go through but thought I would share my process here in case someone finds it helpful.

So, right after the doctor prescribed Cosentyx, the first step was blood work. Since I had my yearly check up they were able to get most of what they needed from my primary doctor, however they still needed a couple of more tests. So got that done and the doctor prescribed Costenyx.

I am in the United States, and have commercial primary insurance (through my husband's work) which is also where our prescription insurance comes from.

I received a call at the end of last week from a specialty pharmacy (we'll just call them Pharmacy A) letting me know they were handling the prescription. Today they called to tell me that I needed to call Cosentyx and join their co-pay program. I thought uh oh we most likely will not qualify but I called them and they really didn't ask me too many questions, NOTHING about income. So they signed me up and also on a secondary credit type (no, not the kind you have to pay back but the kind that if my insurance plus the co pay doesn't pay it all then the credit one will pay the balance) So, I call back Pharmacy A to give them the information. A very short time later, our prescription insurance company called (we'll just call them PIC for short) and informs me that pharmacy A is not in their network so I have to use specialty pharmacy B. Also, PIC informs me I need to call "save on" and get an exemption. Say what? So I call pharmacy A to make sure they know and yes, they already knew and was preparing to send my information to pharmacy B. So I call Save on and tell them I was told to call and why. They explain that it is part of my insurance perk, basically my co pay is a bit over $1300 per 300 mg and that the Cosentyx co pay program will pay half and that the credit program pays the other half but that the save on ensures that if for some reason there is a problem then Save On will pay meaning my cost will never be over $0.00. I guess it's insurance for my insurance But no matter, as long as they don't expect me to pay out that much!

So for all those thinking (like myself) that they would not be able to get assistance, always check to make sure because it seems you just never know!


I used some Taclonex over the weekend as my scalp was just bothering me too much. One application and a definite improvement, too bad it's a steroid ointment. I REALLY didn't want to use it as I used it prior to Stelara and cleared quite a bit which made it difficult to tell how much Stelara was helping right off. I also didn't want things to get worse but I'm hoping I don't have to continue with the Taclonex while waiting for Cosentyx (which should be soon now)

So things are on track it seems. I'll update when I get the call to set up my first round along with a picture for reference.