I'm about to start my first biologic for treatment of my very severe guttate psoriasis.  My insurance company denied coverage for Stelera, so I'm trying Cosantyx.  Anyone using Cosantyx specifically to treat guttate psoriasis?

As you may have seen in my past post Im having a lot of issues from side effects from the meds. The current situation that Im in has now happened almost exactly 1 year apart.

Basically 12 months ago my L elbow swelled out of nowhere. Was hot, reddish...Everything pointed to infection and we suspected cellulitis but the labs and fluid from my elbow were clean. Also there were no crystals or whatever so it wasn't gout. The fluid was not in the joint,so it can't really be drained. its just in all the tissue around my elbow. Its like a softbaball in my arm and has clear pitting edema. Took about 3 weeks to fully subside. Long story short a week ago, my R elbow swells up out of nowhere.....exactly the same as the last one, hot reddish, pitting edema etc. So at this point Im wondering if its Med related not environmental or infection. Since its unlikely gout or cellulitis. What do you guys think it can be? I appreciate any input or even guesses.

Last time it happened was on humira, this time is on simponi

Hi all, recently started Tremfya. Started my loading dose (Week 0 and week 4). It is currently week 8, my next/third shot would be week 12. Start week 7 until today, I have been having unusual headaches 24/7 with a sense of dizziness also. I am also more sleepy than usual. I was seen by a doctor after a week of symptoms, all my blood work came back normal and I had a CT scan of my head that was also normal. I see a neurologist in two days. I was just posting to see if anyone else had similar symptoms with Tremfya or other biologics? This medication cleard everything up. What Embrel and humira couldn't, Tremfaya did. However at a cost. These headache/dizziness are unbearable to be honest. Anyway, needless to say I will be quitting this med :(.

Hi folks, I was wondering if anyone has any tips for foods that might possibly help alleviate the symptoms of PS. I heard that anti-inflammatory foods are best, but various websites I looked at don't seem clear on what to go for and what to avoid, and what they are, precisely. For example, one site said to avoid tomatoes, another that they were good. I read that vitamin D is helpful but a lot of sources seem to be fish based - I'm veggie, so a plant or dairy source would be good. Any tips, please, would be great, thanks.

Hi all, I've been having light treatment for a while now and there has been a real improvement. The referral from my doctor took a while to come through but it was worth it, and a relief after trying a whole bunch of creams and ointments. I'm on Enstilar and Calcipotriol as well. I'm wondering if many others have had light treatment and how long lasting you found the effects to be after treatment ended; I'm wondering what to expect, if it will come back with a vengeance or stay reduced for a while at least. Thanks  

Hello everyone, I am getting my first cosentyx jab tomorrow. Feeling both excited  and slightly apprehensive at the same time. I have been having psoriasis for the last 20 years or so. Been on UVB the last 7 years but lately it's been losing its effectiveness. Am wrroied about the side efffects of cosentyx so any tips or advice would be very much welcomed.

Wish me luck !! Will post updates along the way!

Hello Good evening . I dont know if it is Psoriasis or anykind of skin desease , Its a red rashes and flaky spreading all over my body and my scalp for almost seven months , i dont go in Derma because im afraid , I dont know why . I use many kinds of Cream and ointment like Betnovate , Clobetasol with vaseline original for moisturizing and Aveeni lotion , Salycilic soap and Ketoconazole shampoo for my scalp but still its getting worst. Im so very Stress on how to get rid this   Can you please suggest the what should i use?

Hi everyone,  I've had psoriatic arthritis for about 6 years - arthritis came with a vengeance about 4 years ago. Luckily after a pretty bad year the arthritis calmed down and I have had only light twinges since. Have also bronchiectasis so medication for this and psoriasis is a double whammy on the immune system. Should have started Acitretin in November last year but decided at the last moment not to as I was frightened of the side effects. Symptoms are much worse now and I have tried almost every cream known with no great success. Only thing which gave the most respite was when I was on a course of steroids for my lungs and that cleared it wonderfully. Only thing was that I nearly always had a bad flair up after. I've enjoyed reading through the posts, got some great info on Acitretin.  Second tablet tonight - fingers crossed side effects aren't too bad.

The FDA declined  the approval of Duobrii (halobetasol propionate and tazarotene IDP-118 lotion) for psoriasis.

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Ortho Dermatologics, a division of Valeant Pharmaceuticals International, Inc, today announced that it has received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) regarding the company's New Drug Application (NDA) for DUOBRII (halobetasol propionate and tazarotene) (IDP-118) lotion in the treatment of plaque psoriasis.

"The CRL did not specify any deficiencies related to the clinical efficacy or safety of DUOBRII and no issues with CMC processes. The CRL only noted questions regarding pharmacokinetic data," said Joseph C. Papa, chairman and CEO, Valeant. "We are working to resolve this matter expeditiously and have already requested a meeting with the FDA. We hope to bring forward this important new treatment option for those who suffer from plaque psoriasis as quickly as possible."

This study suggests there is no reason to exclude over 65s from Bio's in the treatment of psoriasis.

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Background:
The number elderly patients with psoriasis is steadily increasing in the Western world, nevertheless they are frequently excluded from biologic clinical trials and described as a high‐risk group for adverse events. Thus, there is lack of information concerning safety and effectiveness of available treatments for psoriasis in the elderly, particularly about new biologic systemic drugs.

Objective:
Our aim is to describe our experience with all biological therapies currently used in the elderly (> 65 years) psoriatic patients.

Methods:
A retrospective multicentric review of clinical records of all psoriatic patient aged 65 years or older actually receiving biological drugs (etanercept, adalimumab, infliximab, golimumab, certolizumab pegol, ustekinumab or secukinumab) was undertaken.

Results:
Our study population included 266 elderly psoriatic patients actually receiving any biological therapy (Adalimumab 31,2%, Ustekinumab 28,9%, Etanercept 20,3%, Secukinumab 15%, Infliximab 3%, Golimumab 1%, Certolizumab pegol 0,6%). The PASI score at the baseline (week 0) ranged from 4–54; mean ±SD, 16,5±7,1, which changed after biologic administration to 3,7±8 at week 16, 1,6±2,1 at week 28 and 1,2±2,1 at week 52. Among 266 elderly psoriatic patients 25 adverse events were reported during the observation period. The most frequent events were infections with 12 (48%) reports, followed by malignancies with 4 (16%) reports.

Conclusions:
To date, our study represents the widest experience on the use of biological drugs in elderly psoriatic patients. We found that all biologics for psoriasis showed a great efficacy also in elderly people and the rate and the type of adverse effects were similar to the younger patients. In conclusion the age alone should not limit our therapeutic options. Further observational study using multiple data sources is needed to evaluate long‐term effectiveness and safety for elderly psoriatic patients.

Hello Everyone . I am currenty suffering Psoriasis for almost 7 months , I had used so many oinment ,Cream Salycic acid , Ketoconazole shampoo for flaky scalp but still keep going worsen . What would i do ? Iost my confident till now .. I am currently seeking job but because of my condition , i dont have any self confident to go my interview because of . Can you pls suggest how can i get rid this ??

Hi,

hello from Berlin, Germany.

I'm Claudia and I have my Psoriasis since I was 3 years old – and this is 46 years ago. Most time my psoriasis was on hands and soles – Psoriasis vulgaris palmoplantaris. 

The most effective way for relief was the Dead Sea – and now it's Cosentyx. I tried almost all medications. If you have german-related questions – feel free to ask (and other questions too) 

So hello to everyone in my boat. We all know the great fun we have with this horrible affliction so I'm here to share my experiences and treatments (and to learn anything new I can along the way)

I have had pretty much all available topical forms of creams and lotions, some success but not really any more than 2/10 - Moved on to light treatment twice, cleared me first time for around four months and second time for around six weeks. 

Acetretin, bloody awful to use for me, cracked lips and the feeling that the top couple of layers of skin was sliding across the others on my hands. 0/10 Hated it and didn't clear anything at all...

Next was Cyclosporin, this was a God send. Full clearance for just over two years when I started getting abnormal bloods (kidney) along with swollen gums, so I was taken off it. 10/10
Huge flare up 

Next on the list was Fumaderm. Had small improvement with this and the most mental hot flushes ever! Ladies, you have my sympathy. 3/10

Next was Methotrexate. Fairly good at keeping things under control but without actually clearing the red patches, and you can't drink!!!. Again, bad bloods (liver) had me off it within 14 months 6/10
Huge mega never been anywhere this bad flare up 

After almost 3 months without any treatment, I have just taken the first two injections on Consentyx last Friday. Fingers crossed this works as I'm running out of options... 

I will keep you up to date on how this goes, hope to see an improvement very soon (still in long sleeves and it's now June) 

This is the result of a phase 2 study on Tremfya (guselkumab) for use with psoriatic arthritis.

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Background:
Guselkumab, a human monoclonal antibody that binds to the p19 subunit of interleukin 23, has been approved for the treatment of moderate-to-severe psoriasis. Psoriatic arthritis is a common comorbidity of psoriasis with an umet need for novel treatments. We assessed the efficacy and safety of guselkumab in patients with active psoriatic arthritis.

Methods:
We did a randomised, double-blind, placebo-controlled, phase 2a trial at 34 rheumatology and dermatology practices in Canada, Germany, Poland, Romania, Russia, Spain, and the USA. Eligible participants were aged 18 years or older with active psoriatic arthritis and plaque psoriasis affecting at least 3% of their body surface area, with three or more of 66 tender joints and three or more of 68 swollen joints, who had an inadequate response or intolerance to standard treatments. We randomly assigned patients (2:1) via a central interactive web-response system using computer-generated permuted blocks with a block size of six, stratified by previous anti-tumour necrosis factor-α use, to receive subcutaneous guselkumab 100 mg or placebo at week 0, week 4, and every 8 weeks thereafter for 24 weeks. Patients, investigators, and site staff were masked to treatment assignment until final database lock at week 56. At week 16, patients with less than 5% improvement in swollen and tender joint counts were eligible for early escape to ustekinumab. At week 24, the remaining placebo-treated patients crossed over to receive guselkumab 100 mg at weeks 24, 28, 36, and 44 and guselkumab-treated patients received a placebo injection at week 24, followed by guselkumab injections at weeks 28, 36, and 44. The primary endpoint was the proportion of patients with at least 20% improvement at week 24 in signs and symptoms of psoriatic arthritis according to American College of Rheumatology criteria (ACR20) in the modified intention-to-treat population (ie, all randomly assigned patients who received at least one dose of study treatment). Safety analyses included patients according to the study drug received. This study is registered with ClinicalTrials.gov, number NCT02319759.

Findings:
Between March 27, 2015, and Jan 17, 2017, we randomly assigned 149 patients to treatment: 100 to guselkumab and 49 to placebo. 17 (35%) of 49 patients in the placebo group and ten (10%) of 100 patients in the guselkumab group were eligible for early escape to ustekinumab at week 16. 29 (59%) of 49 patients in the placebo group crossed over and received guselkumab at week 24. Three (6%) of 49 patients in the placebo group, one (3%) of 29 patients who crossed over from placebo to guselkumab, and six (6%) of 100 patients in the guselkumab group discontinued study treatment before week 44. 58 (58%) of 100 patients in the guselkumab group and nine (18%) of 49 patients in the placebo group achieved an ACR20 response at week 24 (percentage difference 39·7% [95% CI 25·3–54·1]; p<0·0001). Between week 0 and week 24, 36 (36%) of 100 guselkumab-treated patients and 16 (33%) of 49 placebo-treated patients had at least one adverse event. The most frequent adverse event was infection in both groups (16 [16%] of 100 patients in the guselkumab group vs ten [20%] of 49 patients in the placebo group). The prevalence of adverse events between week 0 and week 56 in guselkumab-treated patients (51 [40%] of 129) indicated no disproportional increase with longer guselkumab exposure. No deaths occurred.

Interpretation:
Guselkumab, a novel anti-interleukin 23p19 antibody, significantly improved signs and symptoms of active psoriatic arthritis and was well tolerated during 44 weeks of treatment. The results of this study support further development of guselkumab as a novel and comprehensive treatment in psoriatic arthritis.

Results from a phase 2 are in for Filgotinib JAK1 inhibitor for psoriatic arthritis.

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Gilead Sciences and Galapagos NV announced that the randomized, placebo-controlled Phase 2 EQUATOR study of filgotinib, an investigational, selective JAK1 inhibitor, in 131 adults with moderate to severe psoriatic arthritis, achieved its primary endpoint of improvement in the signs and symptoms of psoriatic arthritis at Week 16, as assessed by the American College of Rheumatology 20 percent improvement score (ACR20). There was an ACR20 response of 80 percent for filgotinib versus 33 percent for placebo (p<0.001). The ACR50 and ACR70 responses at Week 16 were also significantly higher for filgotinib versus placebo (ACR50: 48 percent for filgotinib versus 15 percent, p<0.001; ACR70: 23 percent versus 6 percent, p<0.01).

Filgotinib was generally well-tolerated in the EQUATOR trial, with no new safety signals observed and similar laboratory changes compared to those reported in previous trials with filgotinib in rheumatoid arthritis patients. The adverse event rate was similar in both groups with mostly mild or moderate events reported. There was one serious infection in the filgotinib group, a patient who experienced pneumonia with a fatal outcome. One other patient receiving filgotinib developed herpes zoster. There were no cases of opportunistic infection, tuberculosis, thromboembolism, or malignancy.

“The data from the EQUATOR study are very impressive and indicate that filgotinib has the potential to have a significant effect on signs and symptoms of psoriatic arthritis, a condition where there is still a high unmet medical need,” said Dr. Philip Mease, Director of Rheumatology Research, Swedish-Providence-St. Joseph Health Systems and Clinical Professor, University of Washington, Seattle, WA.

“We are pleased to report that filgotinib remains consistent in terms of activity and tolerability, now also in psoriatic arthritis,” said Dr. Walid Abi-Saab, Chief Medical Officer at Galapagos.

Detailed results from the EQUATOR trial will be submitted for presentation at a future scientific conference.

Hi all, not been here for a while so thought I would give you an update. 
GP gave me Betnovate cream to try and referred me to skin specialist, only had to wait 4 weeks, that's the good bit.
Was offered another cream or light therapy which I refused as all creams/ lotions have made me so sore,told her I do not want to try any more.
She said I couldn't have tablets or injections as not bad enough, even though been off work 2 weeks as feet and heels so sore cracking and bleeding, cannot wear shoes, and hands so sore, calves sore.
My psoriasis score is only 6 ish, although specialist didn't look everywhere, did quality of life questionnaire scored 30.
I was not happy, think specialist could see I was about to burst into tears so left room , came back and said I could do tests to see if I could have Methotrexate or Acitretin, meanwhile would you like to try Enstilar.
So had all blood tests done and chest X-ray same day, thinking when results are in I will get an appointment, 2/4 weeks. NO, 12 weeks next app.
On the up side 10 days using Enstilar I have no flaking and soreness gone on calves, knees and elbows.
Heels are still tender and cracked and psoriasis appearing on soles so still off work as cannot wear shoes.
Hands are still red and sore, it seems to be on every joint on my fingers, knuckles etc and palms now, which I never had 30 years ago.
According to leaflet I can only use for 4 weeks so I don't know what to do after that, think I will ring specialist.

I'm on year 14 of my 'journey' with psoriasis. It began on my scalp when I was 19 and has fairly randomly waxed and waned since then. I've had upwards of 60% body coverage at times but it typically hovers between 20-40%. Alcohol, stress, and the cold weather all exacerbate my condition. That being said I quit drinking, try to keep my stress levels low, and have managed to find a contractor to work for in the Florida Keys during the frigid Upstate NY winters.

I have tried a variety of topical ointments, but they did very little to help. After years of negative experiences with numerous dermatologists I decided to just live naturally and do the best I can. So I exercise and eat well and just do the best I can.

Any other questions feel free to ask.

About to start using Taltz.(which is waiting in the fridge and I get rid of this chest infection)
Is anyone else on this Biological Drug? If so, how are you doing? Thanks. 

In 2006 I had Sarcoidosis and Erythema nodosum and but 2010 was 94% recovered, but 5 months ago i walked into a shopping trolley and got a bruise on my leg and it never really recovered, the bruise went but the small cut soon expended into 50p shape itchy skin that never really healed, i just thought not much of it as it was just itch skin that looked like it was peeling but it never did.
Anyway, went to GP yesterday and he said it was Psotiasis

After doing google research i can see Sarcoid, Erythema nodosum, and Psotiais is all an autoimmune condition so my question is if I have had those threee things what could I potentially get next? has anyone had all 3 of these and what else have you got? so at least prepapred and also could insisit GP test or look into

Hello everyone !

I am new to this site and i want to say hello to you all!


I have psoriasis for 8 years and for the last year i was on cosentyx and i was clear 100%. 

Two months ago i found out that i had crohn desease and my dermatologist stopped the cosentyx because of that and now the psoriasis is back .She said i shoud get on 
otezla but i am afraid for the side effects .I dont know what to do...