This study suggests there is an association between psoriasis and migraine.

Quote:

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Background:
Psoriasis and migraine share several pathogenetic mechanisms due to systemic inflammation, which increase the risk of developing cardiovascular disease.

Objective:
Our aim is to investigate the prevalence of migraine with (MA) and without aura (MO) in the psoriatic population, investigating a possible new comorbidity of the psoriatic disease.

Methods:
We referred 68 psoriatic patients to a 9 questions survey formulated on the basis of the International Headache Society (IHS) diagnostic criteria for migraine. Than, in the case of MA, the mean monthly number of migraine crises was assessed. Data of psoriatic patients were than compared with those of a psoriasis free control group composed of 235 migraine patients (with and without aura).

Results:
A clinical diagnosis of migraine was performed in 32 psoriasis patients with a great prevalence in women (F: 87.50% - M: 12.5%). Moreover we found a much higher prevalence (62.5%) of MA, with the remaining 37.5% diagnosed with MO. Comparing the prevalence of MA between psoriasis + migraine patients and the control group we observed a statistical significative difference (p<0.0001); furthermore the number of MA crises was significantly higher (p<0.0001) in patients with psoriasis with respect to the MA control group.

Conclusions:
We showed a significant association between psoriasis and migraine, especially MA, probably due to common pathogenetic mechanisms, but further studies are needed to assess their interplay in developing cardiovascular diseases.

Following on from this thread Janssen seeks approval of Guselkumab for the treatment of psoriasis the FDA have approved Tremfya (Guselkumab)

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Janssen Biotech, Inc. (Janssen) announced today that the U.S. Food and Drug Administration (FDA) has approved TREMFYA™ (guselkumab) for the treatment of adults living with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy. TREMFYA™ is the first and only approved biologic therapy that selectively blocks only IL-23, a cytokine that plays a key role in plaque psoriasis. Approval comes after an expedited regulatory review following application of an FDA Priority Review Voucher. TREMFYA™ is administered as a 100 mg subcutaneous injection every eight weeks, following two starter doses at weeks 0 and 4. In clinical studies, patients receiving TREMFYA™ experienced significant improvement in skin clearance and greater improvement in symptoms of plaque psoriasis including itch, pain, stinging, burning and skin tightness when compared with placebo at week 16. Superior results in skin clearance (PASI 90) were demonstrated with TREMFYA™ compared with Humira® (adalimumab) at weeks 16, 24 and 48.

“TREMFYA™ represents a significant milestone in the treatment of moderate to severe plaque psoriasis as evidenced by the proven skin clearance demonstrated in the majority of study patients receiving this IL-23–specific therapy at week 16 and up to week 48,” said Andrew Blauvelt, M.D., M.B.A., President of Oregon Medical Research Center, and study investigator. “We continue to make progress in understanding the science of psoriasis and the important role IL-23 plays in the pathogenesis of this disease, which is another reason why today’s approval of TREMFYA™ is exciting, both as a researcher and a practicing dermatologist.”

I´m sure I´ve read it on here somewhere, but I can´t find it anymore

Which interleukines have a reaction with the DMF?

well started methotrexate today.. fingers crossed, see what happens.

I made the decision to start with Stelara after reading many posts on this forum of others who have gone down this road. My psoriasis is primarily on my lower legs and tops of feet. My first injection was on July 6, 2017. So far the only reaction I've noticed was stinging at the injection site for about 2-3 hours afterwards. Today I feel a little tired but it could be due to having to get up in the middle of the night with our new puppy. My husband wondered if becoming easily irritated was one of the side effects?

Next injection will be in 4 weeks.

My insurance denied the request from my doctor for Stelara treatment and wanted me to use Humira first. Dr. insisted this was the best treatment and Janssen (the manufacturer) approved me for "free" injections through the end of the year...what's the catch? Dr. said many times the manf. will do this, show that this treatment is working and then the insurance provider typically will support the treatment going forward, i.e. not deny a treatment that is working...hopefully!

Hey folks...

After starting Leflunomide 6 weeks or so ago, last monday, i noticed my sense of taste was diminishing.. a few days later, it has all but gone and replaced with a metallic taste. 
after charting my bloods (bi-weekly), my Urea count is up each test and currently at 10 as well as a bit of kidney ache. 

Since last Friday, i have upped my water intake to 4 litres (not easy) to try to help flush my system a bit.

I called my rheumy specialist nurse this morning but she wasn't available, so left a message and am awaiting a call back.

Looks like Leflunomide isn't for me, as was Sulphasalazine... i don't know if they'll swap me to Methotrexate next or maybe try Bioligics ?

the joys of PsA

Orencia previously used to treat rheumatoid arthritis has been given FDA approval to treat psoriatic arthritis.

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Bristol-Myers Squibb Company (NYSE:BMY) announced today the U.S. Food and Drug Administration (FDA) has approved ORENCIA for the treatment of adults with active Psoriatic Arthritis (PsA), a chronic, inflammatory disease that can affect both the skin and musculoskeletal system. ORENCIA is approved and available in both intravenous and subcutaneous (SC) injection formulations. ORENCIA should not be administered concomitantly with TNF antagonists, and is not recommended for use concomitantly with other biologic Rheumatoid Arthritis (RA) therapy, such as anakinra. This approval marks the third autoimmune disease indication for ORENCIA.

“This approval underscores the efficacy of ORENCIA in adult patients with active Psoriatic Arthritis, who have been in need of new treatments,” said Brian J. Gavin, Vice President, ORENCIA Development Lead at Bristol-Myers Squibb. “Helping to advance clinical understanding of autoimmune conditions is a key focus of our immunoscience research, and we’re proud to introduce ORENCIA, a selective T-cell co-stimulation modulator, as an additional treatment option for PsA.”

The co-stimulation blockade of ORENCIA inhibits T-cell activation and the resulting cascade of events that contribute to inflammation. T-cell activation is involved in the pathogenesis of PsA.

Psoriatic Arthritis can cause joint pain, stiffness and reduced range of motion, potentially affecting the ability to do everyday activities, such as getting dressed and tying shoes. In PsA, the immune system attacks healthy joints and skin.

“Psoriatic Arthritis takes a toll on patients and families over time,7” said Randy Beranek, president and CEO, National Psoriasis Foundation. “We welcome the introduction of an additional treatment option for adults with active Psoriatic Arthritis, because we believe advancements, along with further research, education and support services, are critical to helping improve the lives of those impacted.”

The approval was based on results from two randomized, double-blind, placebo-controlled trials in which ORENCIA improved (or reduced) disease activity in both TNF-naive and exposed patients with high disease activity, high tender and swollen joints, and a disease duration of more than seven years.

ORENCIA PsA IV and SC Studies Demonstrated Improved Disease Response

The efficacy of ORENCIA was assessed in two randomized, double-blind, placebo-controlled studies (Studies PsA-I and PsA-II) in 594 adult patients with disease duration more than seven years. Patients had active Psoriatic Arthritis (≥  swollen joints and ≥  tender joints) despite prior treatment with DMARD therapy and had one qualifying psoriatic skin lesion of at least 2 cm in diameter. In PsA-I and PsA-II, 37% and 61% of patients, respectively, were treated with TNF inhibitors (TNFi) previously. The primary endpoint for both PsA-I and PsA-II was the proportion of patients achieving ACR 20 response at Week 24 (Day 169).

In PsA-I, a dose-ranging study, 170 patients received study drug IV at Days 1, 15, 29, and then every 28 days thereafter in a double-blind manner for 24 weeks, followed by open-label ORENCIA every 28 days. Patients were randomized to receive placebo or ORENCIA 3 mg/kg, 10 mg/kg (weight range-based dosing: 500 mg for patients weighing less than 60 kg, 750 mg for patients weighing 60 to 100 kg, and 1000 mg for patients weighing greater than 100 kg), or two doses of 30 mg/kg followed by weight range-based dosing of 10 mg/kg without escape for 24 weeks. Patients were allowed to receive stable doses of concomitant methotrexate, low dose corticosteroids (equivalent to ≤ 10 mg of prednisone) and/or NSAIDs during the trial. At enrollment, approximately 60% of patients were receiving methotrexate.

Cosentyx has received approval from the EU for two label updates including scalp psoriasis.

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Novartis announced today that the Committee for Medicinal Products for Human Use (CHMP) has approved a label update for Cosentyx® (secukinumab), the first interleukin-17A (IL-17A) approved to treat psoriasis. The label update includes 52 week data from the CLEAR study demonstrating the long-term superiority of Cosentyx versus Stelara® * (ustekinumab) in psoriasis]. The updated label also includes use of Cosentyx to treat moderate-to-severe scalp psoriasis - one of the most difficult-to-treat forms of psoriasis, which affects approximately 60 million people worldwide[. The updated label is based on the proven efficacy and consistent safety profile of Cosentyx.

The addition of the CLEAR study data in the European product label reflects the benefit of Cosentyx for people living with this chronic and often distressing condition. The 52 week data show that Cosentyx is superior to Stelara in delivering long-lasting clear or almost clear skin over one year of treatment in adults with moderate-to-severe psoriasis. Cosentyx remained consistently superior to Stelara in achieving and sustaining a PASI 90 response (76% versus 61%) and significantly better in achieving a PASI 100 (clear skin) response (46% versus 36%) at Week 52.

The updated label for Cosentyx on scalp psoriasis, in a difficult-to-treat area of the body, addresses an important unmet need. Many patients with scalp psoriasis do not achieve an adequate response from currently available treatments. Also, scalp psoriasis can be particularly challenging to treat as disease activity is often maintained through hair care, scratching, and shampooing of the scalp, adding to the fact that the application of topical treatments is challenging. Approximately half of all 125 million patients with psoriasis worldwide suffer from scalp psoriasis.

"We are happy to see these two important label updates for our IL-17A-inhibitor, Cosentyx, the first IL-17A inhibitor approved to treat psoriasis. We are continually investigating new areas for Cosentyx to significantly enhance patients' quality of life, such as scalp psoriasis," said Vas Narasimhan, Global Head, Drug Development and Chief Medical Officer, Novartis. "Cosentyx is an innovative, groundbreaking treatment for people living with auto-inflammatory diseases, and we're proud to continuously expand treatment possibilities for an even greater number of patients."

Cosentyx is currently the only fully human IL-17A inhibitor to demonstrate efficacy and safety in a dedicated Phase III study of scalp psoriasis. The CHMP approval is based on results from the 24 week study of moderate-to-severe scalp psoriasis where Cosentyx demonstrated superior efficacy compared to placebo. Psoriasis Scalp Severity Index (PSSI) 90 responses were achieved by a significantly greater percentage of patients receiving Cosentyx 300 mg (53%) than placebo (2%) at Week 12 (P<0.001).

The label update is applicable to all European Union and European Economic Area countries. Cosentyx is approved in more than 75 countries for the treatment of moderate-to-severe plaque psoriasis. Cosentyx is also approved in more than 70 countries for the treatment of active PsA and AS.

This study suggests that targeting IL-23 alone could be a potential treatment for psoriasis.

Quote:

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Background:
The development of monoclonal antibodies targeting IL-12 and IL-23 has enhanced the therapeutic options available for psoriasis patients. Recent research suggests that IL-23 alone plays a role in the pathogenesis of psoriasis.

Objective:
The objective was to review the phase III clinical trial data for the anti-IL-23 agents in order to evaluate the safety and efficacy profile of each agent.

Methods:
We reviewed the results of the phase III clinical trials for the anti-IL-23 agents tildrakizumab and guselkumab. The results of phase III trials on risankizumab have not yet been reported.

Results:
By week 12, the proportion of patients reaching Psoriasis Area and Severity Index (PASI 75) was greater than 60% among the most efficacious dose of each agent. The percentage of patients achieving PASI 90 at week 16 was the primary endpoint for the phase III trials for guselkumab, which was above 70%. The safety profiles of the agents were comparable, with the most commonly reported adverse events of nasopharyngitis and upper respiratory tract infections.

Conclusion:
The anti-IL-23 agents demonstrated a rapid clinical improvement that is similar or superior to the improvement seen with currently marketed IL-17 inhibitors with a favorable short-term safety profile. The results of the phase III trials support the notion that IL-23 is a potential target in psoriasis treatment.

Hi Guys (gals)

So I am disappointed with my journey so far.  I am interested in knowing what others might be doing, in as far as those whom are doing races, whether its a triathlon, or marathon, or swimming, (or sport of yours, that anyone would consider stressful)  Today, I have looked, and found some sites that support psoriasis, and PA, but in my cursory looks, I couldn't tell if the person is being treated, or if they are participating in that activities as not being treated?

My background, I am a couple years away from 50, and I am still serving my countries finest armed services. Such as I need to serve my country, I need to pass my fitness test.  Which is in no way super difficult.  I do have hard time mustering the "guts" or what ever that tells me, I am too exhausted to do anything, and which I tend to find  something else to do.  I would love to do one more marathon, start riding my bicycle around the local trails.

Currently doing 5 pills of methotrexate.  recently dropped from 7.  (I don't remember dosage level) previously I was on acetritan, and that effected my eyes prescription, and various other issues, I don't recall, outside the eye change of prescription 2 times after starting taking the prescription.  Light box, I was in a long time, during summer time, I cannot continue due to being so Scandinavian that my white skin can not tell if I am burnt or not. (Not my call, I would have continued)  I felt that the light did minimize the spots.  it just took a while.  

as well as clob whatever steriod cream, and that vitimin d ointment.  (sorry If I didn't find the same article, I looked for marathon, and other similar words)

Hi friends. I've had psoriasis since 2003. It got much worse when I was pregnant in 2007 and I was diagnosed with psoriatic arthritis in 2015. I've read some posts on here and I saw someone had mentioned that they had used dovobet on their face. A friendly word of advice. Don't I got rosacea from doing this and it got infected too. I've been searching through tonight because I believe my psoriasis that has always been on my ears has gone inside my ear and I have the worst ear ache ever. Hopeful that someone can advise me for the fastest solution on a weekend when there's only an emergency dr 14 miles away and no transport

Day zero on Humira =] Here you'll find my updates.

After a lot of "yeah but no but yeah but no but" I caved in and had my first Humira shots today for Psoriasis. It's been six hours now and I feel great. No side effects. First subcutaneous shot set by the Dermatologist, second one by me. Easy peasy =]
PASI score given to me is 11.5. Moderate to severe.

Lets see how this goes   

   ArteMie

Hi guys I'm new to this I was on methotrexate injections and they dident help my psoriatic arthritis at all but all the other medications made me ill I was on Sulfasalazine and ended up loosing 2 stone in a week I also had very bad allergic reactions to the rest so they now trying me on cosentyx let's hope this works 

A new dimethyl fumarate (DMF) treatment for psoriasis has been given European Commission approval.

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Almirall S.A. announced today that the European Commission (EC) has approved Skilarence®, a new oral formulation of dimethyl fumarate (DMF) developed by the pharmaceutical company, for the treatment for patients with moderate-to-severe chronic plaque Psoriasis. Skilarence® is to be indicated as a first-line induction and long-term maintenance treatment.

Almirall is due to start marketing Skilarence® in the third quarter of 2017 in all EU Member states, as well as in Iceland and Norway.

According to Eduardo Sanchiz, Almirall's CEO, "the EC's approval is very good news for healthcare professionals and for a large number of European patients, who will have access to a new therapeutic option for the systemic treatment of moderate-to-severe Psoriasis. Skilarence® is the result of Almirall's commitment to innovation, and making it available to doctors and their patients with Psoriasis will constitute a very important step in reinforcing the company's position as significant player in the field of Dermatology".

Skilarence® is the first fumaric acid ester (FAE) for the treatment of Psoriasis approved by the EC. Its approval in Europe is based on the positive results from the randomised, double-blind, placebo-controlled Phase III trial (BRIDGE), evaluating the efficacy and safety of this new oral formulation of dimethyl fumarate compared to Fumaderm®, presented in September 2016 at the prestigious 25th EADV Congress in Vienna (Austria). Published in the British Journal of Dermatology, the BRIDGE trial showed the non-inferiority of DMF compared to Fumaderm® and a good efficacy and safety profile.1

To date, a fixed combination of fumaric acid esters was only available in Germany in a different composition as well as locally compounded formulations in some countries like the Netherlands, Austria and some Nordic countries. The EC's decision will place this new oral formulation within the reach of all patients residing in all of the European countries.

Fumaric acid esters are a well-established oral systemic treatment for Psoriasis and are recommended in the European guidelines for both induction and long-term maintenance of the treatment of the disease. Long-term evidence coming from retrospective studies and registries highlights the clinical usefulness of the drug as well as its balanced safety profile.

About Skilarence® (dimethyl fumarate)

Skilarence®, dimethyl fumarate (DMF), is a type of fumaric acid ester (FAE), with anti-inflammatory and immune-modulating properties which is recommended in the European S3 Psoriasis guidelines for both induction and long-term treatment of adults with moderate-to-severe chronic plaque Psoriasis.2 A combination of FAEs is currently approved for the treatment of moderate-to-severe Psoriasis in Germany, with a positive risk-benefit profile for long-term use.3 DMF is considered the main active component in this combination.4,5 In fact, FAEs are the most frequently used first-line systemic Psoriasis treatment in Germany, with more than 20 years of an overall treatment experience that comprises of more than 180,000 patients.

Hi guys!

I've been on fumaderm for the last 2 1/2 years, on 6x120 mg a day. As the title suggest, my fumaderm treatment seems to be failing. Long story short, I reduced my dosage from 6 tablets a day to 5 for a couple of months last year. I noticed my psoriasis went from 99% to about 80%. I then increase back to 6 a day. That was over a year ago, and since then my psoriasis has only gotten worse. I would say I'm about 30% covered at the moment, and it's not getting better even with using betnovate. Fumaderm had worked really well up until I had to reduce it.

I was curious if this has happened to other people, and what treatments they went on to next? My dermatologist has suggested I go on methotrexate and have not told me of any other options. I'd rather not go in methotrexate, so would like to hear from other people what other treatments they found effective.


Thanks in advance for any advice given

Hi, my dad has been on acetretin for 6 weeks due to severe psoriasis on the soles of his feet, he has been pretty much housebound for a year due to this, thus week however he has developed a nasty red rash from his throat down to below his ribs... Does anyone know if this is a normal reaction, is it dangerous? 
He has started walking again and he feels his feet have improved, but now we have this rash?! 

Thanks in advance for your help x

Hi Folks.
I have tried a search in case it's been discussed already, but it says search term too short.

so... have people tried CBD oil for managing pain? i have heard good things but as it's £20 a pop for 10ml, i'd rather hear peoples views before handing over the cash 

hi members,

Trying to make my mind up and would really appreciate your input / experiences. Humira, possibly with MTX or Cosentyx.

I'm new, see 'intro ArteMie"  in the right place. PASI 11.5 so eligible for biologicals. Tried UVB (doesn't work anymore...), dymethilfumerate (enteric coated, slow release, still horrible tummy pains.. ) and lots of creams. 

Been to an academic hospital and had bloodwork done. if the results are positive I can choose: 
- partake in study; Humira in combination with a low dose of MTX. 50% of partakers get MTX, the other half only Humira. Computer chooses.
- go for Cosentyx.

I hear good things about Cosentyx. Some nightmare stories but mostly good. The hospital says I can have it but they're slightly reluctant because the medicine is still relatively new; no long term data on side effects.

Whats your view / experience? Would be great to have some input to help me make a choice.

   ArteMie

hi,

How nice to have found such a large and savvy community. I'm from Amsterdam, the Netherlands. This weeks visit to the AMC academic medic hospital gave me a PASI 11.5 score.

Had P since I was 10 or so and it's been on and off, DMF gave relief until the common side effects got to bad. Diet is unsustainable and also doesn't work, there are lots of stress triggers for me.

Now, after 'shopping' at three hospitals, the AMC is the first hospital that says YES to biologicals.
How and where do I put up a proper post with my dilemma there? I can have a choice of meds (hooray?) and I'd like to ask the opinion of people on this forum.

And I want an avatar, but I'm not cleared for changing details on my login yet?

Cheerio and thanks!

   ArteMie

Ok. So, story is, started on Methotrexate 5mg starter dose a couple of weeks ago. Felt a bit rubbish day after, well, knackered in fact. Took 5mg of folic acid daily for the next 6 days. You heard it right 5mgs not mcg. The day before due to take 10mg of MTX, had my bloods done.
Next morning woke up feeling like I had flu. Felt nauseous and headaches. The hospital then phone and said my white blood count was up and also my liver function. Told then wasn't well and they advised to not take the MTX that night but wait and have bloods done the week after. No mention of the folic acid.
By Thursday I was semi consciousness for most of the day and night with excruciating stomach pains, headaches, couldn't get out of bed, couldn't eat or drink, diarrhoea etc. This went on for 3 days. Started to feel a bit better after 5 days but still got bad stomach pains. Headache and dizziness.
My question is: if folic acid is supposed to replace the folic acid that is lost when taking MTX, what happens if you miss a dose of MTX. Where does it go? Is 5mg of folic acid too high or what? What is this poison I am putting in my body? Never again, will I take folic acid or MTX. Just starting to be able to eat and drink a bit. After 2 days I almost called for an ambulance , I thought I was going to die.
I think the folic acid side effects may be worse than the MTX. Do dermatologist really care!!!