A 24 week head to head study of Taltz and Stelara resulted in a Taltz win.

Quote:

---

Eli Lilly and Company announced today that patients with moderate-to-severe plaque psoriasis treated with Taltz® (ixekizumab) demonstrated superior efficacy at 24 weeks compared to patients treated with Stelara®* (ustekinumab).

At 24 weeks, patients treated with Taltz achieved significantly higher response rates compared to patients treated with Stelara, including 83 percent of patients who achieved Psoriasis Area Severity Index (PASI) 90—the study's primary endpoint—compared to 59 percent of patients who achieved PASI 90 after treatment with Stelara.

"For many years, achieving PASI 75 - or 75 percent improvement in skin plaques - has been the standard treatment goal for moderate-to-severe plaque psoriasis," said Kristian Reich, M.D., Ph.D., lead author and professor, Georg-August-University Göttingen and Dermatologikum Hamburg, Hamburg, Germany. "With the introduction of treatments like Taltz, dermatologists can offer treatment options that allow more patients to achieve PASI 90 or PASI 100. The data of the IXORA-S study is significant, as it demonstrates both high levels of skin improvement for patients treated with Taltz, consistent with pivotal Phase 3 trials, as well as higher response rates over Stelara, which is one of the most frequently used biologics in the treatment of moderate-to-severe plaque psoriasis."

In the IXORA-S study, patients were randomized to receive either Stelara (45 mg or 90 mg weight-based dosing per label) or Taltz (80 mg every two weeks for 12 weeks followed by 80 mg every four weeks), following a 160-mg starting dose, for a total of 52 weeks.

This study also evaluated PASI 75, PASI 100 and static Physician's Global Assessment score (sPGA) 0 or 1 with at least a two-point improvement from baseline. PASI measures the extent and severity of psoriasis by assessing average redness, thickness and scaliness of skin lesions (each graded on a zero to four scale), weighted by the body surface area of involved skin.1 The sPGA is the physician's assessment of severity of a patient's psoriasis lesions overall at a specific point in time and is a required measure the FDA uses to evaluate effectiveness.1

At 24 weeks, patients treated with Taltz achieved significantly higher response rates compared to patients treated with Stelara, as demonstrated by the following:

   91.2 percent of patients treated with Taltz achieved PASI 75 compared to 81.9 percent of patients treated with Stelara (p=0.015);
   83.1 percent of patients treated with Taltz achieved PASI 90 compared to 59.0 percent of patients treated with Stelara (p < 0.001);
   49.3 percent of patients treated with Taltz achieved PASI 100 compared to 23.5 percent of patients treated with Stelara (p=0.001).

Additionally, 86.6 percent of patients treated with Taltz achieved sPGA 0 or 1 compared to 69.3 percent of patients treated with Stelara after 24 weeks (p < 0.001).

The majority of treatment-emergent adverse events were mild or moderate. There were no statistically significant differences between treatment groups in overall treatment-emergent adverse events. The safety profile for Taltz was consistent with previous clinical trials.

"The approval of Taltz in the U.S., Canada and Europe nearly one year ago introduced a treatment option that could help patients with moderate-to-severe plaque psoriasis achieve virtually clear or completely clear skin," said Dr. Lotus Mallbris, global brand development leader, Taltz, Eli Lilly and Company. "We are thrilled with the opportunity to share this new data with dermatologists at AAD, as it reinforces the clinical benefits of Taltz for patients with moderate-to-severe plaque psoriasis."

Results from Phase 3 trials evaluating Taltz for the treatment of active psoriatic arthritis are expected to be presented later this year. Taltz is also in Phase 3 trials for the treatment of axial spondyloarthritis.

Hello everyone:  I am very new at this, so forgive me if I make any mistakes.        I am wondering if anyone here has PUSTULAR Psoriasis.  Everything I am reading seems to deal with PLAQUE Psoriasis.
Frank

Hi guys.I am on Fumaderm 120x5 tablets daily.I have severe nausea. I just start to see slight improvement on my skin but it is not that great yet. I don't know what to do because next week I have to increased to 6 tabs a day and if still don't see my skin better,Should I stopped or give it a chance little bit longer if I can manage the nausea?

Hi folks.

Well it's only been a few days now, and I don't weant to speak too soon, but drinking 6 pints of water a day has greatly reduced the flushes.

I noe get a flush about mid day and it's so light.  Bearly noticeable compared to before.

My thinking is that the vastly increased water intake is flushing it through my system quicker.

Ill keep you all updated and see how it goes.  Hopefully going up a dose soon!!!!

Many thanks to all who suggested the water intake (and I really should have known better but.....)

Well, I've been on MTX now for almost 6 years, I have never had any serious side effects and initially it worked well for me.
My current dose is 12.5mg once a week with folic acid every other day of the week.
I have blood tests and a follow up appointment with my Dermatologist every 12 weeks.
I have been monitoring my progress constantly, and the last 12 month's, the MTX has really not been working and my patches of scaling have started to re-appear.
I have been approved for Biological treatments, but the NHS are very reluctant to prescribe it for me.
I have just managed to secure an appointment, in 2 weeks time, so I am now going to try and push for an alternative treatment.
When I go on holiday and spend prolonged time in the sun, I stop taking the MTX for the duration of my stay, as the sun does the job very well and I like a few sherbets when on holiday.
My next appointment is on 14th March, I will post the achievments (or lack of) when I have had this consultation.
I have been taking MTX now for 5 years & 10 month's, so it's time for a change.

I wish all the best to everyone
Good Luck
Micky

I've been to the doctors a few times, first started as little dots on my stomach in September 2016. The doctor told me it was inflamed hair follicles probably where I run and sweat gathers.
Then it started on my legs a few weeks later and I recognised it from when I was 15 (14 years ago) and had similar then and was told it was psoriasis. So went back to the doctors.
They haven't still confirmed it as psoriasis but gave me some dovobet gel to try and it helped a few of them but as it's steroid gel can only use for 8 weeks.
Now it is on my lower legs, upper legs, stomach, back, arms and scalp, even one small patch on my face, just below my eye.
In a way I'm lucky because I've seen some photos online and I'm not covered. Still frustrating, itchy at times and makes me self conscious.
I have a doctors appointment again next Tuesday and hoping to get referred to a dermatologist.
I wanted to be able to show some photos and get your opinion, the ones on my stomach don't really scale over, they're just quite red. The ones on my legs dry out and so does my scalp! Anyway I'm waffling. Hello everyone and help needed

This study suggests psoriasis patients with psoriatic arthritis (PsA) should be monitored more closely and with specific attention.

Quote:

---

Background:
There are a limited number of studies comparing psoriasis patients without psoriatic arthritis (PsA) to those with arthritis. Previous results are controversial.

Objectives:
To perform a comparative analysis of the phenotype, baseline comorbidities, therapeutic profile and incidence of adverse events (particularly overall adverse events, infections and infestations, malignancies, and psychiatric disorders) among psoriatic patients with/without PsA.

Methods:
All the patients on the Biobadaderm registry, a prospective inception cohort of psoriasis patients on systemic therapy, were included. Patients were divided into two groups: those with psoriasis without arthritis at the time of entry into the cohort (Pso group), and those with psoriasis and psoriatic arthritis (PsA group) at entry. Patients were followed until the censorship date (last visit in a lost-to-follow-up patient, or 10 November 2015, whichever occurred first). We excluded all the patients who developed any kind of signs and/or symptoms of joint involvement during the follow-up. A descriptive analysis was performed. We estimated incidence ratios (IRR) of adverse events during systemic treatment using a mixed-effects Poisson regression.

Results:
We included 2120 patients: 1871 (88%) patients with psoriasis without arthritis, and 249 (12%) with psoriasis and PsA. The follow-up time was 5020 patients-year in the Pso group, and 762 patients-year in the PsA group. Patients with PsA had more comorbidities, particularly hypertension and liver disease; used a higher number of systemic therapies, particularly anti-TNFα drugs and combination therapy; and presented more adverse events (IRR adjusted = 1.29; 95% CI [1.05-1.58]), particularly serious adverse events (IRR adjusted = 1.51; 95% CI [1.01-2.26]) and infections/infestations (IRR adjusted = 1.88; 95% CI [1.27-2.79]), independently of the associated comorbidities and present/past therapies.

Conclusions:
Given the differences between patients with psoriasis alone or with psoriasis associated with PsA, patients with psoriasis and PsA should be followed and managed more closely and with specific attention.

 Hi guys just starting otezla today so see how I fair on it iv been on methotrexate for abt 2.5 yrs and new break outs all over and seriously fed up jabbing myself weekly legs black n blue so my consultant suggested this new wonder drug well in the states anyway so I'm up for anything so I'm giving it ago and will keep you updated on my progress for anybody that's interested.

Cheers Tray xx

Hi all new to this I have had psoriasis since 1990 and have all drugs lotions and potions going for it I'm starting Otezla today after being on 25mgs of methotrexate for abt 2yrs plus now as I have reached the point of new patches appearing so there for time to try something else. So otezla is the new wonder drug apparently so we shall see how I fair on it just took first tablet this morning so will keep you updated on the side effects if any. 
Would just like to say the methotrexate side effects I suffered from were terrible sick and headaches so here's hoping I can push through any from this hope it's worth it.

Hello forum members

I'm looking forward to learning a lot here, and hopefully helping others when I can.
I have a relatively light case of plaque psoriasis; it began on my scalp about 18 years ago and moved on to elbows and knees.  It has recently become more visible (backs of hands) and more widespread.  I feel fortunate in that pain and itching are rarely a problem for me.

Odd in a way, but wouldn't it be great if we could someday celebrate the end of this forum?  That would of course come from a Psoriasis cure and the condition becoming a distant memory!  

Best of health to all of you!
-greycloud

This study estimated the prevalence of metabolic syndrome and other cardiovascular risk factors and its association with the psoriasis severity, sex and age.

Quote:

---

Background:
Psoriasis has been associated with metabolic syndrome and with an increased cardiovascular risk especially in patients with severe disease. The goal of this study was to estimate the prevalence of metabolic syndrome and other cardiovascular risk factors and its association with the psoriasis severity, sex and age.

Methods:
Consecutive patients with psoriasis were enrolled in a prospective study over a 1-year period. Blood samples were collected. Psoriasis area and severity index (PASI) and body surface area scores and two dermatology quality of life (DQOL) questionnaires were used to evaluate psoriasis severity and the impact of the disease.

Results:
Altogether 178 patients were included, of whom 44% had moderate–severe psoriasis. The overall prevalence of metabolic syndrome was 30% (men 34%, women 26%) without significant differences between patients with severe and mild disease. Age and menopause appeared to increase the risk for metabolic syndrome. Patients with severe psoriasis smoked more heavily, were more likely to have diabetes or insulin resistance and had higher homocysteine and lower high density lipoprotein cholesterol (HDL-C) levels than patients with mild psoriasis (P < 0.05). In women, a higher waist circumference was observed. Women had higher HDL-C levels and lower smoking and alcohol consumption rates. In accordance with the systematic coronary risk evaluation system, 18% of the patients had a high 10-year risk of fatal cardiovascular disease.

Conclusions:
Psoriasis severity was associated with diabetes, insulin-resistance, smoking habit and higher cardiovascular risk. Metabolic syndrome was related to age and menopause but not to psoriasis severity.

his study looked at the efficacy and adverse events in Enbrel (etanercept), Humira (dalimumab) & Stelara (ustekinumab).

Quote:

---

Background and objectives:
Widely used in the treatment of psoriasis, biologics have been tested in numerous clinical trials. However, drug efficacies and adverse events (AEs) may differ in ‘real-world’ patients as they do not undergo as rigorous selection and monitoring. Our objective was to examine drug survival, efficacy, and AEs (quality, time of onset) in ‘real-world’ psoriasis patients treated with etanercept, adalimumab, and ustekinumab.

Patients and methods:
Retrospective data analysis (Jan 1, 2004 to Jun 30, 2015) of patients treated at a psoriasis clinic in an Austrian hospital. All patients who had received at least one dose of etanercept, adalimumab, or ustekinumab were included in the analysis. We analyzed: demographics, drug survival, Psoriasis Area and Severity Index (PASI), as well as quality and time of onset of AEs.

Results:
In 209 treatment series, the estimated median drug survival varied among the various treatments: 21 months (SE: 6.9) for etanercept, 61 months (SE: 9.4) for adalimumab, and 65 months (SE 1.4) for ustekinumab. Male gender and pretreatment with a biologic were positive predictors of longer drug survival in adalimumab. We found no significant difference in drug efficacy as determined by PASI.

Conclusions:
Most AEs occur during the first year of treatment. Adalimumab and ustekinumab are marked by longer drug survival compared to etanercept.

This study suggests that dose adjustments of bio treatments for psoriasis is common practice by dermatologists.

Quote:

---

Introduction:
Despite the large routine use of biologic drugs in psoriasis treatment, the majority of studies do not take into consideration dose-adjustment practice in ‘real-life’ dermatological setting. In routine clinical practice, the disease management may include a large number of conditions requiring non-standard dosage regimens, including dose escalation, dose reduction and/or off-label treatment interruption.

Objective:
The ONDA (Outcome of non-standard dosing regimen in Psoriasis and Psoriatic Arthritis) study aim was to retrospectively analyse dose-adjustment strategies among biologic therapies for psoriasis in dermatological practice during a 3-year period.

Results:
This retrospective, observational, multicentre study was carried out in 350 patients (68% male, 32% female) affected by plaque-type psoriasis (Pso) with a coexistence of psoriatic arthritis in 164 patients (46.9%). At baseline mean PASI score was 14.9 (SD 7.2). Dose adjustment was demonstrated to be a common practice with 70/350 patients (20%) who needed a dose variation during the treatment time, in particular a dose increase in 20/70 patients (28.6%) and a dose reduction in 50/70 patients (71.4%). Dose increase was due to inefficacy on Pso parameters in 60% of cases and to inefficacy of PsA parameters in 40% of cases, while dose reduction (or temporary off-label treatment interruption) was due to prolonged remission in 54% of cases, other reason in 18% of cases, patient choice or request in 14% of cases, occurrence of concomitant event in 12% of cases.

Conclusion:
Dose adjustment is a common clinical practice, consisting of frequent dose reduction when a disease prolonged remission is obtained or dose increase to improve efficacy on Pso and PsA disease parameters.

This study suggests there is a preclinical phase in patients with psoriatic arthritis prior to the diagnosis.

Quote:

---

Objective:
To assess whether the presence of nonspecific musculoskeletal symptoms, their degree, and change over time predict the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline.

Methods:
This prospective cohort study involved patients with psoriasis who were assessed at baseline to exclude the presence of clinical PsA. The study participants were reassessed annually to determine if they had developed PsA. The presence of musculoskeletal symptoms and the patients’ assessments of pain, fatigue, stiffness, physical function, and psychological distress were recorded at each visit. Cox proportional hazards models were used to assess what symptoms predicted the development of PsA.

Results:
A total of 57 of 410 psoriasis patients developed PsA. At baseline, the presence of arthralgia in women (hazard ratio (hr) 2.59, P = 0.02), heel pain (HR 4.18, P = 0.02), high fatigue score (HR 2.36, P = 0.007), and high stiffness score (HR 2.03, P = 0.045) predicted subsequent development of PsA. In addition, an increase from baseline in fatigue score (HR 1.27, P = 0.001), pain score (HR 1.34, P < 0.001), and stiffness score (HR 1.21, P = 0.03), and a worsening in physical function score (HR 0.96, P = 0.04) predicted the development of PsA.

Conclusion:
A preclinical phase exists in patients with PsA prior to the diagnosis of the disease. This phase is characterized by nonspecific musculoskeletal symptoms, including joint pain, fatigue, and stiffness.

Well hi folks.  A forum for everything!!!

So, how did I find myself here?

I'm in my 50's and had psoriasis since about 21.  Started slowly, head, lugs and legs.  Got all the potions and lotions and eventually light treatment in a half barrel for legs only.  

I eventaully got more bits, some joined together, some on injury sites like voluntary psoriasis biopsies!!! 

Too much light and started the biological stuff.  One put my cholesterol up, meathatraxate made me sick so started injecting, that eventually mae me depressed (self diagnosis) but when you fall out with a cup of coffee and start swearing at it (plus other things) it's time to review meds.

Now on fumaderm.

There might be some side effects!     You're no' kidding Batman

Was up to 270mg daiiy, 99% reduction, 30mg a day maintenance dose for over a year, increased SLOWLY recently to 120mg in the morning.

HOT FLUSHES are killing me.  Even on 30mg/daily.

I'll post looking for HOT FLUSH relief elsewhere.

Nice to find this place.

ATB.

Hi everyone!

I have been looking a lot into psoriatic arthritis lately, and I think I have it but I'm not really sure. I get daily pain in a few of my joints, but I don't know if it's from something else. The most common one is my right knee. Almost every night, it will just start aching and nothing I do, except taking Ibuprofen, helps. The knuckles in my thumbs also hurt often as well as my wrists.

If you have psoriatic arthritis, could you tell me what your experience is like because I'd really like to determine what is behind the aching. 

Thanks so much!
Jenna

Hello I'm Gloria   and have a severe case  head to toe   was diagnosed  in Jan  and had my first injection  of Stelara yesyesterday    wanted to know if there is anything I should avoid, or should start doing  i itch like crazy, any info, suggestions  would be appreciated    Thanks

Hi everyone!

My name's Jenna, and I just discovered Psoriasis Club today. I'm currently a college student, and have been struggling with psoriasis for over eight years. Currently, it covers almost all of my face, most of my body, my scalp, inside my ears, etc. 

Recently, I found an amazing dermatologist (I've had really bad luck in the past) who finally admitted that I have severe psoriasis. This was the first time a doctor had ever really taken it seriously. Soon, I'll be starting injections, and my dermatologist thinks I'll be basically plaque free in about six weeks. Obviously it's not a cure, but I'm so excited to finally have some hope of a working treatment!

Other than my psoriasis, everything is great! I'm a communication major, and loving it. I'm a HUGE animal lover, music nerd, Netflix connoisseur, coffee addict, and book fanatic. I'm so happy to be here and to meet new people! Please feel free to ask me anything; I'm super open and excited to talk. 

Jenna 

Hi - I'm currently on Furdum 3x120 tablets ......is there any conflict if I take Magnsium & Vaclcium Supplements .....or is this a " no no " whilst taking my tablets

Hi everyone, after three years I am finally able to find time to get back onto this forum.
Unfortunately, work can be hectic and I have to work evenings too.

I have now been on Methotrexate now for almost 6 years, I have never suffered any side effects, dosage 12.5mg weekly, but I am now finding that over the last 6/8 month's, it is just not working anymore.

I have been trying to get my Consultant Dermatologist to put me on Biologic Treatments, but because it is the NHS, they keep fobbing me off,
I know this is because of cost...!!!

I look forward to getting back here a little more regular,
Best wishes to everyone
Regards
Micky