This study of 5,438 Swedish psoriasis patients suggests women have a statistically significant lower incidence of severe psoriasis compared to men.

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The fact that men are overrepresented in psoriasis registers and consume more psoriasis care have long led researchers to believe that the common skin disease disproportionally affects men. A unique study with 5,438 Swedish psoriasis patients now reveals that women have a statistically significant lower incidence of severe psoriasis compared to men.

The study, conducted by researchers at Umeå University and Karolinska Institutet, is published today in the American Journal of Clinical Dermatology.

“Our results tell us that the well-established gender differences in the utilization of psoriasis care can at least partially be explained by a higher prevalence of more severe disease in men,” says Marcus Schmitt-Egenolf, who is researcher at the Department of Public Health and Clinical Medicine at Umeå University and senior author of the study.

The study of gender differences in severe psoriasis cases was based on the Swedish quality register for systemic treatment of psoriasis, PsoReg, which contains detailed disease measurement data on all patients measured with the standard method Psoriasis Area Severity Index (PASI). In the analysis, the researchers found that women had significantly (p<0.001) lower median PASI values than men (5.4 for women versus 7.3 for men). The findings of more severe psoriasis in men were consistent across all ages and in all areas of the body except for the head.

“These findings should motivate a gender perspective in the management of severe psoriasis and its comorbidities, such as cardiovascular and metabolic disease,” says Marcus Schmitt-Egenolf.

The researchers point out that the study found no differences between women and men in the use of medications before enrolment in the PsoReg register that may explain the observed sex difference. Instead, the researchers argue, the finding that women have less severe psoriasis can explain the well-known male dominance in systemic treatment of psoriasis.

Iv got it on my face, scalp, ears a bit on my elbows few spots on my chest/stomach and in my belly button but I'm wondering if it can occur under the skin because I get itchy all over even in places  where I have none but it feels like the same itch?

Novartis say that new results show that Cosentyx not only treats psoriasis but can also modify it's course, and have initiated a new trial to assess early intervention in new onset psoriasis with the aim of giving long term clearance.

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Novartis today announced new data suggesting, for the first time, that Cosentyx® (secukinumab) may modify the course of moderate-to-severe psoriasis leading to long-term, treatment-free skin clearance. Cosentyx is the first and only IL-17A inhibitor to have reported this potential of disease modification. These data were presented at the 13th Annual Maui Derm for Dermatologists 2017, Maui, Hawaii at which Novartis presented 14 abstracts.

Following one year of treatment with Cosentyx, patients were randomized to either continuous treatment or treatment cessation until relapse. Patients with continuous treatment maintained their high level of response. Among the patients that discontinued treatment, 21% of psoriasis patients maintained skin clearance for up to one year without treatment and 10% maintained skin clearance after two years without treatment. Patients with longer disease duration were more likely to relapse, suggesting that early intervention increases the chance of remaining relapse free.

Previous data has shown that Cosentyx, a fully human, specific inhibitor of the IL-17A cytokine, delivers long-lasting clear or almost clear skin (PASI 90 to PASI 100) in up to 80% of patients out to four years.

"These results suggest that Cosentyx may go beyond simply treating symptoms and could actually modify the course of psoriasis, and highlights the need for further investigation into early intervention," said Vas Narasimhan, Global Head, Drug Development and Chief Medical Officer, Novartis. "Being able to change the course of disease is the ultimate goal of treatment, which is why we are investing in the STEPIn trial to further understand the disease modifying ability of Cosentyx in psoriasis."

This is the first robust long-term data on psoriasis following treatment discontinuation. These data (from extension study A2302E1) show low scores on the Psoriasis Area Severity Index (PASI) were maintained after treatment discontinuation following one year on Cosentyx (PASI score of 2.9 after 1 year and 1.7 after 2 years off-drug, vs. 20.5 and 19.2 at Baseline). Additionally, of the 120 patients who were PASI 75 responders and switched to placebo at one year, 21% remained relapse-free after one year and 10% were relapse-free after two years off-treatment. Patients who had a longer disease duration before Cosentyx treatment were more likely to relapse, highlighting the potential importance of early treatment. To further investigate the disease modification potential of Cosentyx, Novartis has initiated the STEPIn trial to assess early intervention with Cosentyx in new-onset disease. The ambition is to identify a novel strategy of treating patients with new-onset moderate-to-severe psoriasis, by providing evidence to inform the use of early treatment.

I have pics and I will post them but my fix was to stop taking ibuprofen and I started taking 2 tsbp of Hemp oil.

I don't want this to turn into a political thread and that is not it's intention. But the political situation around the world has got me thinking about our treatments and how things could possibly change in the future.

#1 There has been a lot of talk lately about of possible future trade problems/negotiations after the Trump win in the USA and Brexit in the UK, so how will that effect our treatments?

#2 Also do the drug companies make their treatments in different parts of the world depending on where they sell them and could that change?

I'm currently on Cosentyx which is made by Novartis. They are a Swiss company but my box of Cosentyx has Crawley UK on the back. I live in France and the packaging and leaflet is in French. I'm guessing that my treatment is made in the UK because of the packaging, if it was made in France or Switzerland surely it would have that on the back of the box. So will my Cosentyx still be made in the UK after Brexit and will the price change?

I would be interested to know what others think, and where your prescribed psoriasis treatment is made.

You may have read in the news about the deaths from skin creams that you use for psoriasis. The BBC has has discovered there have been 37 deaths in England since 2010 linked to these types of creams.

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Skin creams containing paraffin have been linked to dozens of fire deaths across England, the BBC has learned.
The products for conditions like eczema and psoriasis can leave people at risk of setting themselves ablaze.
If people use the creams regularly but do not often change clothes or bedding, paraffin residue can soak into the fabric, making it flammable.
The medicines regulator has updated its guidance and says all creams containing paraffin should carry a warning.
Despite warnings going back more than 10 years, BBC Radio 5 live Investigates has discovered there have been 37 deaths in England since 2010 linked to the creams.

Carol Hoe's husband Philip died after accidentally setting himself on fire at Doncaster Royal Infirmary in 2006 when sparks from a cigarette reacted with the emollient cream he was covered in.

"I got a phone call from the ward sister to say can you get to the hospital as soon as possible, Philip's had an accident," she said.

"Philip had caught fire. He had sneaked off onto a landing for a sneaky cigarette, a gust of wind must have caught the lighter, and it set fire to him."

Within seconds Mr Hoe, who was receiving treatment for psoriasis, was engulfed in flames and he died shortly after being transferred to another hospital in Sheffield.

"When we got there, the staff came to me and told us he was covered with 90% burns," said Mrs Hoe.

"There was nothing they could do."

The coroner at his inquest drew attention to the dangers posed by skin creams, and the now defunct National Patient Safety Agency advised that paraffin-based products are easily ignited with a naked flame if used in large quantities.

The Medicines and Health Care Products Regulatory Agency later issued two more warnings, but deaths continued to occur.

5 live Investigates approached all 53 fire brigades in the UK to find out how many deaths had been linked to the use of paraffin-based skin creams since 2010.

Just six from England provided information - revealing the 37 fatal incidents. The majority came from the London Fire Brigade which reported 28 fatalities.

Until recently, the Medicines and Healthcare Products Regulatory Agency only asked that a flammability warning be put on packaging if a cream contained more than 50% paraffin.

The agency is now urging manufacturers to add a warning to the packaging of skin creams containing any paraffin.

And since being alerted to 5 live's findings, the organisation representing manufacturers of branded over-the-counter medicines has said it will explore whether all paraffin-based creams should carry a warning as standard.

This study assess the efficacy and safety of a new formulation of DMF (LAS41008) compared with placebo and Fumaderm in adults with psoriasis.

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Background:
Fumaric acid esters (FAEs) are recommended in international guidelines for induction and long-term treatment of adults with moderate-to-severe chronic plaque psoriasis. The fixed combination Fumaderm® is approved in Germany, with dimethyl fumarate (DMF) being the main active ingredient.

Objectives:
To assess the efficacy and safety of a new formulation of DMF (LAS41008), compared with placebo and Fumaderm®, in adults with moderate-to-severe chronic plaque psoriasis.

Methods:
In this phase III, double-blind, placebo-controlled, noninferiority trial (BRIDGE, NCT01726933, EudraCT 2012-000055-13), patients were randomized to receive LAS41008, Fumaderm® or placebo (2 : 2 : 1) for 16 weeks, uptitrating to a maximum daily DMF dose of 720 mg, depending upon individual response. The coprimary end points were the percentage of patients achieving ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) and the percentage achieving a score of ‘clear’ or ‘almost clear’ in the Physician's Global Assessment (PGA) at week 16.

Results:
In total, 671 patients were randomized and included in the full analysis set (n = 267, LAS41008; n = 273, Fumaderm®; n = 131, placebo). At week 16, 37·5% of patients treated with LAS41008 achieved PASI 75, compared with 15·3% receiving placebo (superiority for LAS41008 vs. placebo: P < 0·001) and 40·3% receiving Fumaderm® (noninferiority for LAS41008 vs. Fumaderm®: P < 0·001). Overall, 33% of patients treated with LAS41008 were ‘clear’ or ‘almost clear’ in the PGA at week 16, compared with 13·0% receiving placebo (P < 0·0001; LAS41008 superiority vs. placebo) and 37·4% receiving Fumaderm®. Most treatment-related adverse events were classed as ‘mild’ in severity.

Conclusions:
LAS41008 (DMF) is effective in the treatment of adults with moderate-to-severe chronic plaque psoriasis.

This study suggests the differences in the expression of CD39 and CD73 Tregs may be a factor in the pathogenesis of psoriasis.

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Background:
CD39 and CD73 are two novel cell surface markers of CD25highFoxp3+ regulatory T-cells (Tregs). Concordant expression of these two ectoenzymes not only discriminate Tregs from other cell populations, but also generates pericellular adenosine, which has been reported to suppress proliferation of activated T effector (Teff) cells. Because it is currently unclear whether human ectoenzymes (CD39/CD73) are involved in the impaired suppressive activity of Tregs in psoriasis, we examined the frequencies and phenotypes of CD39/CD73-expressing Tregs and related receptor adenosine receptor 2A (A2AR) in peripheral blood of patients with different types of psoriasis.

Methods:
Peripheral blood mononuclear cells (PMBC) were prepared from patients with three different types of psoriasis (psoriasis vulgaris, pustular psoriasis and erythrodermic psoriasis). CD4+ cells were separated from PBMC by negative selection on midiMACS columns, and the frequencies and phenotypes of CD39 and CD73 expressing Tregs, and A2AR expressing Teff were all determined by flow cytometry analysis. Blood from healthy volunteers served as controls.

Results:
The expression of single CD73+ Tregs was markedly reduced (approximately 50%) in psoriasis vulgaris, compared to normal controls. In pustular psoriasis, the mean numbers of CD39+ Tregs and A2AR+ Teff was significantly lower than in normal controls. Among three different types of psoriasis, CD39 expression was strikingly reduced in the blood Treg population of pustular psoriasis patients. Decreased CD73+ Tregs levels were observed in psoriasis vulgaris compared to pustular psoriasis and erythrodermic psoriasis.

Conclusions:
The differences in the expression of CD39− and CD73− Tregs may be a factor in the pathogenesis of psoriasis.

This population based Norwegian study looked at the increased risk of fractures in psoriasis patients.

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Background:
An association between psoriasis and osteoporosis has been reported.

Objectives:
To investigate, in a large prospective population-based Norwegian study, whether psoriasis is associated with increased risk of forearm or hip fracture; to investigate the cross-sectional association between psoriasis and bone mineral density (BMD) T-score in a subpopulation.

Methods:
Hospital-derived fracture data from Nord-Trøndelag County (1995–2013) were linked to psoriasis information, BMD measurements and lifestyle factors from the third survey of the Nord-Trøndelag Health Study 2006–08 (HUNT3); socioeconomic data from the National Education Database; and use of medication from the Norwegian Prescription Database.

Results:
Among 48 194 participants in HUNT3, we found no increased risk of forearm or hip fracture in 2804 patients with self-reported psoriasis [overall age- and sex-adjusted hazard ratio 1·03, 95% confidence interval (CI) 0·82–1·31]. No clear association was found between psoriasis and mean BMD T-score; overall age- and sex-adjusted differences in total hip, femoral neck and lumbar spine BMD T-scores were 0·02 (95% CI −0·11 to 0·14), 0·05 (95% CI −0·06 to 0·17) and 0·07 (95% CI −0·09 to 0·24), respectively. No clear association was found between psoriasis and prevalent osteoporosis in either total hip, femoral neck or lumbar spine; overall age- and sex-adjusted odds ratio was 0·77 (95% CI 0·54–1·10). Associations did not change substantially after adjustment for education, smoking, systemic steroid use and body mass index.

Conclusions:
We found no association between psoriasis and risk of fracture. The study did not indicate reduced BMD T-score or higher prevalence of osteoporosis among patients with psoriasis.

MP1032 a twice daily oral treatment for psoriasis has undergone a phase IIa trial conducted at four clinical study sites in Germany.

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MetrioPharm AG, a biotech company developing small molecule immune modulators for autoimmune and other inflammatory diseases, today announces positive top line results from its phase IIa trial with its proprietary drug compound MP1032 in patients with moderate-to-severe plaque psoriasis.

The phase IIa trial conducted at four clinical study sites in Germany was a randomized (1:1), double-blind, placebo-controlled, study with MP1032 given orally twice daily. Forty-four patients received six-weeks of treatment with placebo or MP1032 and were monitored for an additional four-week period.

The primary objectives of the study were to evaluate the safety and pharmacokinetics (PK) of twice daily 100 mg MP1032 in patients with moderate-to-severe plaque psoriasis. Enrolled patients had an average age of 40 years (21–65) and a median baseline PASI score of 13.6 (ranging from 10.1 to 40.8).

With regard to safety, the most frequently reported adverse events were common cold, headache, and itching. All events were mild to moderate in nature and occurred in both the placebo and MP1032 group. There were no effects on lymphocytes or other blood-count parameters and no treatment-related gastro-intestinal adverse effects were reported. No serious or severe adverse events were reported in patients treated with MP1032. No patient treated with MP1032 discontinued the trial because of adverse events or tolerability issues.

Exploratory analyses regarding the potential effect of the drug on PASI scores suggest that patients with MP1032 exposure levels above 120 ng*hr/ml (n=16) have a median reduction from baseline in PASI score of 25 % as compared to 12 % in the placebo group at the end of treatment (week 6). Upon discontinuation of treatment, during the four-week follow up period, median PASI scores in the treatment group trended back upward while the placebo group remained relatively unchanged, suggestive of a therapeutic effect of MP1032.

“This phase IIa study suggests a clinically meaningful activity of MP1032 for the treatment of moderate-to-severe plaque psoriasis. From a clinical point of view, an oral drug with a better tolerability profile than currently available drugs, is desirable. I am looking forward to seeing how MP1032 performs in upcoming clinical trials,” said Prof. Wolfgang Vanscheidt, one of the study’s Principal Investigators.

Dr. Wolfgang Brysch, CEO of MetrioPharm said “The positive results from this trial represent an important milestone in our development program for MP1032. We are very pleased that MP1032 was well tolerated and that there is a meaningful trend in response after only six weeks of treatment. We believe that MP1032 could become an effective, and well-tolerated oral treatment option for patients suffering from moderate-to-severe forms of psoriasis”.

Based on the wide pre-clinical safety margin of the drug, the PK data in psoriasis patients, and the trend in drug effect observed in this trial, MetrioPharm is planning a three-month phase IIb study in patients with moderate-to-severe plaque psoriasis with higher doses of MP1032.

Not sure if this is the right place, but ibuprofen has been shown to increase risk of heart attack by 31%, and diclofenac increases risk to 50%, which I thought relevant news to those of us who take them to relieve psa symptoms.
There is some kind of action on platelets and clotting in the blood. Shame because I find they relieve pain much better than paracetamol..

As I have been here a while now and my journal about Fumaderm and hormone injections is no longer relevant. As I'm clear of prostate cancer and no longer have the awful hormone injections that kept the prostate cancer under control Fumaderm and hormone injections

So I will begin my continued journey here

2 weeks ago I was invited to have an MRI scan on my brain as there we're worries that Fumaderm had been linked to cases of PML ...I told my dermatologist that my lymphocyte levels hadn't been low enough to allow any opportunistic infections to take hold....he felt that it would be wise

So today I had my 3 monthly meeting with the Dermatologist who gave me the good news that my brain scan showed no abnormalities ( I know it's hard to believe)
Also got my blood results with my lymphocyte count at 1.15 ( normal is between 1and 3 )
Kidney and liver function was normal

I have now been on Fumaderm 5 years and have found it to be a life changer for me I barely know I have psoriasis now apart from a stubborn spot on my left elbow.
I am taking 5 Fumaderm tablets a day  3 in the morning with my breakfast and 2 with my evening meal. Always with plenty of fluids .

I found 4 tablets keep my psoriasis under control, but I have increased to five a day to help control the psoriatic arthritis which it seems to be keeping it away as my sore fingers and feet are almost normal with hardly any pain

I will keep this thread updated with my continued journey and hope to keep reporting no change

[Group Specific]

I'm pleased to show some new Psoriasis Club Cards.



I have now removed the old ones so if you do use the cards you will need to download the new ones from this link:

https://psoriasisclub.org/PCcards.pdf

Once you have downloaded the PDF you can print of an A4 page with 8 cards.

*Please do not put them out anywhere without the owners consent.

*Be careful if you approach a stranger to offer a card as some people may be very concious of their psoriasis and you could offend.

I would like to thank a friend (not a member) for making the new Psoriasis Club Cards for us.

Hi All,

Apologies if this has already been discussed(i tried searching previous posts) or if i have posted this topic in the wrong place.

My background: I have suffered from pretty sever psoriasis for 6 years. I tried every sort of treatment to little or no avail, before i was turned onto Fumaderm 16 months ago. From early in the initial course, it was completely cleared. My dermatologist continued to increase my dose until i reached 6x 120mg a day. After this he slowly reduced it.

4 weeks ago i was reduced to 2x 120mg Fumaderm a day, and almost immediately i saw psoriasis return. I have been moved back to 3x 120mg a day, however it has only gotten worse.

I am just wondering if anybody has had any similar issues using Fumaderm?? I am only hoping this is temporary, maybe my daily dose was reduced too low, and now that I am back to 3x a day it will slowly go away!

Thank you in advance for any help you may be able to give!

Hi,
I'm Paul 64 and plagued by Psoriasis. Elbows Knees and back, and the cheeks of my bum!
Been using Dovobet but it's very temporary. Would like to go swimming more but not like this.
Keep scratching and make the sheets look like a bloodbath.

Any hints welcome.

Paul

Does anyone else suffer from Reynaud's Syndrome? This where the small capillaries in your extremities shut down in the cold leaving the area looking dearly white and can also be accompanied by a loss of feeling and or pain.
My middle finger and index finger on the right hand are particularly susceptible and seems to be much worse this winter since being on Acitretin. I've had a quick look on'tinternet but can't find a logical link.

This study suggests that psoriasis patients have more addictions than the general population.

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Background:
Psoriasis is a disease of enormous socio-economic impact. Despite approval of numerous highly efficient and costly therapies, a minor proportion of severely affected patients actually receives sufficient treatment.

Objective:
To investigate whether addictions are associated with psoriasis and to develop evidence-based recommendations for dermatologists in their daily clinical practice in order to improve medical assessment of psoriasis and patients’ quality of life.

Patients and Methods:
Psoriasis patients at the University Department of Dermatology were asked to fill out a paper-based self-reported anonymous questionnaire with 92 questions of validated screening tests for the six most common addictions in Germany (alcohol, nicotine, drugs and illegal drugs, gambling, food). Body weight and height as well as current Psoriasis Area and Severity Index (PASI) were documented as well.

Results:
Between October 2015 and February 2016 102 patients (65 males, 37 females; mean age 49.7 years (SD 13.4), range 18 - 83 years) participated in the study. Fifty-seven of the 102 patients showed addictive behavior. Of these 23.8% were high risk drinkers, 41% regular smokers, 11% at risk of drug abuse, 4.1% at risk of food dependency, and 19% compulsive gamblers. Compared to the general population, these results are significantly higher for alcohol abuse (p < 0.005), nicotine (p < 0.001) and gambling (p < 0.001). Body-mass-index was significantly higher in the study population (p < 0.001).

Conclusion:
Addictions and gambling are more prevalent in patients with psoriasis compared to the general population. Respective screening measures are recommended in daily practice for doctors treating psoriasis patients and PeakPASI is suggested as a score to document patients’ lifetime highest PASI. Parallel to new drug approvals and even more detailed insights into the pathomechanism of psoriasis, public health strategies and interdisciplinary approaches are essential for a general sustained psoriasis treatment.

Hi all, 

I only joined the forum today, to ask some of you good people questions about Taltz. 

Related to that, I started reading up about how the newer Interleukin-17 inhibiting biologics are proving particularly effective, and how this seems to be a promising route to getting psoriasis under control. 

I stumbled across this: LINK REMOVED

It appears Ursolic Acid is a supplement that also inhibits Interleukin-17. I wondered if anyone had heard of it, or tried it? Logic tells me it would also help get psoriasis under control, but perhaps I'm totally wrong?

This study looked at psoriasis patients in Spain and compared them with the rest of the EU.

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Background:
The Multinational Assessment of Psoriasis and Psoriatic Arthritis (MAPP) survey data were not analysed to account for cultural and healthcare system differences across European countries (EC).

Objective:
Utilize MAPP data to characterize psoriasis in Spanish patients, including severity assessment and Dermatology Life Quality Index (DLQI).

Methods:
MAPP was conducted between June and August 2012. This analysis included 1700 patients with self-reported psoriasis (without psoriatic arthritis) from France (n=349), Germany (n=311), Italy (n=359), Spain (n=354) and the United Kingdom (n=327).

Results:
Patients from Spain versus other EC self-reported higher mean body mass index (26.9 vs. 25.6, P≤0.001), lower prevalence of depression (6% vs. 12%, P=0.002) and higher mean self-perceived psoriasis severity at its worst (5.92 vs. 5.33, P<0.001) despite lower estimated body-surface-area involvement. Overall, patients from Spain versus other EC had lower mean global DLQI scores (4.70 vs. 6.06, P=0.001) and mean scores for each DLQI dimension (all P<0.001, except leisure [P=0.002], treatment [P=0.002], and work and school [P=0.005]). Higher DLQI values were inversely associated with age and directly correlated with perceived severity. Palmoplantar, nail and scalp psoriasis were reported less frequently in Spanish patients (P≤0.026) and were associated with higher DLQI values (P<0.01). Spanish patients were more likely to have seen multiple healthcare providers (HCPs, P<0.001) and achieve therapeutic goals (P<0.001), but current treatments were similar to patients in other EC.

Conclusions:
In the MAPP survey, Spanish patients differed from other EC in several characteristics, including comorbidities, extent and distribution of psoriasis lesions, perception of severity and impact on quality-of-life. Their perception of psoriasis severity was higher despite a lower estimated extent, and DLQI scores were significantly lower. Spanish patients had more HCP visits and a higher rate of therapeutic goal achievement. These differences might be attributed to cultural factors, phenotypical variation and differences in HCP access.

Hi everyone, 

I wanted to introduce myself. I've had psoriasis for about 30 years, started as guttate and progressed into plaque. It's pretty much everywhere - scalp, arms, legs, front, back, ears, and even little bits on the palms of my hands. I'd been taking MTX, 10mg a week for about a year, and that had damped it down a bit. Still having flareups while on it, including a recent one which has been the mother of them all. The itching and burning is driving me mad, and it's having quite a serious affect on my mental wellbeing. 

I have my regular appointment at the hospital with the derm tomorrow (in the UK), and I'm really keen to try Taltz after what I've read about it. I wondered if anyone else is in the UK here, and managed to get it? I'm worried my request is going to get turned down. 

Any help would be very welcome.