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.

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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).

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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.

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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.

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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

This study suggests exposure to maternal bereavement may contribute to the development and/or exacerbation of psoriasis.

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Background:
Prenatal stress may alter immune competence of the fetus. Limited data exist on the role of antenatal stress in psoriasis development.

Objectives:
To investigate whether prenatal exposure to maternal bereavement increases the risk of offspring psoriasis.

Methods:
This register-based cohort study included 1 811 917 live singletons born from 1978 to 2008 in Denmark. The children were assigned to the bereaved group if their mothers lost a child, partner/spouse, parent or sibling during pregnancy or up to 12 months before pregnancy. Follow-up started at the date of birth and ended at the date of first hospital treatment for psoriasis or a prescription redeemed for topical vitamin D derivatives (often used to treat psoriasis), emigration, death or 31 December 2010, whichever came first. We evaluated the hazard ratio (HR) of psoriasis in bereaved children using Cox proportional hazards regressions, compared with the nonbereaved group.

Results:
During 28 million person-years of follow-up, 7956 children were hospitalized or prescribed medications for psoriasis. By the age of 30 years, 1·54% [95% confidence interval (CI) 1·25–1·90%] of children from the bereaved group were diagnosed with psoriasis, compared with 1·34% (95% CI 1·30–1·38%) of nonbereaved children. Overall, prenatal exposure to maternal bereavement was not associated with risk of psoriasis in general (HR 1·05, 95% CI 0·91–1·20). However, children born to mothers who lost a partner/spouse or an older child had an increased risk of psoriasis (HR 1·33, 95% CI 1·02–1·73).

Conclusions:
Prenatal exposure to the most stressful life event may contribute to the development and/or exacerbation of psoriasis.

This small study suggests that Humira is a safe option for psoriasis patients with concomitant hepatitis B or C infection.

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Background:
Little data are available about the safety of TNF-α inhibitors in patients with HCV and HBV infection. In particular, data concerning the use of adalimumab in patients with psoriasis and concomitant viral hepatitis are lacking and little is known about the drug's real safety in this context.

Objective:
To assess the long-term safety of adalimumab in a group of 17 consecutive psoriatic patients affected by chronic HBV infection and 20 consecutive psoriatic patients affected by chronic HCV infection.

Methods:
Thirty-seven consecutive patients with psoriasis and concomitant HBV or HCV infection being treated with adalimumab at four Italian referral centres (Modena, Padova, Verona and Turin) were assessed before the treatment and at the end of follow-up. Viral load and radiological studies (echography, Fibroscan) were also carried out in some of the patients.

Results:
The patients responded well to treatment and did not show any HBV or HCV reactivation in a mean follow-up period of 27 and 40 months, respectively. The fibrosis score in eight HCV patients showed a slight reduction: pretreatment mean value 5.83 and post-treatment mean value 5.65.

Conclusion:
The use of adalimumab seems to be safe in patients with severe psoriasis and HBV or HCV infection. Nevertheless, large-scale prospective studies will be able to provide vital information on the impact of anti-TNF treatment on hepatic function in patients with psoriasis and concomitant chronic HCV or HBV infection and appropriate monitoring scheduling.

This study looked at Hashimoto's thyroiditis in psoriasis. Hashimoto's thyroiditis is an autoimmune disease where the thyroid gland is gradually destroyed.

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Background:
Current information indicates that psoriasis is a metabolic disorder with systemic manifestations. Reports have revealed an association between psoriasis and several chronic autoimmune disorders. For one of these disorders, Hashimoto's thyroiditis (HT), there are scarce, and relatively unconfirmed, reports of an association with psoriasis. We sought to determine if such an association is detectable in a large medical record data repository.

Methods:
We searched one institution's electronic medical record data repository from January 2010 to December 2013. Patients were identified by ICD-9 codes (psoriasis: 696.0; 696.1, HT: 245.2). Only data from patients with laboratory-confirmed HT (anti-thyroid peroxidase [anti-TPO] antibodies; thyroglobulin antibodies; serum thyroid-stimulating hormone; and free T3) were eligible for inclusion. Logistic regression analysis was used to obtain an odds ratio (OR) to establish an association between psoriasis and HT. Stratified analyses were performed to test for confounding variable and effect modification.

Results:
Medical records for 856,615 individuals with documented encounters between January 1, 2010, and December 31, 2013, were detected. A total of 9654 had a diagnosis of psoriasis, and 1745 had a diagnosis of HT. Of these, 41 subjects were diagnosed with both conditions. A significant association existed for psoriasis and HT, even after adjusting for confounding variables that included gender, age, psoriatic arthropathy, and the use of systemic anti-psoriatic agents (OR = 2.49; 95% CI 1.79–3.48; P < 0.0001).

Conclusions:
This association has broad clinical impact and deserves further attention with regard to patient care, clinical research, and developmental therapeutics.

Hey Guys ... totally found you by accident today.  This morning I did my second loading dose of Cosentyx and I was googling info on how long it took for people to see results and found this board.

My psoriasis started in my teens and I've had a pretty nasty go with it.  I developed PsA in my early 30's and was slammed so badly, I thought my life would be lived in agony from a wheelchair.  At that point, I was put on MTX and did infusions for close to a decade, I moved to Simponi and that was ok, but my body got used to it.  Apremilast (Otezla) does less than zero for both my skin and joints, and last Monday I did my first loading dose of Consentyx.  This morning was my 2nd loading dose (I'm doing 300 mg.).

Popped on here before for the first time and started looking around to see how this has worked for people.  I think my skin is actually reacting already. My joints are still abominable - my coccyx, at the base of my spine is a painful mess. 

Can't wait for some relief!  Will let you all know how I do.  I didn't take pics last week, but I think I'll start doing that and posting.

Julie

Hi guys and girls

Just wanted to say a formal hello and thank you all for the info ive read and the info i will be reading in the future. Heres a breif description about me.

Like you guys i haave the dreaded P' as you call it.. ive suffered for aout 10 years now...living with it as just a mild issue but over the past few years it has progressed into a nightmare..

2 years ago i had light thereapy and it worked..i also went abroad shortly after and it basically disapeared..2 years later it is back with a vengance...ill post pics once i get used to all this.

I have no idea's about what triggers my P but im a scratcher...i have a very bad diet..i eat all the crap we shouldnt and i think thats my 1st priority to help this and also my weight gain.

I could try and blame alot of things...the 4 kids...the nagging fiance...the job that i do....

But i blame myself for being lazy and not trying harder with  this situation..

But things are about to change...i hope you guys can help and i hope that i can also help you guys in some way.

Big hello from me !!

Hi everyone,

Took my loading dose of humira  a week and a half ago so just thought i'd see what other peoples experiences with the drug are.

I had to stop cyclosporine just after xmas as id been on it for too long, i was gutted about this as it had worked for me with amazing results. Instantly had a MASSIVE flair which has only just calmed down.
I've really struggled this past couple of months mentally, i think having been used to being psoriasis free for the best part of a year it was such a shock to the system to be covered head to toe  within a couple of weeks of stopping. I really took it for granted being clear, its hard to explain how it effects EVERY single thing you do in day to day life.

Anyway enough of the depressing stuff, I'm trying to stop feeling sorry for myself now that I've started the new medication but I've seen no difference whatsoever, i know its only been couple of weeks but there has been nothing, the cyclosporine worked so quickly!

I realise I'm just being very impatient but was just wondering if there were others that had tried humira and if it had worked for them?

Thanks for reading
Jamie

Hi friends,
I just signed on 2- 20 - 17.
74 year old white male.
Psoriasis patient for 55 years.
Treatments back in the 60s were scarce.
Coal tar, baths with various oils, oat meal, etc.
Then came UVA light treatments and methotrexate
Then psoralen capsules were added to UVA treatments and those PUVA treatments helped control my psoriasis until about 3 years ago.
UVB helped some more then even that lost effectiveness.
5 years ago I was infected with Lyme disease. That screwed everything up.
Last year I finally agreed to try a biologic. 
I started Humira in February of 2016. It worked very well and I tolerated it well. It helped my psoriatic arthritis too.
2 months ago Humira began to fail. I start Taltz in 2 weeks.
Here's hoping it will help.
Phil

This study looked at the risk of depression, suicidal ideation, and suicide attempt in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis patients.

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Background:
Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS) patients.

Objective:
To estimate risk of depression, suicidal ideation, and suicide attempt in patients with psoriasis, PsA, and AS, respectively, compared with the general population.

Methods:
This population-based cohort study analyzed 36,214 psoriasis patients, 5,138 PsA patients, and 1,878 AS patients who were frequency-matched with a general population cohort. Annual incidence rate of depression, suicidal ideation, and suicide attempt was calculated separately for psoriasis, PsA and AS.

Results:
There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt among psoriasis, PsA, or AS patients.

Limitations:
Patients were not excluded if previously diagnosed with depression, suicidal ideation, or suicide attempt. Suicide attempt and completed suicide analyses were not adjusted for presence of depression. Use of systemic psoriasis treatment to measure severe psoriasis could lead to psoriasis severity misclassification.

Conclusion:
The risk of depression, but not suicidal ideation or suicide attempt, was significantly increased in patients with psoriasis, PsA, and AS.

This study looked at psoriasis patients preferences for attributes of biological treatments.

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Background and objectives:
Treatment satisfaction can be improved by integrating patients’ preferences into shared decision-making. We recently investigated patients’ preferences for attributes of biologicals, and showed high preferences for safety and efficacy. The objective of the present study was to assess the impact of treatment experience on these preferences.

Patients and methods:
Preferences for outcome (probability of 50 % and 90 % improvement, time until response, sustainability of success, probability of mild and severe adverse events, probability of ACR 20 response) and process attributes (treatment location, frequency, duration, and delivery method) were analyzed in 200 participants with moderate-to-severe psoriasis using conjoint analysis. The impact of current and previous therapies, disease duration, and treatment satisfaction on ‘Relative Importance Scores’ was determined by analysis of variance, post hoc tests, and multivariate regression.

Results:
Participants presently on topical therapy (p = 0.02) or phototherapy (p = 0.032) placed more importance on treatment duration than others. Individuals who had previously been given traditional systemic agents (p = 0.028) or biologicals (p = 0.044) favored sustainability more than others. With an increasing number of systemic agents ever received (p = 0.045) and longer disease duration (p = 0.018), the latter attribute became increasingly important.

Conclusions:
Patients’ preferences for biologicals vary in correlation with treatment experience and disease duration, aspects to be addressed in the context of shared decision-making.