Hello everyone

I have had psoriasis since I was 15 im now 31 .....tried most creams/ointments nothing much worked until my dermatologist put me on methotrexate...this was great but I had terrible side affects, I have heard lots of good things about stelara.
I think at my next dermatolgy appointment I will ask to go on this as Im currently having an awful flare up.
Jenna 

Here's another Bio going for FDA approval. Guselkumab targets the protein interleukin (IL)-23.

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Janssen Biotech, Inc. (Janssen) announced today the submission of a Biologics License Application (BLA) to the U.S. Food and Drug Administration (FDA) seeking approval of guselkumab for the treatment of adults living with moderate to severe plaque psoriasis. Guselkumab is a human monoclonal antibody that targets interleukin (IL)-23, a protein which has been shown to play a key role in the development of immune-mediated inflammatory diseases. Psoriasis is a chronic, autoimmune inflammatory disorder that results in the overproduction of skin cells, characterized by raised, inflamed, scaly, red lesions, or plaques, which can cause itching, discomfort and pain. It is estimated that 7.5 million Americans have psoriasis, which can range from mild to severe and disabling.

"We are committed to translating scientific advances into innovative therapies for chronic immune-mediated diseases like plaque psoriasis," said Newman Yeilding, M.D., Head of Immunology Development, Janssen Research & Development, LLC. "We look forward to working with the FDA during the agency's review of the application as we believe guselkumab addresses continued needs of patients living with moderate to severe plaque psoriasis."

Data from four studies evaluating the efficacy and safety of guselkumab administered by subcutaneous injection in the treatment of adults living with moderate to severe plaque psoriasis served as the basis for the submission. These studies include VOYAGE 1, VOYAGE 2 and NAVIGATE Phase 3 studies, and the X-PLORE Phase 2 study, which appeared in The New England Journal of Medicine in July 2015. Results from the VOYAGE 1 study were recently presented at the European Academy of Dermatology and Venereology congress, and results from the VOYAGE 2 and NAVIGATE studies are planned for presentation at upcoming scientific congresses.

One for the DMF Gang. Ask them on Psoriasis Club, we have a few of them willing to give a personal experience.

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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.

More good news for Cosentyx and it's use for psoriatic arthritis.

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Novartis announced today new data showing Cosentyx® (secukinumab) delivers sustained improvements in the signs and symptoms of psoriatic arthritis (PsA) over three years - including patient-reported pain. These findings were presented at the 2016 Annual Meeting of the American College of Rheumatology (ACR) in Washington DC, United States, at which Novartis presented 28 abstracts in total.

Cosentyx is the first approved fully human interleukin-17A (IL-17A) inhibitor to demonstrate   three-year efficacy in patients with PsA, a life-long inflammatory disease that affects the skin and joints. Cosentyx is also the only IL-17A inhibitor indicated for ankylosing spondylitis (AS), PsA, and psoriasis - this is significant as up to eight in 10 patients diagnosed with PsA already have psoriasis.

"Joint pain severely impacts the lives of many people living with psoriatic arthritis. The knowledge that Cosentyx delivers lasting pain relief, reduces swelling and helps keep joints moving is important as it means it could help improve both patient overall quality of life and mobility," said Vasant Narasimhan, Global Head, Drug Development and Chief Medical Officer, Novartis. "Cosentyx provides much-needed pain relief and also delivers high and long-lasting skin clearance for psoriasis, which the majority of people with psoriatic arthritis also suffer from."

In the first year of the three-year open-label extension study, which is a continuation of the two-year double-blind study previously reported, 77% of PsA patients achieved an ACR 20 response (American College of Rheumatology response criteria) with Cosentyx. Completion rates for the extension study were high with 95% patients completing the first year of the extension trial. These new data show that response rates were consistent from Year 1 (69.4%) to Year 3 (76.8%) and this was independent of whether patients received an anti-TNF prior to receiving Cosentyx. Importantly, a component of this measure includes patient-reported pain. Cosentyx has previously shown 79% of AS patients achieved an ASAS 20 response (Assessment of Spondyloarthritis International Society response criteria) at two years. Previous data also show up to 80% of AS and 84% of PsA patients treated with Cosentyx at two years had no radiographic progression in the spine or joints respectively, as shown by X-ray assessment. Cosentyx continues to have a favorable safety profile, which was consistent with that shown in Phase III studies.
                                             
In addition, analyses, using Matching-Adjusted Indirect Comparison (MAIC) presented at ACR show Cosentyx may improve the signs and symptoms of AS and PsA more than Humira® (adalimumab). In a new MAIC for AS, the ASAS 20 response rates at Week 52 were higher for Cosentyx (74%) than for Humira® (65%). Likewise, in the MAIC for PsA patients, ACR 20 response rates at Week 48 were higher for Cosentyx (72%) than for Humira® (56%).

Following these MAIC analyses, Novartis plans to initiate new head-to-head clinical trials to directly compare Cosentyx versus Humira® in patients with AS and PsA. These will include 850 patients and will be the first ever adequately powered head-to-head studies with biologic medicines to differentiate the effectiveness of treatment in these conditions.

This study evaluated the long term trends of biologic use outside the realm of clinical trials. The following Bio's were used.
Enbrel (etanercept)
Humira (adalimumab)
Remicade (infliximab)
Stelara (ustekinumab)

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Background/Objectives:
Data on biologic drug survival in real-world psoriasis treatment are limited. There is a need to evaluate long-term trends of biologic use outside the realm of clinical trials.

Methods:
A multicentre chart review was conducted with patients' data from September 2005 to September 2014. Kaplan–Meier plot analysis was used to determine 5-year drug survival rates. A log–rank test was used to compare the rates of drug survival between the studied biologics.

Results:
For the 398 patients and 545 treatment series analysed, 1, 2, 3, 4 and 5-year survival rates were 0.826, 0.687, 0.563, 0.475 and 0.420 with etanercept; 0.804, 0.648, 0.553, 0.508 and 0.508 with adalimumab; 0.838, 0.664, 0.554, 0.485 and 0.382 with infliximab; and 0.914, 0.856, 0.800, 0.755 and 0.755 with ustekinumab, respectively. A statistically significant difference was seen between ustekinumab and the other three biologics.

Conclusion:
A progressive decrease in treatment adherence was seen with all four biologics, as expected, but the survival rate of ustekinumab was highest.

This small study of 90 patients with psoriasis was conducted to assess the presence of entheseal abnormalities as detected by ultrasound, and to determine any correlation with nail involvement.

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Background:
Although subclinical enthesopathy is a well-established diagnostic criterion for psoriatic arthritis (PsA), it is frequently overlooked, as many patients are asymptomatic. The possibility of finding a clinical clue predicting enthesopathy would help clinicians establish an early diagnosis of PsA.

Material and methods:
A prospective single-center study of a total of 90 patients with psoriasis was conducted to assess the presence of entheseal abnormalities as detected by ultrasound, and to determine any correlation with nail involvement.

Results:
Entheseal abnormalities were found in 23 patients (25.5 %), 19 (82.6 %) of whom showed nail involvement, whereas four (17.4 %) individuals did not. Enthesopathy was present in 31.1 % (19/61) of patients with onychopathy compared to 13.8 % (4/29) of those without nail involvement (p = 0.07). There was a significant correlation between target NAPSI score and evidence of enthesopathy. In addition, the number of nails affected also showed a significant correlation with the presence of enthesopathy (p  = 0.035).

Conclusions:
Clinical evidence of onychopathy may be the clue to an early diagnosis of enthesopathy in psoriasis patients.

Hi I am Jen. I've had psoriasis since I was 10 years old (now 40). I've got guttate, plaque, inverse, scalp,PsA, and I had bout of Von Zumbusch.

Since it's been 30 years, I've been on a million different creams, ointments, etc. I'm currently only using topicals but I'm planning to return to biologics. I'm in the midst of a horrible flare.

Beyond psoriasis, I am a mom to two kids, a wife, a school paraprofessional to a girl with CP, and an avid reader.

Hey Everyone! 

Just made an account, was recently diagnosed with Palmoplantar Pustulosis Psoriasis. I've had this now for about 3 months, it only affects my hands and feet. 

My finger nails on one hand have the typical excess skin under the nail forcing the nail off etc and my hands are peeling, red, itchy but not really sore. 

My feet however are where the real problem is, I have several lacerations and new ones opening on a regular basis making it extremely difficult to walk and i'm in quite some pain no matter what i'm doing with my feet.

I'm only 23 and this just kind of came out of nowhere, i don't mind the aesthetics, I guess i'm lucky in that not many people see your feet but even the finger nails and hands it's not a big deal for me, the issue is with the effect it is having on my quality of life, I train MMA 5 days a week, I cycle a lot I walk places etc and I haven't been able to train for nearly 3 months now, it's getting me down not to mention the pain of just walking around in every day life.

Any advise or tips for dealing with this would be much appreciated, thanks!!

Hi, my name is Emir. I am 17 years old and bave been living with psoriasis since i was just 2, back in  2001. I got diagnosed cause od stress , a dog attack. I have  been able to cut my psoriasis down to just my elbows, knees and feet  However... For 3 Years i faintly belive my doctor that i have  foot fungus which is extremely painful. I was able to Pierce the skin and get all of the green pus run out. After it appears,it lasts a few days , turns brown and i Peel off all of my skin. It grows back and after about a month or less comes back. I am attatching photos so you Guys can  see ,comment and share your experiences, perhaps even diagnose or Help me. Thanks in  advance

I am a woman 58, just was diagnose of psoriasis... not 100%   , but very close, going to see dermatologist next week..
I am covered by terrible red spots (a lot!) - hands look ugly, legs too, but other parts of the body start to show these red spots... Feel very frustrated..How can i go to south vacation - i look scary for people.

Hello everyone

I find there is not much information about Acitretin when it comes to treating disorders other than psoriasis.
I have been suffering from seborrheic dermatitis and folliculitis on the scalp and chest for about 10 years, I am a 25 year old male.

My folliculitis is whats bothering me the most. I have been on Tetralysal before which did not help me and I just got prescribed Acitretin 10mg to take every day. 
I'm sorry if my question is not fit for this forum but does anyone here have any information or experience when it comes to treating these disorders with Acitretin?

Anyone taking Consentyx every experience at Hairloss, about to take the drug and wondering if this is one of the side effects.

I am about to start consentyx and I am a 37 year old male.  We are planning to have our second child and wondering if this affects a man in conceiving or the baby

I have very minor psoriasis (it is never thick, doesn't flake and I've never had a patch much bigger than a coin) and less than 1% of my body is covered  but recently I have noticed I am getting small pimples appear on my legs, mainly on the calves. If I didn't have psoriasis I wouldn't be at all concerned about them but because I do and have heard about pustular psoriasis I'm wondering if that is what it is. 

The only treatment I've had for psoriasis is topical creams, namely Dovonex and Dovobet.  I use Dovobet once on Saturdays and Sundays and Dovonex twice a day on week days. I know a side effect of topical steroids is folliculitis and I'm wondering if it's that? I have noticed there has been a hair coming directly through the middle of the pimple a few times but it's not always the case as you can see in the pics. I have to admit I sometimes lightly prick these pimples with a sterilised needle and gently squeeze them after which they disappear after a few days. I've never had more than two at any one time but a new one will pop up every few days or so.. 

Here is a couple of pics of two different pimples on the back of each leg. 

Hi, I thought I would join this club as I am starting Cosentyx tomorrow (Nov 2/16).  I have heard and read lots of good things about this drug.  I have been a psoriasis suffer for most of my adult life (30 years +).  I have tried all kinds of topical ointments and have done lots of UV treatments,  nothing seems to work.  I use Olux-E Foam for the itch.  I have not been able to use biologics because I have kidney failure.  Cosentyx seems to be easier on the body so I have finally got the ok to use it.  I am looking forward to seeing what it can do for me.  Hoping everyone on here continues to get relief.

Hi everyone! Hope you are all well 

So I am a 25 year old from London, and for three years ago i came up with a really small patch of psoriasis. At the time I didn't think anything of it. It went away (lived quite a healthy lifestyle etc).


This year i have come up with psoriasis quite badly- at first it was only on my elbows (plaque) and a think patch on my leg and lower back. I started using dovabet, but I also started getting guttate spots all over. Now it has spread to my face, scalp, arms, legs, back and is even on my...well yeah sorry for too much info!!

Currently having photothreapy three times a week but its still coming up so probably going on Cyclosporine  in a couple of months after the photothreapy (which is scary so any experiences would be appreciated!!)

I guess the reason I am posting here is that I am finding it difficult to come to terms with - I know there are so many worse things out there and I should consider myself lucky, but I can't help feeling very UNlucky - i just look around at all my friends, colleague, people on the tube, and wonder how come everyone else is fine and I've got psoriasis - i cant even really cover the scars on my face that well! I haven't always treated myself well, and I have been a smoker for years, so I guess I feel like it is my fault and i deserve it - none of my family have it and i just can't understand how has happened. I feel really sad but I am embarrassed to talk to much about it because I feel like my friends do not understand and think i am just being a self indulgent, vain, narcissist - does anyone else feel like this??

Any tips on how to come to terms with the fact I will be living with this forever, or any treatment suggests/ experience would be really appreciated  

thanks!!

Good news for those in the UK waiting for Taltz The National Institute for Health and Care excellence (NICE) are about to approve it for use on psoriasis patients.

The key dates for this appraisal are:

Closing date for comments: 22 November 2016

Second appraisal committee meeting: 25 January 2017

Until final guidance is issued, NHS organizations should make decisions locally on the funding of specific treatments.

Source: nice.org.uk

Taltz (ixekizumab)

Hi all and thank you for having me. I have suffered from plaque psoriasis for over 10 years now. Glad to find a group to share experiences, hope and treatment options with! I took a year off from my Stelara treatments, and just resumed them. Got my first injection last month at the doctor's office, and my booster today. I can honestly say that NOTHING has worked for me the way the Stelara does. Thank God my insurance pays for it.

This study looked at the difference between early (before 40) and late (after 40) onset of psoriasis and suggests they are different.

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Background:
There is accumulating evidence that early-onset psoriasis (EOP; presenting at or before 40 years of age) and late-onset psoriasis (LOP; presenting after 40 years of age) are different diseases.

Objectives:
We aimed to identify potential clinical and immunocytochemical differences between EOP and LOP.

Methods:
We assessed immunocytochemistry in involved (PP) skin and uninvolved skin (n = 31) and demographics, psoriasis phenotype and psychological parameters (n = 340) in a cross-sectional study.

Results:
Immunocytochemistry revealed (17 EOP, 14 LOP) a greater lymphocytic infiltrate in PP skin of EOP compared with LOP (P = 0·03), with a higher epidermal CD4+ : CD8+ ratio in LOP (1·3) compared with EOP (0·5) (P = 0·002). In 340 patients with psoriasis (278 EOP, 62 LOP), we found an association with a positive first or second degree family history of psoriasis [62·0% vs. 35·6%, adjusted odds ratio (OR) 8·32, 95% confidence interval (CI) 1·90–36·52] and a higher likelihood of having parents with EOP (adjusted OR 10·34, 95% CI 1·32–81·83) in the EOP group. Patients with EOP were more likely to have received biological therapy (13·3% EOP vs. 3·5% LOP, P = 0·042), while patients with LOP had a higher likelihood of having type 2 diabetes (adjusted OR 3·43, 95% CI 1·004–11·691) and autoimmune thyroiditis (adjusted OR 5·05, 95% CI 1·62–15·7). Patients with LOP also had greater anxiety than patients with EOP (mean Hospital Anxiety and Depression Scale-A score LOP 8 ± 5, EOP 5 ± 5; P = 0·006).

Conclusions:
Our findings provide further evidence for the difference between EOP and LOP.

Another feather in the cap for Cosentyx

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Novartis has been awarded the prestigious 2016 Prix Galien USA Award for Best Biotechnology Product for Cosentyx® (secukinumab), as well as the Prix Galien Foundation "Discovery of the Decade" Award for Best Pharmaceutical Product for the drug Gleevec® (imatinib mesylate). The awards were presented at a ceremony in New York City on October 27.

"We are honored to receive these prestigious awards for Cosentyx and Gleevec, which not only have changed the practice of medicine for certain conditions, but also represent years of hard work by our scientists," said Joseph Jimenez, CEO of Novartis. "These wins underscore our commitment to addressing the unmet medical needs of patients through science-based innovation."

Cosentyx was the first fully human interleukin-17A (IL-17A) antagonist approved by the US Food and Drug Administration (FDA) in 2015 for the treatment of adults with moderate to severe plaque psoriasis1. Psoriasis affects an estimated 7.5 million people in the US2. It is a chronic immune-mediated disease characterized by thick and extensive skin lesions (plaques), which can cause itching, scaling, and pain2. Cosentyx was also approved for the treatment of active ankylosing spondylitis and psoriatic arthritis in 20161.

The discovery of Gleevec marked the first time in the history of cancer treatment that scientists were able to identify a chromosomal abnormality and then develop a drug that would target that specific protein. Gleevec, a molecularly targeted treatment, rapidly became a therapy of choice for Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) and KIT (CD117)-positive gastrointestinal stromal tumors (KIT+ GIST)3. By showing that certain diseases can share a drug-sensitive target with seemingly unrelated ailments, and that molecular targeting can be medically and commercially successful, Gleevec helped establish a new paradigm for drug development.

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About the Prix Galien Awards

Considered "the pharmaceutical industry's Nobel Prize," the Prix Galien rewards excellence in scientific innovation that improves the state of human health. The award was first established in 1970 by French pharmacist Roland Mehl and was inaugurated in the United States in 2007 to recognize the technical, scientific and clinical research skills necessary to develop innovative medicines. Since 1970, Novartis has received more than 40 national Prix Galien awards in fifteen countries for innovative therapies such as Gleevec® (imatinib mesylate), Rimactane® (rifampin), Parlodel® (bromocriptine mesylate), Sandimmune® (cyclosporine), Sandostatin® (octreotide acetate), Simulect® (basiliximab) and Visudyne® (verteporfin)4.

The "Discovery of the Decade" is a special once-in-10-years recognition for distinguished industry achievement in medical innovation. The awards honor extraordinary human health impact in three categories - Best Pharmaceutical Product, Best Biotechnology Product, and Best Medical Technology. In addition to Gleevec® (imatinib mesylate), two other Novartis products were nominated for "Discovery of the Decade," including Coartem® (artemether/lumefantrine) for Best Pharmaceutical Product and Promacta® (eltrombopag olamine) for Best Biotechnology Product. Gleevec won the Prix Galien International Prize in 2002, and was recognized again in 2009 by the Prix Galien USA committee for "Best Pharmaceutical Product"5.

About Cosentyx and interleukin-17A (IL-17A)

Cosentyx is a fully human monoclonal antibody (mAB) that selectively binds to the interleukin-17A (IL-17A) cytokine and inhibits its interaction with the IL-17 receptor1.

Cosentyx is approved in more than 65 countries for the treatment of moderate to severe plaque psoriasis which includes the European Union countries, Japan, Switzerland, Australia, the U.S. and Canada6. In the U.S., Cosentyx is approved for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy (light therapy). Cosentyx is also approved in the US for adult patients with active ankylosing spondylitis and active psoriatic arthritis1.

More than 10,000 patients have been treated with Cosentyx in clinical trial settings across multiple indications, and over 50,000 patients have been treated in the post-marketing setting worldwide7.