Hi all! my Otezla arrived today I take my first tablet tomorrow A.M!!......I will keep you all updated!!

This small study looked at the levels of High mobility group box 1 protein (HMGB1) in patients with psoriasis. It showed an increased level of HMGB1 in patients with psoriasis and suggests that levels are significantly increased with disease progression and are down regulated after standard therapies.

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Background:
Psoriasis vulgaris (PV) is an autoimmune-related chronic inflammatory disease, which appears mostly in skin, but also affects the vascular and metabolic system. The incidence of PV is 2–3% in the general population and there is still no possibility to cure. Trigger factors have been identified to initiate and maintain inflammation in the skin, which is characterized by Th1-, Th17- and Th22- cells.

Objective:
We hypothesize that the damage-associated molecular pattern (DAMP) molecule high mobility group box 1 (HMGB1) plays a role in the pathogenesis of PV. HMGB1 is a DNA-binding protein located in the nucleus, which acquires cytokine-like properties once released from the cell upon necrotic cell death or actively secreted by immune cells in inflammation and cancer.

Methods:
We recruited 90 psoriatic patients under and without therapy with mild, intermediate and severe progression of disease, defined by the Psoriasis Area Severity Index. Serum levels of HMGB1 in patients with PV were detected by enzyme-linked immunosorbent assay (ELISA).

Results:
Our results show an increased level of HMGB1 in the sera of patients with PV in comparison to healthy donors. Furthermore, our analyses reveal that HMGB1 levels are significantly increased with disease progression and are downregulated after standard therapies for PV have been conducted.

Conclusion:
Our data provide insights into a possible role of HMGB1 for inflammation in PV.

Hi, my name is Inge and I'm from Belgium. I have an 8 year old daughter Nore.
When she was 4 years old she had, after the separation from me and her father, a first time psoriasis. The dermatologist immediately asked if Nore had experienced something emotionally . We got all kinds of ointments prescribed with cortisone. Over the last 4 years she got some scabs on her head and face, not heavy till last december. It started with a spot here and there but during the holidays it got much heavier. Head, face, , back, sides, belly and legs. This is accompanied by severe itching this time. I don't want to use cortisone. 
Does anyone here has a child that has psoriasis? Does anyone have some advice...again, I do not want to use cortisone. Thanks a lot for your help!

YHello everyone . Have any of you got any tips or suggestions for a good diet to help with the dreaded p.

Hope I've posted this in the right place.I've suffered with psoriasis for the past 10 years and psoriatic arthritis for the last 7 years.I've managed to control the psoriasis for most of the 7 years due to injecting methotrexate then moving onto humira.Also taking other medication.For the last month ive been poorly with one thing or another and yesterday a trip to the doctors with me being covered head to toe in spots to be told its guttate psoriasis.apparently brought on by tonsillitis just wondered  if anyone else has experienced this and why humira doesn't seem to have stopped it.

Hi all
Stumbled upon this forum at lunch time and you seem like a happy bunch, so thought I'd give it a go. Never done a forum before so please excuse if I drop the odd clanger. I've had P for about 13 years (I have always been a late starter). Sadly non of the topicals or UV have had any success. Sort of wrestling with the thought of hitting the 'hard' stuff now.

Hello

Back again on behalf of my 77 year old  husband, desperate for help and to find out if anyone has had anything similar experience wise. Fumaderm started in July and built up to full dose - 2x monthly blood tests - took a while, but the psoriasis did subside. In October consultant found blood in urine and sent us to the GP who thought it was an infection. Saw  consultant on 9th and again blood in the urine.  He then said he would refer to a haematologist. I then got a letter yesterday saying my husband had been referred to the Nephrology Team and the Heamaturia Clinic - the figure from the Urinalysis PCR showed protein to creatine ratio 72 - I think it should be below 30? My husband also has anaemia and low sodium.
I was somewhat surprised to read that proteinuria is a very rare side affect of Fumaderm. The Dermo has asked the Clinic Consultant Nephrologist if my husband should continue to take the Fumaderm but has said to stay on it until he hears back. I am concerned because my husband also has Lupus which I think puts him at higher risk anyway of kidney problems yet I do not want him to come off the Fumaderm unless really necessary.
GP is also suggesting a bladder scan - he also did extra tests on Tuesday for something but laughingly said he would not tell me what he was testing for because I would only 'google it'. !!!! My husband is 77 and weighs less than 8st - lost 3st since the Summer so I do not honestly think I am being neurotic. These test results seem to suggest a potential kidney problem to me! Also the blood test end of December showed a borderline Urea result and that is the one the GP wanted re tested. I am struggling to try and work out how these medical people work together and who is responsible for what! I guess I just wait for the appointments to come through and take it from there? I cannot easily go with my husband although he is quite deaf, because the ambulance service won't take me and a taxi would be £70 return. I think I will phone when I get the appointments and ask exactly what is going on because if he does have kidney disease and advice is given on how to manage it, I think I may well need to be there with him. Sorry for rant - basically I know some of you have been on Fumaderm long term and wondered how common this is or could it even be totally unconnected and more likely due to the Lupus. On the bright side, maybe the consultant is just being cautious and if there is kidney disease it is very mild. Thanks for reading.

Good morning all. Just a quick question, have any of you guys tried nappy or for my American friends diyper cream,, excuse my spelling

Hi guys.. If I haven't met you yet I'm Danny from England, I've had p for 16 years I'm about 60 percent covered and started aceterin 7 weeks ago,, 20 mg a day,, so far p is getting worse.. I was wandering if any of you have found that alcohol causes you to flare, I'm not sure, then again I do like a beer or two as I work in a brewery  Look forward to hearing your feedback
            
                        Danny

well i've not been on for a while and oh boy what a journey i've had was told i had P originally by one of my local gp's but because of nhs cuts, didn't give me anything on prescription and sent me away to try other forms of treatment (diet change etc etc). anyway that didn't work so i went to see another gp, who decided he thought i had a fungal infection not P!, tried several creas and potions, nothing worked. so today i decided to see a different doctor, new to the practise so i thought why not, after an examination he confirmed yes it's definately P and sent me away with a hefty perscription dovonex ointmement, dovbet gel and diprosone lotion for the various different areas and 2 of each item, which is unusual for my doctors. so lets hope this starts to clear up some of these areas and i can get things under control.

This study looked at the risk factors of total hip arthroplasty (replacement) in patients with psoriasis.

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Objective:
Outcomes of total hip arthroplasty (THA) in patients with psoriasis have been poorly studied. This study was undertaken to assess whether patients with psoriatic arthritis (PsA) or those with cutaneous psoriasis (PsC) without evidence of inflammatory joint disease are at an increased risk for worse outcomes after THA as compared to patients with osteoarthritis (OA).

Methods:
Among subjects in a prospective THA registry, PsA and PsC cases were identified by International Classification of Diseases, Ninth Revision codes, and all cases were matched with patients with OA as controls. Analyses were performed to identify predictors of poor postoperative pain or function.

Results:
Of the 289 potential cases of PsA or PsC, 63 with PsA and 153 with PsC were validated. Self-report data were available postoperatively from 75% of PsA patients, 69% of PsC patients, and 94% of OA controls. In total, 51% of PsA patients and 56% of PsC patients were male, compared to 45% of OA controls (P = 0.04). Body mass index was higher in those with PsA or PsC (P = 0.002 versus controls). There were no differences in race or education between the 3 groups. PsA patients and PsC patients had more comorbidities than OA controls. PsA patients were more likely than PsC patients and OA controls to be current or previous smokers. Moreover, 54% of PsA patients were being treated with biologics or nonbiologic disease-modifying antirheumatic drugs, compared to 8% of PsC patients. There were no significant differences in pre- or postoperative Western Ontario and McMaster Universities OA Index scores for pain or function between the 3 groups. Short-Form 36 mental component summary scores were significantly better in the OA controls, both pre- and postoperatively (P = 0.006 and P < 0.001, respectively, versus PsA or PsC). EuroQol 5-domain health-related quality of life scores were significantly worse postoperatively for those with PsA or PsC (P < 0.0001 versus OA controls). In regression analyses, neither PsA nor PsC were risk factors for worse THA outcomes. Satisfaction with the outcomes of THA was similarly high among all 3 groups (P = 0.54).

Conclusion:
Neither PsA nor PsC are risk factors for poor outcomes after THA. This is important information to convey to patients with either PsA or PsC who are contemplating surgical intervention with THA.

Hello everyone , I'm Danny from Leeds in England, I've had p for 16 years and started on acitretin 7 weeks ago.. So far it's flared big time but my skins got smoother.. Is the drug working ? Would be glad of any feedback

hi,

ps suffer for 20 years+ (35 age) about 40% body when bad flares. Been using dovobet 10 years but led to blepharitis and rosacea.

if i was a dog they would put me down.

from midlands, uk, would love to share my lovely experience with others lol

Hello All I hail from Vancouver Island, am 54 years old and am very happy to have found this site..! I started this journey in my late 20's after a bout with an unusual strep infec., that was not diagnosed for some time, then guttate and finally trip to dermatologist.
Plaque psoriasis came after 3rd child in late thirties and has plagued me on an off ever since. Stress and traumatic events have been a part of every major outbreak.
Currently, it is the worst it has ever been (feet and legs) and joint pain. This last precursor; major financial change, back to school for a bit, job change, kids leaving home - qualify all this. Except - they are not ceasing or getting better as time goes on!!!! Nasty turn of events and left it some time assuming it would just ease up.
This time I believe menopausal hormone shifts are exacerbating, causing all added fun - both guttate and plaque, lol.
I have seen a new, very young dermatologist with hopes of current discussion regarding treatments etc... funny, ended up with a coal tar treatment to start. This is merely irritating everything, and next appt. is long away. SO - that is where I am at at this moment in time - thanks for reading

Ahh, and last but not least, my mum and grand dad had psoriasis as well...

This is an early view before publication from the Australasian Journal of Dermatology that suggests pine tar is an effective treatment with minimal safety risk for psoriasis and other skin problems.

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Pine tar is the end product of pine wood carbonisation following distillation using extreme heat.

An extensive literature search was conducted back to the 1950s for this review. Pine tar has been used in medicine for more than 2000 years to treat a range of skin conditions because of its soothing and antiseptic properties.

Pine tar should not be confused with coal tar, which has been produced from coal for approximately a hundred years. Pine tar is thought to exert its effect by reducing DNA synthesis and mitotic activity, which promotes a return to normal keratinisation. In addition, pine tar has been shown to be antipruritic, anti-inflammatory, antibacterial and antifungal. These properties make pine tar suitable for the topical treatment of eczema, psoriasis, seborrhoeic dermatitis and other dry, itchy, flaky or inflamed skin conditions. Topical products available over-the-counter in Australia today contain up to 2.3% pine tar, and come in several different formulations that can be used on the entire body, including the face. Modern day pine tar is manufactured with increased purity to eliminate toxic phenol and carcinogenic components, which have been of concern in the past. Primary irritation is uncommon.

In conclusion, the long experience with topical pine tar therapy and its worldwide usage, together with the evidence presented in this review, suggests that pine tar is an effective treatment with minimal safety risk.

Has anyone been swimming with Psoriasis? It's honestly been so long since I've been that I cant remember if it affects it or not

Hello i started on fumaderm a few weeks ago and after some advice please.

The stage I am at just started the second week of the blue 120mg tabs I am taking first tab at 7 am with other meds.

The second I decided to take with dinner at 7 pm . from 4 pm on Monday started suffering from the run's but no pain.

Suffered all throughout the night and stomach pains from 4-5 am . 

Up til now I haven't seemed to have suffered from side effects.

Questions.

1. How can I tell it's the fumaferm or a bug ? As someone had bug last week at work.

2. What's the best times to take fumaderm to avoid side effects.

Any advice would be very helpful.

Thanks

Baz

Following on from the report about Benepali getting a positive opinion from CHMP Benepali biosimilar gets positive opinion from CHMP Biogen have announced they have been granted marketing authorization in the European Union (EU).

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Biogen has been granted European Commission (EC) approval for BENEPALI® , an etanercept biosimilar referencing Enbrel®i. BENEPALI has been granted marketing authorization in the European Union (EU) for the treatment of adults with moderate to severe rheumatoid arthritis (RA), psoriatic arthritis, non-radiographic axial spondyloarthritis and plaque psoriasis. Biogen intends to make BENEPALI available for patients in the coming weeks.

BENEPALI is the first etanercept biosimilar referencing Enbrel to be approved in the EU, making it the first subcutaneous anti-TNF biosimilar available there. Anti-TNF’s are the largest component of the EU biologics market, accounting for approximately $10 billion of all biologics sold there.ii

“The approval of BENEPALI is a significant step forward for patients and physicians, and an important milestone for Biogen as we bring to market the first product from our biosimilar pipeline,” said Alpna Seth, Ph. D., Senior Vice President and Global Head of the Biosimilars Business Unit at Biogen. “As a biotechnology pioneer, Biogen is proud to translate our heritage and expertise in biologics to biosimilars. BENEPALI, as the first etanercept biosimilar referencing Enbrel approved in the EU, can help expand access to treatment options for people affected by chronic inflammatory conditions.”

The EC approval was based on a robust preclinical and clinical data package submitted to the European Medicines Agency by Samsung Bioepis. The data in the preclinical submission leveraged sophisticated molecular analytics, technical development and manufacturing expertise. Confirmatory data from well-controlled, head-to-head Phase 1 and Phase 3 clinical trials compared BENEPALI to its reference product Enbrel.iii, iv The 52-week, double-blind, Phase 3 study randomized 596 patients with moderate to severe RA despite methotrexate therapy, across more than 70 sites in 10 countries to receive BENEPALI or Enbrel in a 1:1 ratio. Analysis of the primary endpoint showed that BENEPALI had equivalent efficacy to Enbrel, as shown by an ACR20 response at week 24 of 78.1% in the BENEPALI arm versus 80.3% in the Enbrel arm. Further analysis at 52 weeks confirmed comparable efficacy as shown by an ACR20 response of 80.8% in the BENEPALI arm versus 81.5% in the Enbrel arm. The safety profile of BENEPALI was comparable to that of Enbrel throughout the study.

“For more than 15 years anti-TNF therapies have revolutionized the care and outlook for patients living with chronic inflammatory diseases such as RA. However, access to these highly-effective treatments has been restricted by high costs," said Professor Peter Taylor, MA, FRCP, Ph. D., Norman Collisson Professor of Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford. "The development of biosimilar drugs is a welcome solution to help alleviate some challenges with access. The newly-approved treatment BENEPALI has similar quality, efficacy, and a comparable safety and immunogenicity profile to Enbrel.”

I read some time ago that there is a short term cure for psoriasis that your doctor could prescribe if you were going on holiday soon for example. I can't remember now what it is called. can anyone help?

Following on from Europe giving the go ahead for Cosentyx to treat psoriatic arthritis the FDA have now given it the go ahead in the U.S

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Novartis announced today that the US Food and Drug Administration (FDA) has approved Cosentyx® (secukinumab) for the treatment of two new indications - adults with active ankylosing spondylitis (AS) and active psoriatic arthritis (PsA). AS and PsA are both life-long, painful and debilitating inflammatory diseases that affect the joints and/or spine. If not treated effectively, both conditions can lead to irreversible joint and/or spinal bone damage caused by years of inflammation.

Cosentyx is the first in a new class of medicines called interleukin-17A (IL-17A) inhibitors to treat both AS and PsA. The two new indications follow the earlier FDA approval for Cosentyx in January 2015 to treat adult patients with moderate-to-severe plaque psoriasis, and European approval for AS and PsA in November 2015.

"These new approvals are a potential turning point for people living with ankylosing spondylitis and psoriatic arthritis in the US, as Cosentyx provides a novel and targeted way of inhibiting the inflammatory process of these two conditions," said David Epstein, Division Head, Novartis Pharmaceuticals. "The results from our studies have shown that the majority of patients treated with Cosentyx have a significant reduction in their signs and symptoms of ankylosing spondylitis and psoriatic arthritis, and show major improvements in their ability to undertake everyday activities."

In the US, it is estimated that up to 0.5% of the population have AS, and up to 1% live with PsA. If not treated effectively, these conditions can lead to irreversible damage to the spine and joints, causing life-long pain and disability that can have a negative impact on even simple tasks in life. There is an urgent unmet need for new medicines for these conditions. Currently many patients are dissatisfied with their treatments, and up to 40% do not respond sufficiently to anti-tumor necrosis factor-alpha (anti-TNFs) therapy.

The approvals are based on the efficacy and safety outcomes from four placebo-controlled Phase III studies, which included over 1,500 adult patients with AS or PsA that were biologic treatment naïve or had an inadequate response / were intolerant to anti-TNFs[1]. In the studies, Cosentyx met the primary endpoints achieving statistically significant improvements versus placebo in the signs and symptoms of AS and PsA, as measured by at least a 20% improvement in the Assessment of Spondyloarthritis International Society criteria (ASAS 20*) at Week 16, and a 20% reduction in the American College of Rheumatology (ACR 20) response criteria at Week 24, respectively. ASAS 20 and ACR 20 are standard tools used to assess clinical improvement in AS and PsA.

More than 9,600 patients have been treated with Cosentyx in clinical trials across multiple indications, and over 15,000 patients with psoriasis have already been treated in the post-marketing setting. The safety profile of Cosentyx was shown to be consistent with that seen in clinical trials across multiple indications.