Ixekizumab has once again showed it can significantly Improve signs and symptoms of psoriatic arthritis, and report less progression of structural joint damage when treated for 24 weeks.

Quote:

---

Eli Lilly announced today that psoriatic arthritis (PsA) patients treated with ixekizumab for 24 weeks achieved significant improvements in signs and symptoms of their disease when compared to placebo, while also experiencing significantly less progression of radiographic structural joint damage, reduced disability when performing certain physical functions and improved skin clearance of plaque psoriasis.

"The SPIRIT-P1 data show that ixekizumab may be able to address unmet or underserved needs that many patients living with psoriatic arthritis have, including the reduction of painful and debilitating skin and joint inflammation, which are the hallmarks of this chronic disease," said Philip Mease, M.D., chief of rheumatology research, Swedish Medical Center, and clinical professor, University of Washington, Seattle. Dr. Mease is a SPIRIT-P1 study investigator.

During the 24-week, double-blind period of this Phase 3 study, patients who had never received a biologic disease-modifying antirheumatic drug (bDMARD) were treated with either 80 mg of ixekizumab once every two weeks or every four weeks (following a 160 mg starting dose); adalimumab at the approved dose of 40 mg every other week; or placebo. Adalimumab was employed as an active control in the SPIRIT-P1 study and was not powered for comparison with ixekizumab treatment groups.

In both dosing regimens, ixekizumab-treated patients demonstrated significant improvements compared with placebo in disease activity of PsA as demonstrated by the proportion of patients achieving an ACR20 response at 24 weeks, the study's primary objective. Improvements were experienced by ixekizumab-treated patients as early as one week after treatment initiation. ACR20 represents at least a 20 percent reduction in a composite measure of disease activity as defined by the ACR. Other measures included ACR50 and ACR70, which represent 50 percent and 70 percent reductions in disease activity.

At 24 weeks, 62 percent of patients treated every two weeks and 58 percent of patients treated every four weeks with ixekizumab achieved ACR20 compared with 30 percent of placebo-treated patients. The proportions of ixekizumab-treated patients who achieved ACR50 when treated every two weeks or every four weeks were 47 percent and 40 percent, respectively, compared with 15 percent of patients treated with placebo. Furthermore, 34 percent of patients treated with ixekizumab every two weeks and 23 percent of those treated every four weeks experienced a 70 percent reduction in disease activity. Six percent of patients treated with placebo achieved this level of improvement.

Patients treated with ixekizumab at both dosing regimens also experienced significantly less radiographic progression of structural joint damage than those treated with placebo, as measured by the change from baseline in the van der Heijde modified total Sharp score (mTSS) for PsA at 24 weeks. Structural joint damage caused by PsA may lead to permanent joint deformity and reduced physical function.

Ixekizumab treatment groups also experienced significant improvements compared with placebo in other key secondary measures, including physical function as assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI), and improved skin clearance of plaque psoriasis as measured by the Psoriasis Area and Severity Index (PASI), including PASI75, 90 and 100. A PASI75 score indicates at least a 75 percent reduction in a patient's plaque psoriasis from the patient's baseline assessment, while PASI90 reflects a 90 percent reduction and PASI100 represents a 100 percent reduction, reflecting complete skin clearance.

Efficacy results with adalimumab compared with placebo during the SPIRIT-P1 study were significant on most measures. At 24 weeks, 57 percent of patients treated with adalimumab, the study's active control, achieved ACR20, while 39 percent and 26 percent achieved ACR50 and ACR70, respectively.

The incidence of treatment-emergent adverse events (TEAE) was greater with ixekizumab treatment compared with placebo. The most common (≥4 percent) adverse events observed with ixekizumab treatment were injection site reaction, injection site erythema and nasopharyngitis. These events are consistent with those reported in the Phase 3 studies of ixekizumab for the treatment of moderate-to-severe plaque psoriasis (UNCOVER 1, 2, 3). Serious adverse events and discontinuation rates due to adverse events were not significantly different between treatment groups.

Following on from Cosentyx recently getting approval in Europe for psoriatic arthritis Cosentyx gets psoriatic arthritis approval in Europe. This latest news release reveals that 84% of psoriatic arthritis patients showed no further progression in joint damage.

Quote:

---

Novartis announced today new results for Cosentyx® (secukinumab) showing no further progression in joint damage in 84% of patients with psoriatic arthritis (PsA). In addition, Cosentyx maintained a treatment response in joint and skin disease, physical function and quality of life in patients over two years of treatment.

Cosentyx is the first of a new class of medicines called interleukin-17A (IL-17A) inhibitors to demonstrate efficacy in Phase III studies in PsA - a life-long inflammatory disease that affects the skin and joints. If not treated effectively, it can lead to irreversible joint damage and disability caused by years of inflammation.

"Psoriatic arthritis patients need therapies that can prevent the progression of this debilitating disease. In this two-year study, Cosentyx showed no further progression in joint damage in over 80% of PsA patients while maintaining improvements in joint and skin disease, physical function, and quality of life," said Vasant Narasimhan, Global Head of Development, Novartis Pharmaceuticals. "These results show the potential for Cosentyx to create an important new option for the treatment of psoriatic arthritis".

New medicines with an alternative way of working are needed as many patients do not achieve an adequate response from current treatments, such as disease-modifying anti-rheumatic drugs, non-steroidal anti-inflammatories or anti-tumor necrosis factor (anti-TNF) therapies. Many patients do not respond to or tolerate these therapies, with approximately 45% of PsA patients dissatisfied with their treatments.

These results from the FUTURE 1 study represent the longest Cosentyx Phase III study in PsA to date. Responses in joint and skin disease, physical function, and quality of life at Week 24, were maintained over two years. After two years of treatment, 67%* of patients (n=202) treated with Cosentyx 150 mg achieved the standard treatment goal of an ACR 20 response (American College of Rheumatology response criteria). In addition, 84% of patients showed no further progression in joint damage as shown by x-ray assessment. Cosentyx was well tolerated with a safety profile consistent with that observed in previous studies.

Given all the talk about the amazing, wonderful recovery of a baby with leukaemia after gene therapy, I wondered if it will ever be possible to apply to other conditions such as psoriasis - or is there no faulty gene at work in psoriasis?
Maybe someone with a better grasp of this might know if it's a potential future treatment?

I got prescribed Mometasone Furoate this morning by my Dermatologist. Never heard of it Anyone ever used it for their Psoriasis?

Chronic Plaque Psoriasis sufferer for 45 years who's having an interesting experience with Novatretin, the Canadian-sourced generic form of Acitretin. I'm in New Zealand.

Acitretin (as NeoTigason) has been my go-to miracle drug for flare-ups. I've taken it 8 times previously (over 30 years) at a dosage of 35mg/6 weeks then 25mg/6 weeks then discontinued. Results have always been fantastic: significant thinning and fading all over by end of week four or five, then complete fading by weeks 8-10. Often I've stopped taking it with a couple of weeks to go since clearance has been so good. Rash slowly returns over next year but is usually well-behaved only requiring topicals for the next few years until the next flare-up.

In the last couple of years my rash had become a little nasty with spots and patches all over which I was managing with Daivonex and a low dose steroid for the scalp. I didn't have a flare-up but decided to get Acitretin from my derm who thought it was a good idea to try a lower dose regime.

Neotigason is no longer funded so Novatretin was substituted. I began 20mg/day on Aug 12. I anticipated a slower improvement and indeed it took about 2-3 weeks before I noticed any fading which was only on some areas of my body. But by week 6 I noticed some new spotting and some increased activity in the patches that had started to fade. I particularly noticed heat and activity on my palms and especially soles which had been wonderfully clear for the last 2 years.

So now at week 7 the rash is about the same as it was when I started, perhaps worse if I add in my soles. It's disturbing to me that after a mild initial improvement things have returned to their original state.

I've got a couple of theories:

- the lower dose is enough to provide some initial improvement but also just enough to be antagonistic resulting in an overall unsatisfactory result and worsening in some areas
- the generic is simply not as good as NeoTigason

I've just had my second round of blood tests so I intend contacting my derm with my experience and concerns. I will suggest increasing the dosage to 30mg and see what he thinks.

Other side effects are hardly noticeable with a little dryness and increased sun sensitivity. But this is very mild compared to what happens at my normal dose of 35mg.

I'm wondering if anyone else has had experience with generics when they've previously had excellent and consistent results with the regular brand.

Now I understand that some folks experience flare ups or worsening before improvement but since my long term experience has been quite different it seems very strange to me that this time my reaction is so distressingly different. By now, every time without fail, my rash has been radically reduced and almost cleared, and that's after a major flare-up.

Any thoughts welcome.

Hi There Everyone,

I hope everyone is doing well. My name is Jim and I’m here because my life has turned somewhat upside down within the last 24 hours. I’m not entirely sure what I hope to get out of this post, but perhaps a Psoriasis sufferer that has dealt with similar characteristics can help me focus my train of thought. I do apologize for how winded this may be, but if you don’t mind, it will help me process all that has happened.
 
Before last week, I was a 30 year old relatively healthy male with no history of any skin-related issue, aside from puberty and the occasional pimple brought on by stressing for a big work meeting here and there. Last week, I had an itch on my legs that wouldn’t go away. When I actually pulled up my pant leg to investigate the “bug bite”, I noticed I had a long red rash that carried ½ way around my calf, right at my dress sock line. It literally looked like I had worn socks that were too tight. The odd thing is, I have almost the EXACT same marking around my other leg. Same color, general length and location (sock line, wrapped around ½ my calf). I originally thought maybe I was having a reaction to the type of fabric (I did just buy new socks…….so much talk of socks…how boring…I’m sorry!). I then started to notice little red marks on the backs of my hands/wrists. They seem to bunch in the area in between my thumb and index finger, on both hands. All of these marks have been somewhat pale red, with flaky dryness on top. The point here is….aside from a dot here and there on different areas of my body, this “rash” has been so contained to these two areas (calves and back of hands) and they are almost symmetrical in pattern.
 
All that aside, I saw the dermatologist yesterday and instead of giving me some cream for a reaction I thought I was having, she instead gave me a lifelong commitment to battling Psoriasis. I still just don’t understand…..I have so many questions and I won’t burden anyone…..it just doesn’t make a lot of sense to me right now. The doctor’s first action was to check my elbows and knees (I guess these are common outbreak areas?), though I have no markings there. She kind of pushed my comments aside about how oddly symmetrical the leg markings were…..which I thought was the original ground zero site all along…..she took a biopsy, which I am awaiting the results from. In the meantime, she told me to stop taking the steroid tablets that the Urgent Care gave me two days before (I was worried about it and didn’t want to wait for my derm appointment), then she told me the outbreak will get worse now once I come off the steroids (awesome!) and then she basically just threw some trial spray of something called Kenalog at me. Everything happened so fast….and I now have a mountain of questions and concerns and once I hear back about the biopsy, I do plan to meet with her (or another derm) to really go over proper care, warning signs, etc.
 
I just feel a little lost right now…….and I guess I’m wondering if anyone has had similar Psoriasis flare-ups, specifically with characteristics that somewhat mimic mine?
 
Regardless, thanks for your time….and apologies again for the lengthy post.

Hello everyone , I have been living with psoriasis for over 50 years . in hospital 3 maybe 4 times over 80 percent a few times .I have had a few periods of over 5 years when it has been under control.
I have learned a lot if anyone has any questions.

Hi I am Keith i am a 49 year old Builder from Consett Northeast England.
I have called this post " How i repaired my body " Because i believe that's what you need to do , and Psoriasis is a result of something else
no matter what the doctors say. But I'm just a builder remember
My Psoriasis started in 2012 just on my elbows and knees, so i went to see the doc, got some cream to wash with and keep in moisturise he said
I did but it just got worse ,went back and got Dovobet , at first i thought it was helping, but then it seemed spread , this went on over about 2 years , i was referred to Durham hospital, given other creams and tablets  can't remember the name off the tablets but they made me bad and i packed them in after a few days as i could hardly walk 
So being a biulder i started to look at it more practically, if a wall in your house is damp there is a multitude of things and ways to cover it up or mask it but, it if you don't fix the problem it will not go away.
I stopped all the creams the consultant had given me  i think dovobet is horrible stuff.

These photos where taken on the 27/10/2014 its the only ones i have to give you some idea ,I don't know how bad this would be classed as but it was bad to me, i had it everywhere my legs were as bad as my arms, hands ,feet ,scalp, ears ,some on my face to and and finger nails,, nothing helped


SO i read a lot of things  on the internet about all sorts of herbal stuff and all sorts, they say infections thrive in an acidic body, i got a ph test kit off eBay and sure enough i was acidic.
Also it seems most people in the west are magnesium deficient even with a balanced diet. The minerals just are not in food and water like they used to be due to modern farming treatments and mineral depletion in soil and modern water treatment. 
I started taking Magnesium and Zinc about 3 times the dose they recommend  for about 2 months then dropped to what they recommend.  It can not hurt you it also has a alkaline effect on the body.
I believe i had a yeast (candida) infection in my intestine and that the psoriasis was my body telling me there was something wrong ,
so i also started taking coconut oil. Its the best thing to kill yeast overgrowth in the body, its also anti fungal and anti bacterial.

I started on hemp oil for the pains in my joints, its the best balance of the omega oils for humans there is , after 3 weeks i really felt different on it ,it is also good for depression too.
Also one lemon a day - the citric acid has a alkaline effect on the body ,but make sure you clean your teeth after as the lemon juice is not good for your teeth. 

The only cream i put on was a little vaseline but only for about 6 weeks then stopped and i don't put anything on my skin. 
The psoriasis started to calm down after few week and small bits went after about a month.
I told the consultant i refused the other treatments, she just looked at me as if i was from another planet ,but i did do the light treatment for about a month, i don't know if that helped as it had already started to go before that, but the nurse was amazed at the difference and said just keep doing what i was doing.

So 1 year later to the day apart from a couple of dots on my knees that will be gone soon,  its gone from everywhere.  My nails are back to normal, the bulk of it went in about 4 months and it stopped itching in a couple of weeks. 

So this is what i do
1 table spoon of coconut oil
1 table spoon of hemp oil both dissolved in a little warm water and a squeezed lemon and drink it, I still don't like the taste of them but stick with it, it can repeat on you for the first few weeks but that seems to stop. 
I take magnesium and zinc and vitamin D3-  buy good quality ones. 
I also soak in the bath a couple times a week with a couple of big hand full of magnesium sulphate (epsom salts) in it its the best way to get magnesium into the body , 25kg bags on eBay are about £20 its a lot cheaper than small boxes of epsom salts.
 Thats it no creams, I never cut alcohol out or anything out my diet really either and its gone and so has the joint pains.

I haven't posted anything before so this is a first hope the photos show up as I'm not sure I've done that right, I'm not the prettiest but i hope  it helps

Hello I am new to the club. My name is David.

I am a disabled veteran from the United States Army. I spent 10 years in the service with four different deployments to Iraq before getting out in 2010. I started showing signs of psoriasis in 2008 while still active duty. In the last 8 months or so after several tests, treatments, steroid ointments, and doctors visits they tell me I have psoriatic arthritis. I'm just now trying to research different techniques on managing the symptoms and will likely have a lot of questions. I plan on spending some time reading as much of the posts in this club as I can before asking my questions in order to keep from asking something that has already been answered. 

I thank you all ahead of time for your help and support and I look forward to chatting with you all in the future.

Ideas for things that may be helpful to members

getting started Beginners guide to posting your introduction

Newbie tips Newbies Tips

how to put an internal link to other posts or threads Internal linking

Using codes in your post...Codes in your posts

starting a new thread Starting a new thread

how to keep up with the forum using unread post button View Unread Posts

putting photos in your post [Group Specific]... or. ... [Group Specific] ....or. [Group Specific]

using the portal. Showing last 20 posts etc Portal!

idea if you return to the forum and aren't sure where your posts are,  at the top of the front page there is a link to all your posts and threads, they can also be accessed from your profile page

Cosentyx has been given European approval for the treatment of Psoriatic Arthritis (PsA) by the Committee for Medicinal Products for Human Use (CHMP) the approval is applicable to all European Union and European Economic Area countries.

Quote:

---

Novartis announced today that the Committee for Medicinal Products for Human Use (CHMP) has recommended the approval of Cosentyx™ (secukinumab) in Europe to treat ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients. Following two separate regulatory submissions, Cosentyx is now recommended for the treatment of active AS in adults who have responded inadequately to conventional therapy, such as non-steroidal anti-inflammatory drugs (NSAIDs), and for the treatment of active PsA in adult patients alone or in combination with methotrexate (MTX) when the response to previous disease modifying anti-rheumatic drug (DMARD) therapy has been inadequate.

Cosentyx is the first of a new class of medicines called interleukin-17A (IL-17A) inhibitors to be recommended for AS and PsA - conditions that affect around five million people in Europe. Both are 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 damage caused by years of inflammation.

"Novartis is pleased to be so close to bringing this life-changing medicine to people living with ankylosing spondylitis and psoriatic arthritis who are struggling to find the right treatment to control their symptoms," said David Epstein, Division Head, Novartis Pharmaceuticals. "With Cosentyx, we have seen major and rapid reductions in the signs and symptoms of disease, including pain, disease progression and joint damage, paving the way for a potential new standard of care."

New treatment options with an alternative way of working are needed for both conditions as many patients do not achieve an adequate response from standard treatments, such as DMARDs, NSAIDs or anti-TNF therapies. For example, with the current biologic standard of care - anti-TNFs - up to 45% of PsA patients and up to 40% of AS patients are dissatisfied with, do not respond to or do not tolerate their treatment.

Cosentyx Phase III studies have consistently demonstrated significant improvements in the signs and symptoms of AS and PsA. Clinical improvements were seen as early as Week 3 and through to Week 52, with benefits reported across the spectrum of patients who have either never taken or who have had prior treatment with anti-TNF therapies.

The safety profile of Cosentyx was shown to be consistent to that reported in clinical trials across multiple indications involving more than 9,600 patients.

The European Commission reviews the recommendations of the CHMP who then provide their final decision on approval, usually two months or earlier, following CHMP opinion. This is applicable to all European Union and European Economic Area countries. Cosentyx has been approved for the treatment of PsA in Japan since December 2014 and has received approval in 49 countries worldwide for the treatment of moderate-to-severe plaque psoriasis.

About the CHMP recommendation
For patients with AS and PsA, the recommended dose is Cosentyx 150 mg by subcutaneous injection with initial dosing at Weeks 0, 1, 2 and 3, followed by monthly maintenance dosing starting at Week 4. For PsA patients with concomitant moderate-to-severe plaque psoriasis, or who are anti-TNF inadequate responders, the recommended dose is Cosentyx 300 mg.

I am so happy to have a place to come for information. I have had psoriasis since 2005 and it is spreading. I find it very helpful reading the posts concerning the natural treatments rather that drugs. Don't like them and find they actually make things worse for hands and feet. Thank you for letting me join.

Leo Pharma have announce that their Calcipotriene and Betamethasone Dipropionate Foam, 0.005%/0.064% (Enstilar) has been accpeted by the FDA for the treatment of Plaque Psoriasis.

Quote:

---

LEO Pharma announced today that the U.S. Food and Drug Administration (FDA) has approved Enstilar® (calcipotriol/betamethasone dipropionate 50 micrograms/g / 0,5 mg/g) Foam for the treatment of psoriasis vulgaris in patients 18 years of age or older in the United States.1 Enstilar® is a once-daily, alcohol-free topical treatment.

“We are very pleased by the U.S. approval of Enstilar® and believe it will provide patients with the type of treatment option that they are looking for,” said Gitte Aabo, President and CEO of LEO Pharma.  “At LEO Pharma, we are committed to providing patients with innovative, new solutions and we believe the foam formulation of Enstilar® can help patients living with psoriasis.”

Enstilar® was developed to treat patients with psoriasis vulgaris – the most common clinical form of psoriasis.

The U.S. approval of Enstilar® was based on the Phase 3a PSO-FAST study which evaluated the efficacy and safety profile across a four week period,5 and the Phase 2 MUSE safety profile study.6  In the pivotal Phase 3 PSO-FAST clinical trial, over half of patients treated with Enstilar® were “Clear” or “Almost Clear” by Week 4 as measured by the 2-step Investigator Global Assessment (IGA) improvement score.1 Additionally, more than half of patients treated with Enstilar® achieved a 75% improvement in Psoriasis Area and Severity Index (PASI) score from baseline.

In March 2015, LEO Pharma submitted Marketing Authorisation Applications to 30 European Health Authorities for Enstilar®; however, the product is currently only approved for use in the U.S.  

Enstilar® combines a vitamin D analogue (calcipotriol) with a potent corticosteroid (betamethasone dipropionate) to achieve a normalizing result on the affected skin cells and promote a greater anti-inflammatory response than the monotherapy components alone in patients suffering from psoriasis vulgaris.

Apply Enstilar® to affected areas once daily for up to 4 weeks. Patients should discontinue use when control is achieved. Instruct patients not to use more than 60 g every 4 days.

INDICATION AND USAGE
Enstilar® (calcipotriene and betamethasone dipropionate) Foam is indicated for the topical treatment of plaque psoriasis in patients 18 years of age and older.

Apply Enstilar® to affected areas once daily for up to 4 weeks. Patients should discontinue use when control is achieved. Instruct patients not to use more than 60 g every 4 days.

IMPORTANT SAFETY INFORMATION
For topical use only. Enstilar® is not for oral, ophthalmic, or intravaginal use. Instruct patients to avoid use on the face, groin, or axillae, or if atrophy is present at the treatment site, and not to use with occlusive dressings, unless directed by a physician.

The propellants in Enstilar® are flammable. Instruct patients to avoid fire, flame, or smoking during and immediately after using this product.

Hypercalcemia and hypercalciuria have been observed with use of Enstilar® Foam. If hypercalcemia or hypercalciuria develop, patients should discontinue treatment until parameters of calcium metabolism have normalized.

Topical corticosteroids can produce reversible hypothalamic-pituitary-adrenal (HPA) axis suppression with the potential for glucocorticosteroid insufficiency. Risk factors include use of high-potency topical corticosteroids, use over a large surface area or on areas under occlusion, prolonged use, altered skin barrier, liver failure, and use in pediatric patients. If HPA axis suppression is documented, gradually withdraw the drug, reduce the frequency of application, or substitute with a less potent steroid. Systemic effects of topical corticosteroids may also include Cushing's syndrome, hyperglycemia, and glucosuria. Use of more than one corticosteroid-containing product at the same time may increase total systemic corticosteroid exposure.

Adverse reactions reported in <1% of subjects treated with Enstilar® in clinical trials included application site irritation, application site pruritus, folliculitis, skin hypopigmentation, hypercalcemia, urticaria, and exacerbation of psoriasis.

Patients who apply Enstilar® to exposed skin should avoid excessive exposure to either natural or artificial sunlight, including tanning booths, sun lamps, etc. You may wish to limit or avoid use of phototherapy in patients who use Enstilar®.

There are no adequate and well-controlled studies of Enstilar® in pregnant women. Enstilar® should be used during pregnancy only if the potential benefit to the patient justifies the potential risk to the fetus. Because many drugs are excreted in human milk, caution should be exercised when Enstilar® is administered to a nursing woman. Do not use Enstilar® on the breast when nursing.

The safety and effectiveness of Enstilar® in pediatric patients have not been studied.

This study looked at drug survival rates of different biologic agents in a cohort of psoriasis patients. I concludes the overall efficacy of biologic agents is reduced with time. And patients with the comorbidity of metabolic syndrome demonstrate a loss of adherence to biologic treatment.

Quote:

---

Background:
Psoriasis often requires lifelong therapy, and adherence to treatment is considered a marker for treatment success. Data on the drug survival of biologics in psoriasis patients with comorbidities are lacking.

Objectives:
This study was designed to estimate the long-term drug survival rates of different biologic agents in a cohort of psoriasis patients and to evaluate reasons and predictors for treatment adherence.

Methods:
Drug survival rates and outcome parameters in psoriasis patients treated with biologic agents were analyzed.

Results:
A total of 125 treatment periods with adalimumab (n = 37), efalizumab (n = 9), etanercept (n = 55), infliximab (n = 13), and ustekinumab (n = 11) were administered to 67 psoriasis patients. Patients with psoriatic arthritis (P = 0.010) and without comorbidity (P = 0.033) demonstrated significantly greater rates of drug survival.

Conclusions:
The overall efficacy of biologic agents is reduced with time. Patients with the comorbidity of metabolic syndrome demonstrate a loss of adherence to biologic treatment.

I thought I would share this little study that suggests El Niño decreases the occurrence of psoriasis.

Quote:

---

The El Niño Southern Oscillation (ENSO) is a complex climate phenomenon occurring in the Pacific Ocean at intervals of 2–7 years. The term refers to fluctuations in ocean temperatures in the tropical eastern Pacific Ocean (El Niño [the warm phase of ENSO] and La Niña [the cool phase of ENSO]) and in atmospheric pressure across the Pacific basin (Southern Oscillation).

This weather pattern is attributed with causing climate change in certain parts of the world and is associated with disease outbreaks. The question of how ENSO affects skin and skin-related disease is relatively unanswered.

We aimed to review the literature describing the effects of this complex weather pattern on skin.

El Niño has been associated with increases in the occurrence of actinic keratosis, tinea, pityriasis versicolor, miliaria, folliculitis, rosacea, dermatitis by Paederus irritans and Paederus sabaeus, and certain vector-borne and waterborne diseases, such as dengue fever, leishmaniasis, Chagas' disease, Barmah Forest virus, and leptospirosis, and with decreases in the occurrence of dermatitis, scabies, psoriasis, and papular urticaria.

La Niña has been associated with increases in the occurrence of varicella, hand, foot, and mouth disease, and Ross River virus (in certain areas), and decreases in viral warts and leishmaniasis.

Reports on the effects of ENSO on skin and skin-related disease are limited, and more studies could be helpful in the future.

Stumbled on this website when researching the new drug my dermatologist has given me (Soriatane, 10 mg).  Have very severe ps on palms of hands, bottoms of feet.  Have been hospitalized four times because of the infections  (sepsis, I think they called it?).  Believe me, I am VIGILANT about using antibiotic ointment and keeping clean, doesn't seem to matter; my hands and feet are like giant open wounds all the time.  I try covering them with a very large band-aid, but my skin is so sensitive to the glue in the bandaid that I have to be extremely careful.  I can't take oral antibiotics, so they usually only keep me overnight, or 2 days, put me on massive doses of IV antibiotics, put in a stent (or whtever its called) and I go back and get the drug at the hospital every day for 10 days.  This has happened at least once a year for the last 3 years.  Arrrrghhhh.  

Both hands and feet are constantly shedding, cracking, bleeding, itching, etc.  Pain is sometimes unbearable.

Am 59 years old, and have taken an early retirement because the stress and pain of the ps was just getting to be too much.  I miss my work, but have much to keep me busy. 

Grew up in Ohio, hated the cold, so did my post-grad studies in California and Florida, finally settling on Florida in 1983.  Met the love of my life in 1999 and moved, of all places, to CANADA...where my first year I discovered four feet of snow in my yard was to be a "typical" winter.  Sigh.  Never had psoriasis before coming to Canada, but within a year of being here, my hands started developing it.  Finally became so bad that I sought help.  Have seen at least eight dermatologists, tried every topical (and I do mean, EVERY - at last count, I had tried over 48 different prescription ointments/creams.  

Have a history of proliferative glomerial nephritis (kidney disease) and some liver issues do to the treatments for the kidney, so docs have always been reluctant to try oral meds.  I have finally gotten my liver function to a healthier state and my new derm is allowing me to try this Soriatane.  I am hoping for a miracle, because I believe in miracles!! 

Thanks for being here.

Kersty

Merck's Tildrakizumab treatment for psoriasis came out superior to placebo, maintained for 52 weeks of treatment, and persisted for 20 weeks after cessation, and was generally safe and well tolerated. Results of phase llb

Quote:

---

Background:
Tildrakizumab is a high-affinity, humanized, IgG1/κ, anti-interleukin (IL)-23p19 monoclonal antibody that does not bind human IL-12 or p40 is being developed for the treatment of chronic plaque psoriasis.

Objectives:
To evaluate the safety and efficacy of subcutaneous tildrakizumab in patients with moderate-to-severe chronic plaque psoriasis.

Methods:
A three-part, randomized, double-blind, phase IIb trial was conducted in 355 adults with chronic plaque psoriasis. Participants were randomized to receive subcutaneous tildrakizumab (5, 25, 100, 200 mg) or placebo at weeks 0 and 4 (part I) and every 12 weeks thereafter until week 52 (part II). Study drug was discontinued at week 52 and participants were followed through week 72 (part III). Primary efficacy end point was Psoriasis Area and Severity Index (PASI) 75 response at week 16. Adverse events (AEs) and vital signs were monitored throughout the study.

Results:
At week 16, PASI 75 responses were 33·3% (n = 14), 64·4% (n = 58), 66·3% (n = 59), 74·4% (n = 64) and 4·4% (n = 2) in the 5-, 25-, 100- and 200-mg tildrakizumab and placebo groups, respectively (P ≤ 0·001 for each tildrakizumab dose vs. placebo). PASI 75 response was generally maintained through week 52; only eight of 222 participants who achieved PASI 75 response at week 52 and continued to part III relapsed following discontinuation up to week 72. Possible drug-related serious AEs included bacterial arthritis and lymphoedema (part I), and melanoma, stroke, epiglottitis and knee infection (part II).

Conclusions:
Tildrakizumab had treatment effects that were superior to placebo, maintained for 52 weeks of treatment, and persisted for 20 weeks after cessation. Tildrakizumab was generally safe and well tolerated. These results suggest that IL-23p19 is a key target for suppressing psoriasis.

The FDA have turned down XELJANZ® (tofacitinib citrate) for the treatment of adult patients with moderate to severe chronic plaque psoriasis. The US regulator sent Pfizer a Complete Response Letter stating that it would be unable to approve Xeljanz (tofacitinib) for psoriasis without additional information. It is thought to relate to the safety of the drug, and Pfizer have responded on their website.

Quote:

---

Pfizer Inc. announced it has received a Complete Response Letter from the U.S. Food and Drug Administration (FDA) for its supplemental New Drug Application (sNDA) for XELJANZ® (tofacitinib citrate) for the treatment of adult patients with moderate to severe chronic plaque psoriasis. The Agency provided recommendations specific to the moderate to severe chronic plaque psoriasis sNDA. Pfizer will work with the Agency to determine an appropriate path forward to address their comments, including providing additional safety analyses of XELJANZ for the proposed indication.

“Pfizer remains committed to XELJANZ based on the strength of the clinical data for the treatment of psoriasis,” said Kenneth Verburg, PhD, senior vice president and head of global medicines development, Global Innovative Pharma Business. “It is our goal to work closely with the FDA to understand and address their comments about our filing for the use of XELJANZ in patients with chronic plaque psoriasis.”

Hi all,

I've got a a patch of psoriasis on my forehead. My doctor has perscribed Hydrocortisone- it takes the redness and dryness down for a while, but after a couple of days without H/C, the psoriasis thickens and reddens. Could anyone recommend a good treatment for my problem?

Thanks,
Mark