This small study looked at he features of circulating CD4+ CD28null cells in patients with psoriasis.

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Background:
Psoriasis is a chronic inflammatory disease that affects the skin. CD4+ CD28null cells are a subset of T lymphocytes associated with systemic inflammation and increased cardiovascular disease risk, and may be involved in the pathogenesis of psoriasis.

Objectives:
To study the features of circulating CD4+ CD28null cells in patients with psoriasis, adjusted for the influence of known cardiovascular disease risk factors.

Methods:
Forty-two patients with psoriasis and 42 controls entered the study. Peripheral blood mononuclear cells were analysed for the frequency of CD4+ CD28null T lymphocytes and their expression of cytotoxic granules and homing receptors. Immunostaining for cutaneous cytotoxic granules was assessed in skin biopsies from 11 patients.

Results:
There were no differences in the frequency of CD4+ CD28null T cells between groups in all situations analysed. However, there was an increased number of cells expressing cytotoxic granules and a decreased number expressing CXCR3 in ex vivo samples of patients with psoriasis. A negative correlation was observed between the frequency of ex vivo CD4+ CD28null cells and psoriasis severity. After clinical remission in nine patients, ex vivo CD4+ CD28null lymphocytes expressing cytotoxic granules decreased. Perforin-, granzyme B- and granulysin-containing cells were found in skin lesions. Patients with psoriasis also had increased plasma levels of C-reactive protein.

Conclusions:
These data suggest that cytotoxic cells, such as CD4+ CD28null lymphocytes, within an inflammatory environment may play a role in the pathogenesis of psoriasis.

More good news for Cosentyx (secukinumab) after Novartis present new data showing that the majority of patients are able to maintain clear or almost clear skin with Cosentyx across 3 years.

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Novartis announced today new late-breaking data demonstrating that Cosentyx (secukinumab) provides high levels of skin clearance and sustained efficacy in patients with moderate-to-severe plaque psoriasis while maintaining a favorable safety profile across three years. The results of this study - the longest Phase III Cosentyx trial conducted to-date - were presented at the 24th Annual Congress of the European Academy of Dermatology and Venereology (EADV) in Copenhagen, Denmark. Cosentyx is the first fully human interleukin-17A (IL-17A) inhibitor approved to treat adult moderate-to-severe plaque psoriasis.

In this extension study, 320 patients received Cosentyx in a fixed dosing schedule for three years. 69% achieved clear or almost clear skin (PASI 90) at year one. This response was extremely well maintained after three years with 64% of patients continuing to have a PASI 90 response. In addition, 43% of patients maintained completely clear skin (PASI 100) at year three (from 44% at year one). 83% achieved the standard treatment goal of PASI 75 skin clearance at three years.

"Psoriasis patients want therapies that maintain high levels of skin clearance over the long-term given the impact of the disease on their physical and psychological wellbeing," said Vasant Narasimhan, Global Head of Development, Novartis Pharmaceuticals. "In these new data from our longest Phase III trial to date with Cosentyx, we are pleased to show patients were able to maintain clear or almost clear skin for up to three years."

The PASI score assesses the reduction from baseline in the redness, scaling and thickness of psoriatic plaques and to what extent it affects each area of the body. PASI 75 has historically been considered the goal for psoriasis treatment. However, with newer treatments with increased efficacy, there is now a focus on PASI 90 (clear or almost clear skin) and PASI 100 (clear skin) as the ultimate goal for treatment, as recommended by clinical guidelines and regulatory authorities.

In this study, Cosentyx had a favorable safety profile consistent with that observed in previous Phase III studies.

I have some feedback about your office staff. I have tried for a month to contact the director of this website 4 times now and have not received an answer. I think your office staff should have answered me or at the very least let me know they have passed my email on to the director whom I had addressed it to. I am very disappointed that I have had to register as a member to try and speak to the director. So will someone please get in tough with the director and tell him or her that I wish to discuss advertising my website on this forum. I manufacture and sell my own psoriasis and eczema cream that can help all of your members.

In exchange for an article on this forum and a link on your links page I would be prepared to offer all of your members a generous 30% discount. I am also prepared to offer an annual payment of $100 to your donations page.

You can contact me via the email address I used to register. This is the same email I used to try and contact the director that your staff did not pass on.

Disappointed.

Following on from the report last year about BI 655066 achieving psoriasis clearance for 66 months, Boehringer Ingelheim said today it had also cleared skin better, faster and for longer than Stelara (ustekinumab)

Last years report: Psoriasis clear 66 months after one subcutaneous injection of trial drug BI 655066

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New results from a Phase II head-to-head psoriasis study showed superior efficacy of Boehringer Ingelheim’s investigational biologic compound BI 655066, over ustekinumab. After nine months, 69 percent of patients with moderate-to-severe plaque psoriasis maintained clear or almost clear skin (PASI 90) with BI 655066 in the higher dose group compared to 30 percent of patients on ustekinumab.1 Patients also achieved this skin clearance significantly faster (approximately eight weeks versus approximately 16 weeks) and for more than two months longer (≥ 32 weeks versus 24 weeks) than those on ustekinumab.  In addition, completely clear skin (PASI 100) was maintained after nine months in nearly triple the percentage of patients on BI 655066 compared with ustekinumab (43 percent versus 15 percent).

"These results are striking. They further strengthen our understanding of the potential skin improvement that can be achieved with BI 655066, in moderate-to-severe plaque psoriasis. We saw a third more patients achieve clearer skin in a short time period. And this clearance was maintained longer compared to the commonly used treatment ustekinumab,” commented Kim A. Papp, MD, PhD, President of Probity Medical Research, Waterloo, Ontario, Canada. “Achieving clear skin quickly and maintaining clearance is an important goal for patients that have to deal with the daily impact of psoriasis.” These meaningful 24-week findings from a Phase II study in psoriasis were presented today in an oral presentation by Dr. Kim A. Papp  at the 24th European Academy of Dermatology and Venereology (EADV) congress in Copenhagen.

The study (NCT02054481) investigated the efficacy and safety of BI 655066 versus ustekinumab in 166 patients.1 These data build on Phase II data presented earlier this year at the Annual Meeting of the American Academy of Dermatology (AAD). Primary endpoint results showed nearly double the percentage of patients with moderate-to-severe plaque psoriasis achieved clear or almost clear skin (PASI 90) after 12 weeks of treatment with BI 655066, compared to ustekinumab (77.1 percent versus 40 percent of patients). The new data further demonstrate that BI 655066 has similar safety and tolerability to ustekinumab, regardless of dose, with no serious drug-related side-effects.1 The most common side effects were runny nose, sore throat, and headache.

“The results are an exciting milestone in Boehringer Ingelheim’s growing immunology pipeline. These Phase II study results represent a major step towards our vision of transforming the treatment of immune diseases and the patients affected by it,” said Dr. Steven Padula, Therapeutic Area Head Medicine Immunology at Boehringer Ingelheim. “We look forward to continued research and are currently planning multiple Phase III studies.”

Additional trial information
The data discussed in this press release represent results for BI 655066 180mg (n=42) injection under the skin, delivered at weeks zero, four and 16.

The BI 655066 90mg (n=41) dose also showed superior efficacy, onset and duration of action over ustekinumab after nine months.

More patients with moderate-to-severe psoriasis maintained almost clear skin (PASI 90) with BI 655066 compared to those on ustekinumab (81 percent versus 30 percent)
 
More patients on BI 655066 had completely clear skin (PASI 100) compared with ustekinumab (54 percent versus 15 percent)

An exploratory single dose of BI 655066 18mg (n=43) was also studied.

Ustekinumab 45mg/90mg (n=40) was delivered as an injection under the skin at weeks zero, four and 16.

Hello all, 

My name is Jessica and my main concern is my facial P.  All I ever hear is how rare it is and no solution.  I have tried over the counter cortisol creams to maintain it but I don't won't to keep using the steroids. There's got to be a better and safer.

Hi I'm new to this site and in of help.  I have plaque psoriasis on my face, scalp, outer and inner ears, elbows, and knees.  I don't care about all the areas except for my face and I can't find help to stop it or control it.  The only product that works so far is over the counter cortisol cream but it's a steroids.  Anyone have this on their face?

this is a trial and I may be one of 15 in the UK and 300 world wide.

HI I'm richard and I've psoriasis

I'm freaking out fellow flakers!! After almost a year of clear skin I noticed a few new spots today. Granted they are really small and maybe only six or eight total but I'm at a loss as to why. My stress is at an all time low and I'm eating and drinking the same bad stuff I always do. I want to put a stop to this pronto, without topical steroids. HELP!! And please don't say it's from eating a nightshade or drinking. I have been eating and drinking all of the wrong things for a year with zero flare ups.

Hi all, 
I am Joanne. New to this site and posting , as well. Lived with psoriasis for 40 years now. Completely clear due to Stelara, but now facing major dental issues. Saw a few threads on subject. Is anyone else suffering from this ?  Thank you.

How long to leave a cold before asking advice? And (in UK) would you approach GP or derm about it?
I have a sneezy runny nose, sore throat and cough - classic cold.

was talking to my boyfriends mum today and she was telling me her boyfriend is going into hospital next week for a week to do tar treatment and will then have light treatment after to keep him clear. I didn't even know they still done this! I used to get this done about 20 years ago when I was a little girl! Anyone else tried this in recent years?

Like all of us, I have a demanding job, a family and little time to spend by myself and there's nothing I like more than a hot bath. A long, indulgent soak in enough water to drown a large village at a temperature that Satan himself would be cautious of entering is something that I allow myself every few days. 

I take with me my iPad, a cup of tea and lay there for around two hours or so, occasionally topping myself up from the red coloured tap using my toes buying stuff I don't need from websites I don't trust enjoying music that is way outside the listening demographic of my ever-aging mind.

It has been said however that soaking in nuclear-heated water can be really bad (like really, really bad) for skin and really really really bad for psoriatic skin.

I like showers in the same way (hot hot) but invariably spend less time as I am on my way to work. 

I haven't noticed that my skin is dryer, more itchy or inflamed as it usually is but the powers that be (have you met my wife?) insists that it does. After hauling my usually pink carcass from the depths of the tub and leaving behind me a trail of mist that can only be likened to a Bollywood movie, the only difference I feel is deep in my soul. Calm, relaxed and at one with myself and the steam I have left dripping from the ceiling. 

I'm not entirely sure now whether this post is a statement or a question. Either way, I would be interested to hear what you have to say.

Fin.

An interesting little study that looked at the lengthening of time between shots of Humira (adalimumab) and Enbrel (etanercept) it concludes that it is safe, effective, and also cost effective.

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Anti-tumor necrosis factor (TNF) alpha therapy has changed the course of psoriatic arthritis (PsA), but clinical experience about lengthening of time intervals between drug administrations is still limited.

The aims of the study were to evaluate: (1) the long-term efficacy (over a 4-year period) of etanercept/adalimumab in a subset of PsA patients who did not require switches; and (2) the progressive lengthening of time intervals between treatments in patients who achieved minimal disease activity (MDA).

PsA outpatients attending the Rheumatology Clinic-University of Padova who took a single anti-TNF agent (etanercept/adalimumab) for a 4-year period were studied. Therapy efficacy was assessed using clinical, biochemical, and disease activity (DA) indexes. The intervals between treatments were empirically and progressively lengthened after MDA was reached and maintained. One hundred and forty-one patients (mean age, 51.22 ± 12.34 years; mean disease duration, 12.1 ± 8.42 years) treated with etanercept/adalimumab (47.5% and 52.5%, respectively) were studied. DA indexes showed a marked, persistent improvement in all the patients throughout 4 years. The interval between injections could be extended in 46.1% of the patients (35% for adalimumab, 58% for etanercept) without provoking relapses. The mean therapy interval at the end of the study period was 3.12 weeks for adalimumab 40 mg (with respect to 2 weeks) and 2.75 weeks for etanercept 25 mg (with respect to 0.5 weeks).

The new therapy timetable also led to cost savings. In conclusion, lengthening the time intervals between injections of anti-TNF agents in PsA patients who reach MDA is safe, effective, cost-effective, and facilitates patient compliance.

Following on from this report Cosentyx doing well for psoriatic arthritis 1 year on Novartis announced that results from the pivotal Phase III FUTURE 1 study for Cosentyx (secukinumab) showed significant efficacy in patients with psoriatic arthritis.

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Novartis announced today that results from the pivotal Phase III FUTURE 1 study for secukinumab in psoriatic arthritis (PsA) were published online in the New England Journal of Medicine (NEJM). Secukinumab is the first interleukin-17A (IL-17A) inhibitor to demonstrate efficacy in a Phase III study in patients with active PsA, a painful, debilitating condition causing inflammation of joints and skin. PsA is part of a family of long-term diseases impacting joints, known as spondylorarthritis.

In this study, secukinumab met the primary endpoint with a 20% reduction in the American College of Rheumatology response criteria (ACR 20) at Week 24 showing rapid and significant clinical improvements versus placebo. ACR is a standard tool used to assess improvement of PsA signs and symptoms. In addition, secukinumab met all secondary endpoints, including improvements in skin and joint diseases and joint structural damage progression.

Results showed that half of patients (50.0% and 50.5%) in both secukinumab-treated dose groups (150 mg and 75 mg; p<0.001) achieved ACR 20 response compared with only 17.3% of placebo patients. Clinically significant improvements with secukinumab were observed as early as Week 1 and sustained throughout 52 weeks of treatment.

"Secukinumab is the first IL-17A inhibitor with detailed positive results for the treatment of PsA, further validating the importance of the role IL-17A plays in spondyloarthritis," said Vasant Narasimhan, Global Head of Development, Novartis Pharmaceuticals. "Novartis looks forward to advancing this important therapy to address the unmet need for patients living with PsA."

PsA is a debilitating, long-lasting inflammatory disease associated with joint pain and stiffness, skin and nail psoriasis, swollen toes and fingers, persistent painful tendonitis and irreversible joint damage. These all lead to significant disability, poor quality of life and reduced life expectancy. Importantly, in FUTURE 1, clinical benefits with secukinumab were observed regardless of prior exposure to anti-tumor-necrosis-factor (anti-TNF) medicines, the current standard of care. Many patients do not respond to, or tolerate these therapies and approximately 45% of people are dissatisfied with current treatments. There is therefore, a high unmet need for patients with PsA.

Secukinumab was well tolerated in the study, with a safety profile that was consistent with that observed in the large psoriasis clinical trial program involving nearly 4,000 patients. The most common adverse events (AEs) were the common cold, headache and upper respiratory tract infections.

Today I start the above treatment  - the first time I've taken anything other than topical creams and a few bouts of puva. However the Psoriasis is making a break for it and it needs putting back in its place!

So, as Fingers did on his thread earlier I'm thinking of taking some photos - he got me thinking... I'm going to try and take some timelapse, same shot, each day...and once I have something worthwhile I'll post-it up here (somehow)!

Right, anyone seen my tripod?!

I thought I would start a new thread about issues I am having with my toes. My toes, specifically the ones in the middle cramp or lock up. Anyone who had played a physical sport has probably had experience with cramping. Stretching, drinking water, and light jog normally relieves the cramping within 10 minutes. The issues with my toes is similar but different. They last a lot longer and stretching and keeping hydrated does not work. When cramping is over my toes are typically warm and fuzzy. Anyone else have similar issues? Any ideas to help? I have been taking two celebrex per day (it helps), but honestly it probably not safe to take a high dose for extended periods of time.

Maybe another one to watch for the future as Galectin Therapeutics announces it's phase 2a proof of concept study of GR-MD-02 to determine safety and efficacy in 10 patients with moderate to severe plaque psoriasis.

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Galectin Therapeutics Inc, the leading developer of therapeutics that target galectin proteins to treat fibrosis and cancer, announces the start of a 10-patient pilot study with GR-MD-02 in patients with moderate-to-severe plaque psoriasis.

The genesis of this study is the apparent remission of a patient with severe psoriasis who participated in the Company's Phase 1 study cohort of 4 mg/kg of GR-MD-02 for the treatment of non-alcoholic steatohepatitis (NASH). That patient received her fourth infusion of GR-MD-02 in May 2014, and her psoriasis remained in complete remission for 17 months, with slight scaling becoming evident on her elbows just this month.

"We are excited to begin this study at the Brooke Army Medical Center in San Antonio, Texas," said Peter G. Traber, M.D., Galectin's president, chief executive officer and chief medical officer. "We know from the scientific literature that galectin-3 is at higher levels in the skin of psoriasis patients, and that GR-MD-02 inhibits galectin-3. It would follow that GR-MD-02 could affect this disease. We are hopeful that patients with moderate-to-severe plaque psoriasis will show a clearing of their disease without the negative side effects associated with many of the currently available therapies. In addition, a successful pilot study would add to our robust therapeutic pipeline for this compound."

Psoriasis, which manifests most often as plaque psoriasis, is a chronic, relapsing, inflammatory skin disorder. Although plaque psoriasis is rarely life threatening, it often is intractable to treatment. According to the International Federation of Psoriasis Associations, about 3% of the world's population has some form of psoriasis. In the U.S. there are about 150,000 new cases every year, and psoriasis affects about 2% of the population, according to the Cleveland Clinic.

About the Psoriasis Study

This study is a Phase 2a open-label trial in patients with moderate-to-severe plaque psoriasis in which 10 psoriasis patients with ≥ 10% of their skin affected and a PASI (psoriasis activity and severity index) of ≥ 12 points will be treated with 8 mg/kg of GR-MD-02 every other week for a total of seven infusions. The primary endpoint will be the PASI-75, or a 75% improvement in the severity of the disease 30 days following the final infusion. More information on the trial can be found in a CEO Perspective published today, which can be found here.

About GR-MD-02

GR-MD-02 is a complex carbohydrate drug that targets galectin-3, a critical protein in the pathogenesis of fatty liver disease and fibrosis. Galectin-3 plays a major role in diseases that involve scaring of organs including fibrotic disorders of the liver, lung, kidney, heart and vascular system. The drug binds to galectin proteins and disrupts their function. Preclinical data in animals have shown that GR-MD-02 has robust treatment effects in reversing liver fibrosis and cirrhosis.

About Galectin Therapeutics

Galectin Therapeutics is developing promising carbohydrate-based therapies for the treatment of fibrotic liver disease and cancer based on the Company's unique understanding of galectin proteins, which are key mediators of biologic function. Galectin seeks to leverage extensive scientific and development expertise as well as established relationships with external sources to achieve cost-effective and efficient development. The Company is pursuing a development pathway to clinical enhancement and commercialization for its lead compounds in liver fibrosis and cancer.

Do not use Etin Skin Solution it contains a potent steroid and is not authorised for use as a medicinal product in the UK, it's available on the open market including Ebay and and could cause you serious problems.

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The Medicines and Healthcare products Regulatory Agency (MHRA) and the British Association of Dermatologists are today warning people not to purchase or use Etin Skin Solution, a lotion claiming to treat skin conditions and known to have been supplied from various Asian and African beauty shops.


Etin Skin Solution was brought to the attention of MHRA by a consultant at Birmingham Children’s Hospital who became concerned following a complaint by a patient. Investigations to identify the source of this product are being conducted.


MHRA has recently tested samples of the lotion and found it to contain variable amounts of the corticosteroid betamethasone. Etin Skin Solution is not authorised for use as a medicinal product in the UK.


Corticosteroids are prescribed to treat inflammatory skin conditions, especially eczema and psoriasis. Long-term use can cause skin thinning and can worsen conditions such as eczema. Another listed ingredient is clotrimazole which is used in anti-fungal medications.


There are strict legal requirements in place in the UK relating to the sale, supply, manufacture, distribution and advertising of medicinal products. The legislative controls seek to ensure that products meet certain quality and safety standards; a breach of these legal requirements may constitute a criminal offence. The MHRA investigates any report of suspected illegal activity concerning medicines, or medical devices, and takes appropriate action.


MHRA senior policy advisor, Lynda Scammell said “Our advice to anyone who is using this product, particularly on young children and babies, is to discontinue use immediately. People seeking help for skin conditions should discuss alternative treatments with their healthcare professional. Medicines containing corticosteroids should only be given under the supervision of a doctor or pharmacist.”


Professor Celia Moss, Consultant Dermatologist at Birmingham Children's Hospital and one of the hospital's staff who brought the product to MHRA's attention, said: “We discovered the availability of this product after it had been used on the skin of a baby in our care. A nurse from my team visited the shop where it had been purchased and found it was freely available on more than one occasion. We reported this to MHRA and are pleased it has been investigated and action taken.


“However this is just one outlet and it is hard to police every supplier. We are therefore warning people not to use Etin and to report its sale to MHRA. Anyone using a steroid lotion such as this is likely to perceive some short-term benefit, because steroids make red skin look paler. This is because steroids constrict blood vessels in the skin. Unfortunately on discontinuing the product the redness may come back, which of course makes people want to continue it. But to do so is unwise, and after a few days the skin will revert to its previous appearance.”


Dr Firouz Mohd Mustapa of the British Association of Dermatologists said: "Milder steroids for short-term, localised use can be purchased over the counter from a pharmacist, but potent steroids such as this must be prescribed by doctors, who follow strict criteria when prescribing them and monitoring patients using them. This is because they can suppress the skin’s response to infection, can thin the skin, and if applied long term over a wide area, particularly in babies and children, can cause other medical problems.


“For babies and children, NICE guidelines set out clear recommendations on when it is appropriate for dermatologists to prescribe these potent or very potent steroids, the appropriate locations of the body on which they can be used and the duration of treatment. Sale of potent steroid creams directly to the public is illegal for good reason."

Hello, I am new here. Found it by searching for information on Hemp Oil. There is a rumour going around that it can be beneficial to psoriasis sufferers and I wanted to investigate further. 
I would like to know if anyone has any experience or thoughts on Hemp Oil use. I would like to know if it really is a rumour before I spend money on buying some.
What do the experts say?
Is it another fad?
Do I drink it, rub it in or put it into my food?

Thanks for any response in advance.