This 60 case to study looked at inflammatory markers such as sialic acids and the oxidative stress index (OSI) in patients with psoriasis vulgaris. Oxidative stress reflects an imbalance between the systemic manifestation of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage.

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Background and objectives:
Recent studies have implicated the association between oxidative stress and inflammation in pathogenesis of psoriasis and its associated comorbidities. Hence, we undertook to study inflammatory markers such as sialic acids and the oxidative stress index (OSI) in patients with psoriasis vulgaris.

Methods:
Sixty cases and 60 healthy controls were included in this cohort study. Disease severity was assessed by psoriasis area severity index scoring. Serum levels of oxidative stress (total oxidant status, total antioxidant status) and inflammation (highly sensitive C-reactive protein [hs-CRP], total sialic acid, protein bound sialic acid) markers were estimated in controls and cases at baseline and on follow-up. OSI was calculated as the ratio of total oxidant status to total antioxidant status.

Results:
Baseline serum levels of OSI, hs-CRP, and sialic acids were significantly higher in cases compared to controls. Baseline OSI and sialic acids demonstrated a significant correlation with disease severity. After 12 weeks of therapy, there was a significant decline in OSI and serum levels of hs-CRP and sialic acids.

Conclusions:
Our results demonstrate that oxidative stress and inflammation are significantly associated with psoriasis, and treatment with methotrexate results in a significant decline of both the inflammatory and oxidative stress parameters.

This abstract ahead of print looked at the risk of malignancy in patients with psoriasis being treated with biologics.

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There is some debate regarding the risk of developing malignancy and progression of malignancy in patients with psoriasis treated with biologics.

The lack of extensive, long-term, and large studies, including patients with psoriasis, to assess these aforementioned risks makes it difficult to ascertain the safety profile of biologic therapy in these patients. Several studies do support the favorability of the safety profile of biologics in patients with psoriasis in terms of the risk of developing malignancy.

A few studies include patients with a previous history of cancer that were thereafter treated with biologics and show no increased risk of recurrence in those treated with biologics compared to non-biologic therapy. Although recent studies do not show an increased risk of new or recurrent malignancy in patients with psoriasis treated with biologic agents, there is still hesitancy in the widespread use of biologic agents in these patients.

Considering all of the current data and opinions, the benefits of biologic therapy to improve quality of life often outweigh the negligible risk of solid organ malignancy associated with biologics in patients with existing or previous malignancies. Coordinating the management of patients that develop or have a history of previous malignancy with an oncology team is crucial for patient-centered care until clear evidence-based guidelines are developed.

This study looked at Metabolic Syndrome (MBS) in Moroccan patients with psoriasis. Metabolic syndrome is a clustering of at least three of five of the following medical conditions: abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein (HDL) levels.

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Background:
Several recent reports have shown a significant association between psoriasis and metabolic syndrome (MBS).

Objective:
The goal of this study was to investigate the prevalence of MBS and, in particular, the main factors that determine this syndrome in Moroccan patients with psoriasis.

Methods:
A case–control study has included 150 patients with psoriasis and 300 controls matched for age and sex, the MBS was defined according to the International Diabetes Foundation, and the severity of psoriasis was assessed by body surface area.

Results:
Mild psoriasis was seen in 10.7%, 40.3% had moderate psoriasis, and 49% had severe psoriasis. MBS was higher in cases than in controls with statistical differences (44.7 vs. 2.7%, odds ratio [OR]: 26 CI: [12.4–54.3]; P = 0.000). Abdominal obesity and dyslipidemia were the only metabolic factors significantly related to psoriasis whereas diabetes, hypertension, smoking, alcohol consumption, and cardiovascular diseases were not significant. MBS increases with age in our patients with psoriasis, whereas there was no relationship between MBS and gender. Hypertension (P = 0.007), diabetes (P = 0.003), and increased level of triglycerides (P = 0.05) and high-density lipoprotein cholesterol (P = 0.003) were associated with the severity of psoriasis.

Conclusion:
Metabolic syndrome is an important comorbidity in patients with psoriasis, and vigilance and enhanced screening may be important in this population, especially patients with severe disease.

I was hoping to be one of those people you hear about who's psoriasis gets better during pregnancy, but I appear not to have this luck. I have an appointment with my consultant in January so will update you all then. I'm assuming the psoriais cannot be of any danger to the baby?

Hi all. 
I have P since I was in high school talk about a crappy time to get that. Struggled forever. I remember taking Skin Cap spray (international) work do good. Flaunted my short shorts

They took that off market so back to light treatment. Pure pain and hell. 

Been on Embrel for several years decided to try something new in Humira. Insert gigantic regret here. About a little over a month in and I'm miserable. It's all back. Went from about 20% to 75%. 

Anyway first time ever really being open about it  so thanks for creating the forum. Glad to be here.

Hi All

New to site but not new to P & PA   But the site looks good with lots advice and info

Just started on another drug FUMADERM very hopeful about this ?

Baz

The risk of of cancer amongst psoriasis patients has often been spoken about. Here is a population based cohort study that confirms there is an increased risk albeit small.

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Importance:  
The risk of cancer in patients with psoriasis remains a cause of special concern due to the chronic inflammatory nature of the disease, the use of immune-suppressive treatments and UV therapies, and the increased prevalence of comorbid, well-established risk factors for cancer, such as smoking and obesity, all of which may increase the risk of carcinogenesis.

Objective:  
To compare the overall risk of cancer, and specific cancers of interest, in patients with psoriasis compared with patients without psoriasis.

Design, Setting, and Participants:  
Population-based cohort study of patients ages 18 to 89 years with no medical history of human immunodeficiency virus, cancer, organ transplants, or hereditary disease (albinism and xeroderma pigmentosum), prior to the start date, conducted using The Health Improvement Network, a primary care medical records database in the United Kingdom. The data analyzed had been collected prospectively from 2002 through January 2014. The analysis was completed in August 2015.

Exposures of Interest:  
Patients with at least 1 diagnostic code for psoriasis were classified as having moderate-to-severe disease if they had been prescribed psoralen, methotrexate, cyclosporine, acitretin, adalimumab, etanercept, infliximab, or ustekinumab or phototherapy for psoriasis. Patients were classified as having mild disease if they never received treatment with any of these agents.

Main Outcomes and Measures:  
Incident cancer diagnosis.

Results:
A total of 937 716 control group patients without psoriasis, matched on date and practice visit, and 198 366 patients with psoriasis (186 076 with mild psoriasis and 12 290 with moderate-to-severe disease) were included in the analysis. The adjusted hazards ratios (aHRs) with 95% CIs for any incident cancer excluding nonmelanoma skin cancer (NMSC) were 1.06 (95% CI, 1.02-1.09), 1.06 (95% CI, 1.02-1.09), and 1.08 (95% CI, 0.96-1.22) in the overall, mild, and severe psoriasis group. The aHRs for incident lymphoma were 1.34 (95% CI, 1.18-1.51), 1.31 (95% CI, 1.15-1.49), and 1.89 (95% CI, 1.25-2.86); for NMSC, 1.12 (95% CI, 1.07-1.16), 1.09 (95% CI, 1.05-1.13), and 1.61 (95% CI, 1.42-1.84); and for lung cancer, 1.15 (95% CI, 1.03-1.27), 1.12 (95% CI, 1.01-1.25), and 1.62 (95% CI, 1.16-2.28) in the overall, mild, and severe psoriasis groups, respectively. No significant association was seen with cancer of the breast, colon, prostate, or leukemia.

Conclusions and Relevance:  
The association between psoriasis and cancer, albeit small, was present in our cohort of patients with psoriasis. This association was primarily driven by NMSC, lymphoma, and lung cancer.

hi ppls
          has  anyone tryd taking olive leaf extract capsules to help with the condition called ppp or Palmo-planter. mine is on my hands & feet.

Good afternoon Guys,

To get straight to it I think my condition has worsened.  I have a number small patches over my body.  I have seen my doctor and he has finally sent me to the dermo.  Thing is when i made the appointment, I was thinking that I will ask for the new bio drugs or Fumaderm that has been pointed out to me on here.  Since then i have had another problem with my feet which i believed was a running issue.  Plantar Fascitis.    This has been going on for about 10 weeks now and until this morning i had not connected the dots.  When I am making a fist I have a tightness and pain on on knuckle and on the surrounding area.   This has been going on for a few weeks and I am convinced it must be arthritis as my fist dermo guy mentioned this was a likelihood as I have it in on my finger and toe nails.  

So mentally I have been prepared for this so I am fine about it, you get the hand yer dealt I guess.  My question is though, if this is likely arthritis in my feet and hands, will this elevate my chances of being proscribed fumaderm or Cosentyx or will it take my treatment down a different path? 

P.S my dermo appointment is late Feb. There is a huge waiting list.  I have been clawing it back by logging in and picking up cancelled appointments and have pulled a month back so far!

Thanks in advance Guys! 

My fiances grandmother gave me some L'occitane body lotion and body butter yesterday as she mentioned she had used it and it completely cleared her Psoraisis. I was quite baffled as this is not a cheap body lotion, anyone ever used it? I have used the hand cream in the past and although it did not clear the psoriasis, it did a good job of keeping my hands moisturised for long periods of time.

Either way, it wont go to waste, it's some good stuff

Hi all,

I'm new here; have had psoriasis for 20 years but has gotten much much worse in the last 6 months. My dermatologist recommended me to try out Otezla. 
The manufacturer is offering it from free in Ireland at the moment - I think in hope that enough patients will see a benefit which will push the health service here to fund it properly. 

I'm only on day 6 and man oh man they weren't lying about the side effects some people feel on it - the headaches are extraordinary. 

Is there anyone else here who has taken it? Anyone have any stories about how to get through this phase of the treatment on it?

Thanks!

Hi I have been suffering on and off for some years now with psoriasis but it seems to have gotten worse of late so I am now trying fumaderm as nothing else has worked .I've tried for years to get this med from my doctors as I have heard that it has a very good success rate of clearing it . it's the worst it's ever been so I am praying this will work for me .I'm on day 3, week one just 1 pill a day and so far no side effects I think! .all tho was itching more than usual but it's passed . Reading the threads it seems the stronger the dose the more side effects? . Can anyone tell me how long till you see a real difference in the skin ?. I've decided to keep a note weekly of how it's all going . And I can honestly say if the cramps do come  I will at least know, thanks to this club that it seems to be something that passes and is bearable

Hello everyone,
I am new here. My seven years old has been diagnosed with psoriasis. The onset was 2 years ago at least, so he was around 5. At first dr thought it was eczema, only in the last year or so that it become scaly. We did not know much about psoriasis when we got the diagnosis, and thought it was just mild skin condition. Only recently a friend of mine mentioned about how surprised she was to know that my son get psoriasis when he is this young and that her husband has psoriasis and it progressed to psoriasis arthritis. Because of that, I decided to  learn more about psoriasis and frankly now we are scared and worried that my son will get psoriasis arthritis and or uveitis. And the facts that there is no cure. Can anybody share with me what the prognosis is like for children who start to have psoriasis this early? Did any of you had the onset during your childhood? Does yours progress to arthritis? If yes, when did it hapen? Do children with psoriasis have higher chance to get psoriasis arthritis as compared to adult with psoriasis? Please share your stroy if you dont mind, especially those of you who had the onset during your childhood or have children with psoriasis.



Thank you so much

Sandoz a Novartis company and the global leader in biosimilars, announced today that the European Medicines Agency (EMA) has accepted their Marketing Authorization Application (MAA) for a biosimilar to Pfizer's EU-licensed Enbrel.

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Sandoz, a Novartis company and the global leader in biosimilars, announced today that the European Medicines Agency (EMA) has accepted their Marketing Authorization Application (MAA) for a biosimilar to Pfizer's EU-licensed Enbrel® (etanercept) * - a tumor necrosis factor alpha (TNF-alpha) inhibitor. Sandoz is seeking approval for all indications included in the label of the reference product which is used to treat a range of autoimmune diseases including rheumatoid arthritis and psoriasis - more than 120 million people in the EU are living with rheumatic and musculoskeletal diseases (RMDs) and approximately 3.7 million Europeans with psoriasis.

"Today, only 5% of severe psoriasis patients in North America and Europe have access to life-changing biologic treatment options** such as etanercept" said Mark McCamish, M.D., Ph.D., and Head of Global Biopharmaceutical & Oncology Injectables Development at Sandoz. "The acceptance by the EMA of our biosimilar etanercept regulatory submission is a move towards enabling more patients with chronic inflammatory conditions such psoriasis and rheumatoid arthritis to be treated with biologics" McCamish continued.

The regulatory submission to the EMA consists of a comprehensive data package that includes data from analytical, functional, pre-clinical and clinical studies. Sandoz believes that the two pivotal clinical studies; a pharmacokinetic (PK) study in healthy volunteers (HVs) and a confirmatory safety and efficacy study in patients with chronic plaque-type psoriasis (EGALITY), will provide clinical confirmation of similarity to the reference product established in extensive prior analytical comparability studies.

Sandoz has an unwavering commitment to increasing patient access to high-quality, life-enhancing biosimilars. It is the pioneer and global market leader and currently markets three biosimilars. On 3 September, 2015 Sandoz launched the first biosimilar in the United States and recently had its regulatory submissions for biosimilar etanercept and biosimilar pegfilgrastim accepted by the FDA. Sandoz has a leading pipeline with several biosimilars across the various stages of development including five programs in Phase III clinical trials or registration preparation. The company plans to make 10 regulatory filings over a three year period (2015-2017). As part of the Novartis Group, Sandoz is well-positioned to lead the biosimilars industry based on its experience and capabilities in development, manufacturing and commercialization.

I am experiencing an outbreak after a long time in area I had not had problems with for years. The curious thig was that prior to my elbows flaring up I noticed i had lost all the pigment in those areas, it was totally white,then it happened on my ankles a few weeks later the scaling, but pigment is still missing, has anyone else experienced this, its a first for me.

EDIT By Fred: Mention of website removed.

What is an Autoimmune Disorder?

Your body's immune system is responsible for fighting what is perceived to be foreign invaders threatening your body's health: bacteria, viruses and fungi are just a few examples. Your good health depends partly on two important features of the immune system:

It should be able to recognize all tissues and organs within your body as "self" and therefore exempt them from attack by the immune system.
It should be able to identify foreign invaders as "other" to participate in their destruction and mobilize other parts of the immune system to participate in this attack.
Unfortunately, when you have an autoimmune disease, your body's immune system mistakenly confuses what is "self" with what is "other." Instead of protecting your body, the immune system produces cells and chemicals that attack your own body, causing damage and disease. Rheumatoid arthritis; some types of thyroid diseases; and anemia, lupus, celiac disease and type 1 diabetes are also autoimmune diseases.

Why is Psoriasis an Autoimmune Disorder?

As part of its defense against foreign invaders, your body's bone marrow and thymus gland collaborate to pump out specialized white blood cell warriors called "T cells." Under normal circumstances, T cells are programmed to identify and coordinate an attack on enemy combatants.

When you have psoriasis, T cells mistakenly identify your skin cells as "other" and attack them. This attack injures the skin cells, setting off a cascade of responses in your immune system and in your skin, resulting in skin damage (that is, swelling, reddening and scaling).

In an effort to heal, your skin cells begin reproducing rapidly. Activities that should take a month take place in only days, and abnormally large numbers of new skin cells push their way to the surface of your skin. This occurs so quickly that older skin cells and white blood cells aren't shed quickly enough. These discarded cells pile up on the surface of the skin, creating thick, red plaques with silvery scales on their surface: the hallmark of the classic form of plaque psoriasis.

This small study suggests EDIL3  (epidermal growth factor-like repeats and discoidin I-like domains 3), AMOT (angiomotin) and ECM1 (extracellular matrix protein 1) is altered in DMSCs (dermal mesenchymal stem cells) in psoriasis.

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Background:
Dermal microvasculature expansion and angiogenesis are prominent in psoriasis. Our previous microarray study showed that the angiogenesis-related genes EDIL3 (epidermal growth factor-like repeats and discoidin I-like domains 3), AMOT (angiomotin) and ECM1 (extracellular matrix protein 1), had high expression levels in dermal mesenchymal stem cells (DMSCs) from psoriatic skin lesions.

Aim:
To investigate the mRNA and protein expressions of EDIL3, AMOT and ECM1 in DMSCs derived from psoriatic skin in order to better determine the molecular mechanisms of angiogenesis in the skin.

Methods:
DMSCs from 12 patients with psoriasis and 14 healthy controls (HCs) were cultured to passage 3, and identified by morphology, immunophenotype and multipotential differentiation. The mRNA and protein expressions of EDIL3, AMOT, and ECM1 in the DMSCs were determined using real-time reverse transcription PCR and western blotting.

Results:
DMSCs displayed spindle-like morphology and surface protein expression, and were able to differentiate into osteoblasts, chondrocytes and adipocytes. mRNA expression analysis showed that EDIL3, AMOT and ECM1 were expressed at 2.54-fold, 2.11-fold, and 1.90-fold higher levels, respectively, in psoriatic DMSCs compared with HC DMSCs (all P < 0.05). Protein analysis showed significantly (all P < 0.01) higher concentrations of EDIL3, AMOT and ECM1in the psoriasis group than in the HC group.

Conclusions:
Our data demonstrate for the first time that expression of EDIL3, AMOT and ECM1 is altered in DMSCs in psoriasis, suggesting that EDIL3, AMOT and ECM1 are involved in the excessive angiogenesis and vasodilation observed in psoriasis.

This is a population-based cross-sectional study which set to evaluate the association between psoriasis, serum uric acid levels and gout in a cross-sectional study using the US National Health and Nutrition Examination Survey (NHANES) database.

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Background:
Psoriasis has been reported to be associated with raised serum uric acid levels and gout, and uric acid has been demonstrated to mediate inflammatory pathways via secretion of pro-inflammatory chemokines.

Aim:
To evaluate the association between psoriasis, serum uric acid levels and gout in a cross-sectional study using the US National Health and Nutrition Examination Survey (NHANES) database.

Methods:
Data on clinical history of psoriasis, gout and other relevant medical conditions from the questionnaire as well as laboratory parameters for serum uric acid and lipid levels in the periods 2003–2006 and 2011–2012 were analysed. Multivariate analysis with logistic regression modelling was performed, with hyperuricaemia as the dependent variable, and age, sex, ethnicity, body mass index, metabolic syndrome, current smoking status, alcohol consumption and history of psoriasis as the independent variables.

Results:
Of the 11 282 study participants, 297 (2.6%) reported a history of psoriasis and 1493 (13.2%) were found to have hyperuricaemia. Patients with psoriasis were at increased risk of having hyperuricaemia, compared with those without psoriasis (OR = 1.37; P = 0.04). They were also more likely to report a history of gout (OR = 1.83; P < 0.05). However, neither association was significant after adjusting for potential confounders with multivariate logistic regression.

Conclusion:
In conclusion, there was insufficient evidence to show that psoriasis is an independent risk factor of hyperuricaemia or gout. A raised serum uric acid level may be a consequence of metabolic syndrome, which in turn is associated with psoriasis.

According to the British Association of Dermatologists (BAD) the NHS UK are wasting millions of £s on GP's prescriptions for psoriasis. They estimate that the NHS could save around £2million a year if dermatology items listed were obtained from NHS manufacturers and not from pharmacists. For example, one treatment used for psoriasis, coal tar 10% ointment, is listed in the Tariff3 at £274.27, an item which is available from an NHS Specials manufacturer for £15.49 (a 17-fold increase, or an increase of 1670%).

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The British Association of Dermatologists is urging the government to revisit a policy that allows certain medicines prescribed by GPs to cost up to 17 times more than the same drugs prescribed in hospitals, needlessly wasting the NHS millions of pounds each year.

Most drugs prescribed by doctors are ‘licensed’ medicines which have been approved for sale in the UK. When suitable licensed medicines are not available, the Medicines Act allows doctors to prescribe unlicensed medicines. For many common skin diseases including psoriasis and eczema, the range of licensed medicines is limited. As a result, doctors rely greatly on unlicensed creams and ointments, known as special-order medicines, or ‘Specials’. Such medicines are commonplace in dermatology - the British Association of Dermatologists (BAD), for example, recommends 39 Specials for use in skin disease treatment.

However, the BAD has learnt that prices for Specials when prescribed in the community, as opposed to in hospital, are up to 1670 per cent, or 17 times, higher than the same drugs for secondary (hospital) care patients. This huge cost to the NHS is resulting in patients being denied access to treatment, as GPs and the Clinical Commissioning Groups who oversee them are unable to justify such high costs. And the problem is not limited to dermatological Specials, with medicines for other disease areas also being prescribed at greatly inflated prices.

Specials on the Drugs Tariff

In England, when a community pharmacist supplies a patient with a medicine that has been prescribed by a GP, the pharmacist receives a payment from the NHS for this drug. The amount they receive is a set amount, specified in the ‘NHS Drug Tariff’,1 and nine of the dermatology Specials on the BAD’s recommended list of 39 are listed on this Tariff.

The price set out in this Tariff has been decided by the Department of Health, based on an average of costings provided only by members of the Association of Pharmaceutical Specials Manufacturers (APSM), all of whom are private companies, and the Tariff price does not take into account much cheaper quotes from NHS manufacturers.

However, the majority of dermatology Specials are made within NHS hospitals, by hospital manufacturing units, who provide Specials to the NHS at prices reflecting lower manufacturing costs. Among the reasons for the lower costs is the fact that these units are able to produce the medicines in large batches. Conversely, APSM members provide the same drugs at far higher prices, in part due to the bespoke, non-batch approach to the manufacturing.

This system means that in England, Wales and Northern Ireland, a whole-of-market quote has not been obtained for Specials, leading to excessively high prices charged to the NHS for these drugs.

Regardless of where a community pharmacist sources a Special medication from - be it a costly version from a private company or a cheaper version from an NHS manufacturing unit - the pharmacist receives the same reimbursement from the NHS as defined by the Tariff, allowing for large profit margins.

For example, one treatment used for psoriasis, coal tar 10% ointment, is listed in the Tariff3 at £274.27, an item which is available from an NHS Specials manufacturer for £15.49 (a 17-fold increase, or an increase of 1670%). Even allowing for some margin and procurement costs for supplying community pharmacists, a mark-up of £258.78 on an item costing £15.49 is wildly excessive. Salicylic acid 20% ointment (used to treat hard skin build-up in skin disease) is available for £27.25 from NHS manufacturers but has gone on Tariff at £246.93 (806% increase), while another medicine, salicylic acid 2% / sulfur 2% in aqueous cream, is available at £28.68 but has gone on Tariff at £215.85 (652% increase).

In Scotland, NHS Tariff prices are far lower, for example 5% coal tar ointment, used to treat psoriasis, is on the Scottish Tariff at £26.47 and on the English Tariff at £231.28, while 2% eosin solution (used for skin infections in leg ulcers) is listed at £27.60 versus £229.13 in England.

Dr Deirdre Buckley, Chairman of the Specials Working Group of the British Association of Dermatologists said: “The tariff-setting system used by the Department of Health in England relies on an arrangement with the APSM, a body representing only private manufacturers, rather than a mixture of NHS and private. An average of prices paid to members of the APSM, which are much higher than NHS manufacturers’ quotes, are used by the DH to decide the NHS Tariff price.

“The margins of over a thousand per cent attached to NHS Dermatology Special medicines during the Department of Health's tariff-setting process seem wildly excessive. It appears to us that the taxpayer is being overcharged for the sole benefit of community pharmacists and some private Specials pharmaceutical manufacturers, or more worryingly, our patients are denied the medications they need because they are too expensive.”

The British Association of Dermatologists acknowledges that the current tariff-setting process, put in place by the Department of Health in 2011, has led to savings for the NHS, but is asking the government to review the process in light of the highlighted issues, and to ensure further cost savings by including NHS manufacturing units in the equation.

Health Canada has approved Beteflam (betamethasone valerate topical patch), a novel, patent-protected treatment of mild to moderate plaque psoriasis of the elbows and knees for a maximum duration of 30 days in adult patients.

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Cipher Pharmaceuticals Inc. today nnounced that Health Canada has approved PrBeteflam™ (betamethasone valerate topical patch), a novel, patent-protected treatment of mild to moderate plaque psoriasis of the elbows and knees for a maximum duration of 30 days in adult patients.

"We are pleased to make Beteflam available as a valuable new treatment option to Canadian dermatologists and to the patients who suffer from this disease," said Shawn O'Brien, President and CEO of Cipher. "Psoriasis affects one million Canadians1 and can profoundly impact the quality of life for many patients. Once the product is launched in Q2 2016, Beteflam is expected to be our fourth marketed product in Canada behind Epuris®, Vaniqa®, and Actikerall™. With potentially six commercial products on the Canadian market by the end of 2016, we have multiple new near-term revenue streams as we work toward our goal of reaching $50 million in annual sales in our Canadian dermatology business."

Topical corticosteroids remain the primary treatment for steroid-responsive inflammatory skin diseases, including mild to moderate chronic plaque psoriasis. Occlusion with plastic film dressings is a widely accepted procedure to enhance their efficacy, especially in the treatment of psoriasis. Beteflam is a patch that is applied once daily to the affected region and may be cut to fit the particular size and shape of the psoriatic lesion thereby reducing potential contact of the steroid with healthy areas of skin.

Cipher licensed the Canadian rights to Beteflam from Institut Biochimique SA ("IBSA"). The efficacy and safety of Beteflam was demonstrated by two randomized, active-controlled studies involving 555 patients with mild-to-moderate chronic plaque psoriasis, of which 281 patients received Beteflam. The results of the clinical program demonstrated that the clinical efficacy of  Beteflam  was superior to that of  betamethasone valerate 0.1% cream and comparable to that of Dovobet 50 µg calcipotriol plus 0.5 mg betamethasone dipropionate ointment. The commonly reported adverse drug reactions that occurred in patients using Beteflam were skin and subcutaneous tissue disorders, occurring in < 5% of patients treated.