Here's an interesting study that suggest that the people treating psoriasis patients may not have the right training to suggest lifestyle behaviour change. I say interesting because my dermatologist has often suggested to me that exercise and alcohol have a large part to play in psoriasis, I've never disbelieved her but there is no way she is going to be able to push me hard enough to make the changes needed.

Also in her defence, this study is suggesting that my dermatologist needs better training in lifestyle behaviour. I think she has enough training to understand her job, and her job is not to instruct patients on how to live their life. Advise yes but a dermatologist will never be able to convince me that going without alcohol and doing more exercise will benefit me, I'm stubborn and it's just not her job, she has enough on her workload without trying to convince me to stop drinking or do more exercise.

One wouldn't ask an electrician to fix the plumbing in their house, so why put more pressure on a dermatologist to discuss lifestyle changes with a patient.

I would be interested to what others think after reading the study.

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Background:
Psoriasis is associated with significant comorbidity. Excess alcohol use, smoking and higher body mass index are all associated with psoriasis and may contribute to its onset and/or exacerbation. Lifestyle behaviour change (LBC) can be beneficial in the prevention of psoriasis and/or reduction of its severity. LBC techniques are effective when used properly by healthcare professionals.

Objectives:
It is unknown whether clinicians managing patients with psoriasis are familiar with LBC techniques or are confident to deliver LBC support in routine consultations. This study aimed to elicit the views and attitudes of healthcare professionals in primary and secondary care about addressing LBC for patients with psoriasis.

Methods:
We carried out in-depth semistructured interviews with 23 dermatology specialist and general practitioners in English primary and secondary care settings stratified by discipline. Data were analysed using constant comparison and principles of Framework Analysis.

Results:
Clinicians recognized that lifestyle behaviours were important in psoriasis management, but believed it was not their role to facilitate LBC. Limited knowledge and skills to implement LBC principles and techniques underpinned their beliefs. Participants identified a need for training to enable the incorporation of LBC support activity into psoriasis services.

Conclusions:
Clinicians are not yet trained to support patients with psoriasis with effective LBC methods. Training in these methods is needed to enable healthcare professionals to assess and manage psoriasis better.

Hi All,
just found this forum while researching Fumaric acid esters. Ive been taking Metotrexate for 3 years with good results but my psoarasis has been slowly creeping back and dose cant be increased anymore so my dermatologist wants me to try the a above mentioned treatment. Unfortunatly it would cost 144 eurro a month and I cant afford it so I'm not sure where to go from here.

I am living in Shanghai, and I am trying to get Otezla for my uncle. But Otezla is still not in the market of China. Can I get some suggestions about getting the medicine?

Thanks a lot!
Zach

We've been reporting the progress of Secukinumab for a while now on Psoriasis Club, and soon it looks like we will be reporting it has gained FDA approval for the treatment of psoriasis.

Secukinumab is a first in class, fully human, monoclonal IgG1κ IL17A antibody that selectively binds to the pro inflammatory cytokine interleukin 17A (IL17A) and inhibits
its interaction with the IL17 receptor. IL17A is a naturally occurring cytokine that is involved in normal inflammatory and immune responses and plays a role in the pathogenesis of plaque psoriasis.

On the 20th October, FDA advisers will be voting whether to recommend it for full approval. And are due to give a final decision on by January 2015.

The general summery of the FDA Briefing Document states:

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The currently available data support a favorable benefit risk assessment for the use of secukinumab for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy. No major safety issues associated with secukinumab use have been identified to date.

Recently a "new" medication was released in the Netherlands for treating Multiple Slerose. It is based on the working substance Dimethylfumarate.

The medication draws attention because of its price, and was in a Television transmission compared to a much cheaper medication in reality one of our well known psoriasis medications.
The neurologist that brought this discrepancy to the attention of the public, dr. Bob van Oosten, says in this transmission, that for MS he is only allowed by the protocol to prescribe this new medication to MS patients. (Long live the protocol designed by [old|wise] men).

In the mean time, the minister of Health, mrs. Schippers, is also attached to the case, and she already signaled to the producing pharmacologist that they are way too expensive, which has also been mentioned in an article in the papers.
Unfortunately she at the same time says that it should be dealt with by the European Parliament, which shifts this item to somewhere in the future. The EU does not have the name to be quick on items that are really important for the civilian.
Pharma says that the price is relevant and in balance with all the research that has been done, but:
- Why is the other medication than so much cheaper? And this has 20 years of field experience.
- And where are those studies?

If you are interested you can watch the transmission at [web]https://www.rtlxl.nl/#!/132237/ce0a02c6-7153-3bba-b11e-c259ef1b9a46[/web]. It is in dutch, but I think it is not so complicated that you would not be able to follow it.
It is on a site called "Transmission missed?", where one can review all kinds of news transmissions.
The item on the medication starts at around 12:45 minutes, you are able to skip to this time.

Following on from Cimzia (certolizumab pegol) getting approval for the treatment of Psoriatic Arthritis (PsA) in USA, UK, & Ireland See Here: Cimzia gets FDA approval for psoriatic arhtritis
Phase 3 clinical trial data has been presented at the 23rd Congress of the European Academy of Dermatology and Venereology (EADV)

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Treatment with certolizumab pegol showed sustained positive effects on dermatological outcomes over 96 weeks in patients with psoriatic arthritis.

Patients' mean Psoriasis Area and Severity Index (PASI) improved from a score of 12.0 at baseline to 2.6 at week 96.

In addition, a 75% improvement in the PASI score (PASI-75) was seen in 53.0% of patients, and a 90% improvement in the PASI score (PASI-90) was seen in 44.0% of patients over the study period.

The RAPID-PsA trial enrolled adult patients with active psoriatic arthritis who had failed ≥1 disease-modifying anti-rheumatic drugs (DMARDs). In addition, while previous use of a tumour necrosis factor (TNF) inhibitor was allowed for any given patient, the percentage of all patients who had received 1 prior TNF inhibitor could not exceed 40%.

In the first 24 weeks of the study, 409 patients were randomised 1:1 to double-blind treatment with certolizumab 200 mg every 2 weeks, certolizumab 400 mg every 4 weeks, or placebo. Both certolizumab groups initially were given a 400 mg loading dose at weeks 0, 2, and 4.

From week 24 to week 48, a dose-blind period followed, in which patients originally randomised to placebo were re-randomised to certolizumab of either dose. Patients originally randomised to certolizumab continued receiving the same dose. Then from week 48 to week 216, all treatment was open-label, with the same doses being continued. Treatment was administered as a subcutaneous injection.

At week 0, the number of patients randomised to both doses of certolizumab was 273. Of these, 91% completed treatment to week 24, 87% to week 48, and 80% to week 96. A total of 166 of them (60.8%) showed a psoriasis-affected body surface area (BSA) of ≥3% at baseline, with a mean BSA at baseline of 24.2%. Results showed that this group's mean BSA fell to 8.1% at week 24 and then to 6.5% at week 96.

Among these 166 patients, mean PASI score at baseline was 12.0 and this was reduced to 2.7 at week 24 and 2.6 at week 96. Treatment response was also assessed by how many of them reached PASI-75 (61.4% at week 24 and 53.0% at week 96) and PASI-90 (41.6% at week 24 and 44.0% at week 96). In addition, 22.9% of these patients received a rating of "clear" on the Physician’s Global Assessment of Psoriasis (PGA) scale at week 24, which improved to 30.7% at week 96.

Among all patients, the Dermatology Life Quality Index (DLQI) score fell by 5.8 points at week 24 and by 6.0 points at week 96 compared with baseline levels, indicating an improvement in the patient's own assessment of their quality of life impaired by their psoriasis.

The safety analysis included all patients treated with ≥1 certolizumab dose to week 96 (n = 393). Treatment-emergent adverse events (AEs) were reported in 87.8% of patients (n = 345; event rate per 100 patient-years: 329.8), including 45 that were severe (11.5%). Serious AEs occurred in 17.0% of patients (n = 67; event rate per 100 patient-years: 14.5).

Thirty-six patients (9.2%) discontinued the study due to AEs. While serious infections were reported in 16 patients (4.1%; event rate per 100 patient-years: 3.3), no cases of tuberculosis were found. Six patients died (1.5%).

Psoriasis patients in the UK are being let down when going onto the bio treatments according to a new study which shows 54 percent of patients who failed to achieve effective control with a bio had no treatment change six months later, and almost all (92 percent) of patients who lost effective control had no treatment change six months later.

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New UK data from the PICTURE study released at the European Academy of Dermatology and Venereology (EADV) annual congress in Amsterdam show that two thirds of UK moderate to severe psoriasis patients treated with biologic therapies are failing to reach or maintain effective control of their symptoms. These data show one third failed to reach a 75 percent reduction in symptoms, (known as PASI 75), and an additional one third failed to maintain this response.

Additionally, the PICTURE study demonstrated that 54 percent of patients who failed to achieve effective control had no treatment change six months later. Furthermore, almost all (92 percent) of patients who lost effective control had no treatment change six months later. These data suggest UK clinicians may be maintaining patients on initial biologic treatment even though a response has not been achieved, or is not sustained.

Commenting on the results, chief investigator Dr Anthony Bewley, Whipps Cross University Hospital, London said, "These results demonstrate that many patients are failing to achieve optimal treatment for their psoriasis and remain on inadequate therapies. We must be aware of patients who are failing to respond and work with them to ensure they are on the most appropriate treatment so we can make the most of our resources."

In the UK, approximately 1.8 million people live with psoriasis and 20 percent are thought to have moderate to severe psoriasis. Poorly controlled moderate to severe psoriasis patients could cost the NHS up to approximately £6million per year. In addition to the cost burden, psoriasis has been shown to be associated with depression, anxiety and tendency to suicide (350 cases per year) as well as reduced levels of employment and income.

Obvious symptoms of psoriasis include red, itchy skin with scaly patches (plaques). People with moderate to severe psoriasis may have an increased risk of comorbidities, including psoriatic arthritis, obesity, metabolic syndrome, cardiovascular disease, psychiatric illness and cancer.

About the PICTURE study:
The PICTURE study primarily aimed to describe current treatment pathways with biologic therapies used in the management of psoriasis in UK NHS clinical practice.

PICTURE was a retrospective observational study of 221 UK patients with chronic plaque psoriasis aged >18 years at initiation of first biologic therapy. Data were collected from 10 NHS Trust sites across the UK (England, Wales and Scotland).

A novel new drug for the treatment of psoriasis is about to start Phase 1B clinical trials, ShK-186 is Kineta's® lead clinical stage drug candidate in its Autoimmune program. Originally derived from Stichodactyla helianthus, a Caribbean sea anemone. Kineta’s drug product is manufactured synthetically. Preclinical research demonstrated that ShK-186 is effective in animal models of eight autoimmune diseases including multiple sclerosis and rheumatoid arthritis.

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Kineta, Inc., a biotechnology company focused on the development of immune modulating drugs for critical diseases, announced today that the company has opened a Phase 1B proof-of-concept clinical trial for psoriasis using its drug candidate, ShK-186. ShK-186 is a novel, immune-sparing therapeutic in development for a variety of autoimmune diseases. Kineta is planning on initiating an additional clinical trial in patients with psoriatic arthritis in the coming months.

The psoriasis trial is designed to evaluate the effects of biweekly injections of ShK-186 for four weeks in patients with active plaque psoriasis. Patients will be monitored for safety endpoints, assessment of redness, scaling, and lesion thickness, as well as inflammatory biomarker activity in blood and skin biopsy tissue.

“Initiating this trial is another milestone in the clinical development of this novel compound,” said Charles Magness, Kineta’s CEO and President. “Patients with autoimmune diseases desperately need new treatments that effectively address the disease without harmful side effects.”

More good news for New psoriasis tablet Otezla (Apremilast) has been announced at the European Academy of Dermatology and Venereology congress in Amsterdam.

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New analysis of the ESTEEM 2 trial, demonstrated that more than 70% of patients who received treatment with Otezla (apremilast) twice-daily after 16 weeks achieved clinically meaningful improvement when rated by the Dermatology Quality of Life Index.

Pooled analyses of ESTEEM 1 and 2 from 1,250 patients was also presented, showing that Otezla significantly increased work productivity and improved work limitations compared with placebo at week 16. Other data, from ESTEEM 2, demonstrated that the phosphodieasterase-4 (PDE-4) inhibitor significantly improved psoriasis in difficult-to-treat areas such as the palms of the hands and feet, nails and scalp.

Otezla is competing with the injectable tumour necrosis factor (TNF) inhibitors, notably AbbVie's Humira (adalimumab) and Pfizer/Amgen's Enbrel (etanercept). Many observers believe the fact that it does not require routine lab monitoring is a significant plus, while Lluis Puig of Hospital de la Santa Creu i Sant Pau in Barcelona, speaking at an event outside EADV, said oral treatments could be a better long-term option.

Hi guys
I'm new to the club and wish I'd found you years ago.
I am 35 years old mother of 3 boys. I live in Ireland.  I have had psoriasis for 30years. I was on methotrexate for over 2 years but I changed over to Fumaderm 12weeks ago. I am taking 2tabs twice a day.
Since starting the treatment I have not experienced too much cramping thank God but I have been very flushed a lot of the time. I have had a very bad kidney infection, a bout of gastroenteritis and yesterday I developed a middle ear infection.
After my last blood test the dr rang me and asked me to return for another blood test as there was something abnormal with my white blood cell count, she didn't elaborate but I am getting a bit worried. I had the second test this week and am waiting to hear from them.
Does anyone know what might be going on?
Also can Fumaderm cause a person to have interrupted sleep?? I keep waking after only an hour or two and don't sleep properly for the rest of the night.
If anyone can help I would really appreciate it as I am really anxious about this.
Cheers
Shadie xxx

This study looked at personal history of gallstones and risk of incident psoriasis and psoriatic arthritis in U.S. women.

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Background:
Metabolic syndrome has been associated with both gallstones and psoriasis, suggesting a potential biological linkage between gallstones and psoriasis. However, the association between gallstones and psoriasis has not yet been studied.

Objective:
To investigate the association between gallstones and psoriasis.

Design:
Prospective cohort study.

Setting:
Nurses’ Health Study II (1991-2005).

Participants:
89,230 women aged 25 to 42 years who were free of psoriasis at baseline and responded to a 2005 follow-up questionnaire regarding their diagnosis of psoriasis.

Main Outcomes and Measures:
Relative risk (RR) of developing psoriasis or psoriatic arthritis (PsA), which were self-reported and validated by supplemental questionnaires.

Results:
In this population of women, 2,206 participants had gallstones confirmed by a history of cholecystectomy at baseline. A total of 642 individuals had a diagnosis of incident psoriasis, of which 157 had concomitant PsA. After adjusting for known risk factors of psoriasis besides body mass index (BMI), a baseline history of cholecystectomy-confirmed gallstones was associated with increased risk of psoriasis (multivariate-adjusted RR = 2.20, 95% CI: 1.56, 3.10) and concomitant PsA (multivariate-adjusted RR = 4.41, 95% CI: 2.70, 7.18). After additionally adjusting for BMI, the fully-adjusted RRs associated with a history of cholecystectomy-confirmed gallstones were 1.70 (95% CI: 1.20,2.41) for psoriasis and 2.96 (95% CI: 1.80, 4.89) for PsA.

Conclusions and Relevance:
Personal history of gallstones was associated with an increased risk of psoriasis and PsA, independent of obesity in a cohort of US women.

Janssen the makers of Stelara (ustekinumab) are looking for EU approval to treat 12 to 17 year old psoriasis patients that are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.

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Janssen-Cilag International NV (Janssen) announced today that a Type II Variation has been filed with the European Medicines Agency seeking approval of STELARA® (ustekinumab) for the treatment of moderate to severe plaque psoriasis in pediatric patients ages 12 to 17 years old who are inadequately controlled by, or are intolerant to, other systemic therapies or phototherapies.

There currently are limited options for this population in the European Union. In general, children living with moderate to severe psoriasis must contend with a potentially disfiguring and lifelong disease that can permanently impair psychological development.

"Janssen is committed to the continued development of STELARA, especially in this underserved pediatric population," said Newman Yeilding, M.D., Head of Immunology Development, Janssen Research & Development, LLC. "We look forward to collaborating with the European Medicines Agency in working towards providing a new treatment option for dermatologists and pediatric patients 12 years and older who may benefit from STELARA."

The application is supported by data from the Phase 3 CADMUS registration study, which evaluated the efficacy and safety, as well as improvements in quality of life, among adolescents (pediatric patients ages 12 to 17) receiving STELARA compared with patients receiving placebo.

About CADMUS:
CADMUS, a Phase 3, randomized, double-blind, placebo-controlled, parallel, multicenter trial, evaluated the efficacy and safety of STELARA in pediatric patients ages 12 to 17 years with moderate to severe plaque psoriasis. Patients (N=110) had been diagnosed more than six months prior to first study agent administration with a Psoriasis Area Severity Index (PASI) score greater than or equal to 12, a Physician's Global Assessment (PGA) score greater than or equal to 3 and body surface area (BSA) involvement of at least 10 percent. In addition, patients were inadequately controlled with topical therapy or were candidates for systemic/phototherapy.

Patients were randomized 1:1:1 to receive subcutaneous placebo, STELARA standard dosing (SD) [intended to achieve exposures comparable to adults] or STELARA half standard dosing (HSD) [intended to achieve exposures half of those seen in adults]. STELARA dosing tiers were determined by body weight. Patients receiving placebo crossed over to receive STELARA SD or HSD at weeks 12 and 16; all patients continued with maintenance dosing every 12 weeks through week 40. Final efficacy and safety evaluations were made at weeks 52 and 60, respectively. The primary endpoint of the study was a PGA score of cleared (0) or minimal (1) at week 12. Secondary endpoints at week 12 included at least a 75 or 90 percent improvement in psoriatic skin lesions, as measured by PASI 75 or PASI 90, and improvement in quality of life, as measured by the Children's Dermatology Life Quality Index (CDLQI) [patient-reported outcome].

Janssen has reported new findings about Stelara at the annual meeting of the European Academy of Dermatology and Venereology (EADV)

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Janssen has reported new findings at the annual meeting of the European Academy of Dermatology and Venereology (EADV) showing significantly better persistency and lower rates of discontinuation with STELARA® (ustekinumab) therapy in comparison to anti-tumor necrosis factor (TNF)-alpha treatments among patients participating in the Psoriasis Longitudinal Assessment and Registry (PSOLAR), a post-marketing registry following patients with moderate to severe plaque psoriasis. The analysis reports on patients starting treatment, longevity of treatment and discontinuation rates of biologic therapies, including ustekinumab, infliximab, etanercept and adalimumab.

"Finding a therapy that patients can continue long term for a lifelong disease like psoriasis is important, especially when considering the potential consequences from stopping or switching treatment," said Dr Alan Menter, Chief, Division of Dermatology, Baylor University Medical Center, USA and lead investigator. "This particular analysis of the PSOLAR registry showed higher treatment longevity and lower rates of discontinuation with ustekinumab compared with anti-TNF-alpha agents."

PSOLAR is a longitudinal, observational study evaluating safety and clinical outcomes for patients with psoriasis who are treated with or are candidates for treatment with ustekinumab, infliximab, adalimumab, etanercept and other conventional systemic agents.2 PSOLAR is funded and managed by Janssen, and has a Steering Committee that includes external experts in the field of epidemiology and psoriasis. In this analysis, duration of treatment was defined by the length in days between the first dose of treatment and discontinuation of treatment; switch to a different treatment; registry withdrawal or the most recent data collection (August 23, 2013), whichever occurred first. Persistence was assessed by Kaplan-Meier (KM) analysis for time to therapy stop/switch. Cox proportional hazard regression (HR) analysis was used to compare time to stop/switch of ustekinumab with time to stop/switch of infliximab, adalimumab and etanercept.

Separate analyses were performed for first-line use (biologic-naive patients; ie first biologic started, with start occurring on registry), second-line use (second biologic started, with start occurring on registry) and third-line use (third biologic started, with start occurring on registry) to reduce confounding associated with prior exposures. It is important to note that patients are not randomised to treatments in PSOLAR, and interpretation of the results should take into account the characteristics of longitudinal registry studies.

More patients overall were treated with ustekinumab (n=1,833) than adalimumab (n=1,303), etanercept (n=537) or infliximab (n=327). Among first-line use, significantly better persistence was observed for ustekinumab compared with other biologics (adalimumab vs. ustekinumab: HR 4.99; confidence interval (CI): 3.39-7.35; P < 0.0001; etanercept vs. ustekinumab: HR 5.59; CI: 3.77-8.29; P < 0.0001; infliximab vs. ustekinumab: HR 3.04; CI: 1.66-5.57; P = 0.0003). Similar results were observed among the second- and third-line patient groups, with ustekinumab showing better treatment longevity and fewer discontinuations than other biologics. Reasons for stop/switch were similar across all four biologics. The analyses have not yet been adjusted for differences among treatment groups such as socioeconomic factors, setting of administration (self-administration versus in doctor's office) and geographic region.

Additional PSOLAR data presentations, including multiple safety analyses of the various treatment groups, are being presented at the EADV meeting.

Amgen have released results of the ABP 501 phase 3 study evaluating the efficacy and safety of their biosimilar of Humira (adalimumab)

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Amgen today announced its Phase 3 study evaluating efficacy and safety of biosimilar candidate ABP 501 compared with Humira® (adalimumab) in patients with moderate-to-severe plaque psoriasis met its primary endpoint. The primary endpoint was the Psoriasis Area and Severity Index (PASI) percent improvement from baseline to week 16 of treatment. At week 16, the PASI percent improvement from baseline was within the prespecified equivalence margin for ABP 501 compared to adalimumab. Safety and immunogenicity of ABP 501 were comparable to adalimumab. This is the first of two Phase 3 studies intended to form the basis for global regulatory submissions for ABP 501.

ABP 501 is being developed as a biosimilar to adalimumab, an anti-TNF-α monoclonal antibody, which is approved in many countries for the treatment of inflammatory diseases, including rheumatoid arthritis, plaque psoriasis (PsO), polyarticular juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease and ulcerative colitis.

"Results from Amgen's biosimilar Phase 3 plaque psoriasis study met the primary endpoint for efficacy and showed comparable safety and immunogenicity to adalimumab, which further demonstrates the Company's commitment to provide patients with access to high-quality medicines," said Sean E. Harper, M.D., executive vice president of Research and Development at Amgen. "We look forward to continuing to leverage our experience and expertise in biotechnology to bring biosimilars to patients."

Amgen has six biosimilar molecules in development and expects to launch the portfolio starting in 2017.

Study Design:
This randomized, double-blind, active-controlled study (study number 20120263) evaluated safety and efficacy of ABP 501 compared to adalimumab in adult patients with moderate-to-severe plaque PsO. There were 350 patients enrolled and initially randomized. Among them, there were 174 patients in the ABP 501 group and 173 patients in the adalimumab group treated. One patient in the ABP 501 group and two patients in the adalimumab group were randomized but did not receive any investigational product. The primary endpoint, PASI percent improvement, was evaluated at week 16. The PASI is a measure of the average redness (erythema), thickness (induration), and scaliness (scaling; each graded on a 0-4 scale) of the lesions, weighted by the area of involvement. All assessments for a given patient were made by the same observer whenever possible.

At week 16, patients with a PASI 50 or above response will remain on study for up to 52 weeks. Patients continuing on study beyond week 16 were re-randomized in a blinded fashion such that all patients initially randomized to ABP 501 continued to receive ABP 501 and those on adalimumab either continued on adalimumab or switched to ABP 501 in a 1:1 fashion. Patients will continue on treatment until week 48, when the patients will receive the last dose of investigational product. The final efficacy assessments will be conducted at week 50 and the study will end at week 52.

I can't see this helping people with a large amount of psoriasis, but it does sound like a good idea for those with the odd stubborn patch. What do you think?

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Philips launches BlueControl, the world’s first wearable blue LED light therapy device to treat

Royal Philips, the global leader in lighting, today announces the launch of Philips BlueControl, a clinically tested wearable medical device that uses blue LED light to control mild to moderate cases of psoriasis vulgaris. It will be prescribed by physicians and available through distributors in The Netherlands, Germany and The UK from October 2014.

Philips conducted two clinical trials in partnership with the University Hospital of Aachen to investigate the efficacy and safety of Philips BlueControl to reduce the symptoms of psoriasis vulgaris. In the second trial that took place over 4 months (completed in June 2014), patients were treated for 12 weeks. The results showed a 50% reduction on average of symptoms according to the Local Psoriasis Area Severity Index (PASI) which measures the severity of psoriasis plaques (thickness, redness and scaling). No negative side-effects of the blue LED light treatment were observed.

Philips BlueControl has been developed to be easily integrated into a patient’s daily routine and reduces the need for physician’s visits. Worn simply by adjusting a strap on affected arms, legs, elbows and knees, the UV-free blue LED light therapy is enabled by 40 high-intensity blue LEDs with tailored light settings. Designed with the patient in mind, the battery-driven device can be used anytime and anywhere.

“Research proves that blue LED light treatment slows down rapid cell division6 and can also reduce inflammation.7 This research has enabled us to develop, for the first time, an unprecedented treatment device that can make a real difference to the lives of sufferers psoriasis vulgaris.” says Matthias Born, Head of Clinical Affairs for Philips’ Light and Health business.

LEDs for medical treatments require special features which exceed those of conventional LEDs, including high intensities and tailored adjustments such as pulsed LED light. Philips BlueControl is the result of rigorous research with clinical and academic partners and a complex optimization procedure to enable medical grade features to be included in a compact, easy-to-use design.

Amgen the makers of Enbrel and Brodalumab will be presenting several studies at the 23rd Congress of the European Academy of Dermatology and Venereology (EADV) in Amsterdam, Oct. 8-12, 2014.

Brodalumab data to be presented include an exploratory analysis of the Phase 2 trial evaluating efficacy and safety of brodalumab in moderate-to-severe plaque psoriasis patients with prior biologic exposure, along with an analysis from the open-label extension study of that same Phase 2 study evaluating patient response to treatment after nearly three years. Brodalumab is being co-developed by Amgen and AstraZeneca. Kyowa Hakko Kirin, which has an exclusive license to develop and commercialize brodalumab in Japan, China and certain other Asian countries, will present efficacy and safety data from its Phase 2 study evaluating brodalumab in Japanese patients with moderate-to-severe plaque psoriasis.

ENBREL data focus on step-down dosing compared with a high-dose regimen and patient-reported outcomes of treatment with ENBREL compared to treatment with ENBREL in combination with topical therapies. Additional data include the functional equivalence of proposed biosimilar ABP 501 to adalimumab and an analysis of the incidence of symptoms such as itching and pain in patients with psoriasis.

Source: NO LINKS ALLOWED

More on Enbrel (etanercept) and Brodalumab phase 3 results

My Psoriasis was 99% in control. Feb 2014 I had to stop my Humira for 2 moths while I had colon surgery.(Humira use was 2+ years) Now nothing will help and it has spread to my whole body. Currently the doc is trying Remicade for 3 months now but no results. And it is not helping my arthritis. Large swollen patches with burning feeling. Anyone else have to stop meds and go back on them to have them not work?

This study looks at the use of Propylthiouracil (PTU), an anti-thyroid thioureylene as a treatment for psoriasis.

*Propylthiouracil (PTU) or 6-n-propylthiouracil[1] (PROP) is a thiouracil-derived drug used to treat hyperthyroidism (including Graves' disease) by decreasing the amount of thyroid hormone produced by the thyroid gland. Its notable side effects include a risk of agranulocytosis and aplastic anemia. On 3 June 2009, the FDA published an alert "notifying healthcare professionals of the risk of serious liver injury, including liver failure and death, with the use of propylthiouracil." As a result, propylthiouracil is no longer recommended in non-pregnant adults and in children as the front line antithyroid medication.

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Background:
Propylthiouracil (PTU), an anti-thyroid thioureylene, has been shown to be effective in chronic plaque psoriasis. Involucrin is a precursor protein that is upregulated in psoriasis.

Objectives:
This study evaluated the expression of involucrin in the epidermis of skin in psoriatic plaques before and after treatment with PTU.

Methods:
This was an open-label, prospective study in which 25 psoriasis patients underwent skin biopsies prior to treatment with oral PTU 100 mg three times per day for 12 weeks. Patients were assessed at 2, 6, and 12 weeks. Skin biopsies were repeated at the same sites at 12 weeks. Pre- and post-treatment specimens were subjected to immunohistochemical staining and real-time polymerase chain reaction for involucrin.

Results:
Mean ± standard deviation (SD) scores on the Psoriasis Area and Severity Index reduced significantly from 17.86 ± 9.9 at baseline to 4.63 ± 4.1 at week 12 (P < 0.001). Histomorphometric analysis revealed marked decreases in numbers of positively stained cells and intensity of staining. Staining became localized to the upper granular layers after therapy. Immunohistochemical scoring for involucrin reduced from a mean ± SD of 9.00 ± 0.67 at baseline to 3.90 ± 0.88 at week 12 (P < 0.0001).

Conclusions:
In psoriasis, there is increased expression of involucrin, which leads to abnormal keratinocyte differentiation and hence to the formation of psoriatic plaques. The therapeutic effect of PTU in psoriasis may be attributable to the downregulation of involucrin. Larger trials should further elucidate the mechanism and therapeutic potential of PTU in psoriasis.

This study published in International Journal of Dermatology Evaluated body composition parameters in patients with psoriasis.

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Background:
Body composition parameters, such as weight, body mass index (BMI), and visceral fat rating, have been found to be associated with psoriasis. However, the associations of these parameters with psoriasis have not been demonstrated clearly.

Objectives:
This study aimed to evaluate body composition parameters in patients with psoriasis.

Methods:
The relationships between the various body composition parameters and psoriasis were retrospectively examined in 242 patients with plaque psoriasis (119 women, 123 men) over a 2-year period during 2010–2012. In addition, the correlations between body composition parameters and Psoriasis Area and Severity Index (PASI) score were evaluated in treated and untreated patients with psoriasis. Patients were divided into two groups according to whether or not they had received systemic therapy within the previous three months. Body composition values were measured using the Tanita SC-330 Body Composition Analyzer®.

Results:
Statistically significant differences were recorded in terms of weight (kg), body fat percentage, fat mass (kg), total body water (TBW) percentage, metabolic age, visceral fat rating, BMI, and degree of obesity among treated and untreated patients and control subjects. Differences in fat-free mass (FFM) (kg), muscle mass (kg), TBW (kg), and bone mass (kg) were found to be close to the limit for significance. The treated and untreated groups showed no significant differences in any of the parameters evaluated. The correlations between PASI score and the various parameters provided some evidence for such relationships.

Conclusions:
The present study provides evidence of a relationship between some body composition parameters and the occurrence of psoriasis. We suggest that body composition parameters should be analyzed not only in obese psoriasis patients but in all psoriasis patients upon their first diagnosis. Systemic therapy does not appear to cause any changes in body composition parameters.