Who's the better judge to know how a psoriatic patient is feeling? Is it the patient or the physician? This study set out to try and work it out. What do you think, do you know better than your physician? (I know I do I have the bloody psoriatic arthritis they don't.)

Quote:

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Objective:
To assess the extent and determinants of discordance in scoring between patient global assessment (PtGA) and physician global assessment (PhGA) in patients with psoriatic arthritis (PsA).

Methods:
A cross-sectional and longitudinal analysis of data was conducted in patients attending a large PsA clinic. The difference between PtGA and PhGA (each measured on a scale of 0–10, with 0 indicating best status and 10 indicating worst status) reflected the discrepancy between the PtGA and PhGA of joint and skin activity and could take values from −10 (higher rating of disease activity by the patient) to 10 (higher rating of disease activity by the physician). Multivariate regression identified variables that contributed significantly to each of the outcomes. The proportion of variability of each outcome explained by each predictor was expressed by the partial R2.

Results:
A total of 565 patients were included in the analysis. Patients tended to score their disease worse than their physicians, with greater discordance for the joints than for the skin (mean ± SD 1.68 ± 2.41 PtGA–PhGA difference for joints, and 0.77 ± 2.66 for skin). Fatigue accounted for 21% of the variation in the difference between PtGA and PhGA for joints. Pain (inline image = 9%) and disability by Short Form 36 health survey (inline image = 1.2%) were also important factors, each of which led to higher patient rating; whereas increased tender joint count (inline image = 16%) and swollen joint count (inline image = 1.4%) resulted in a higher physician rating of arthritis.

Conclusion:
Fatigue, pain, disability, and tender and swollen joint counts were the most important factors contributing to discrepancy between patient and physician assessment of joint activity.

I'm always saying a positive attitude is a huge benefit to those of us with psoriasis (struggling myself at the moment, but that's another story) and I found this small study interesting in that it suggests *Type D personality is higher in patients with moderate to severe psoriasis as compared to healthy volunteers.

*Individuals with a Type D personality have the tendency to experience increased negative emotions across time and situations and tend not to share these emotions with others, because of fear of rejection or disapproval.

Quote:

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Background:
Psoriasis may imply a remarkable psychological impairment, which can influence patient's personality. The Type D personality is defined by the combination of social inhibition and negative affectivity. Furthermore, Type D personality has been associated with impaired health-related quality of life (HRQOL) and increased cardiovascular risk, both facts being associated with moderate to severe psoriasis.

Objectives:
To explore the prevalence of Type D personality in moderate to severe psoriasis patients; To analyse the relationship between Type D personality and the most common physical and psychological comorbidities in moderate to severe psoriasis and To explore the impact of Type D personality on HRQOL.

Methods:
A prospective comparative study matched to age and sex. Eighty patients with moderate to severe psoriasis and 80 healthy volunteers were included in the study. The participants completed the DS14 test, the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, the SF-36 and the Psoriasis Disability Index.

Results:
The prevalence of Type D personality was higher in patients with moderate to severe psoriasis as compared to healthy volunteers: 38.7% vs. 23.7%, P < 0.001. Psoriasis patients with Type D personality had a 3.2-fold risk of anxiety when compared to patients without Type D personality; odds ratio 3.2 (1.3–8.83 P = 0.01). Type D personality was significantly associated with an impaired general, sexual and psoriasis-related HRQOL (P < 0.01).

Conclusion:
Because Type D personality could represent a frequent type of personality among individuals with moderate to severe psoriasis, it could serve as a ‘marker’ of more psychologically vulnerable patients, probably related to dysfunctional coping strategies. The Type D personality could represent a profile more frequently encountered among patients with psoriasis, and might therefore help identify subjects physiologically more vulnerable to disease, most likely due to inadequate adaptation mechanisms.

Hi my name is lisa.
I am 32 years old and have suffered from plaque and guttate psoriasis since I was 16.
It had recently gotten very bad following an allergic reaction I had to washing powder. I was literally burning on the outside with a good 50% of my body being covered in what felt like sunburn. I was immediately sent to my dermatologist who advised the use of methotrexate tablets 10mg with folic acid weekly. I was a little hesitant at first as the list of symptoms was both long and fairly in depth. I did however after 3 months of pure misery decide to give it a go. I literally couldn't get dressed it had gotten that bad. Everything that I put on burned, diet didn't help, even the topical treatments I had been using for years to control it had failed. I couldn't bathe or shower, I didn't go out, I even stopped going to work. My children couldn't even hug me without me wincing in pain. It was horrific! So the tablets arrived and I started a low dose over a 10 week period gradually built up to 10mg strength. I can tell you all that this treatment has been a huge success. Within just 3 weeks I had noticed the itchy red raw patches were less itchy and not as painful, my skin resisted cracking and flaking as much. It's steadily gotten better and better and 12 weeks in it is gone from my scalp, arms and if faiding on my torso and legs. I am amazed. I am over the moon. My life has come back to me. I can only hope the healing continues in the coming months. Very few side affects. Dry mouth and preety constant headache but that's a very very small price to pay.........

Hello all. I am Michelle vuong. I have been suffering plaque sporisasis for about 6 years. About 6 months ago, I was at my doctor office waiting to see the doctor and scratching my knee cap at the same time. A health educator saw me and told me to use duct tape. I was like " realy", why not?? And 6 month later the 24 hour itchiness is practically gone, the skin is back to normal except there is a white patch where the plaque is used to be. So far the duct tape works for me. May be someone on this site might want to try it. Good luck.

Thunder,

There are no sigs that psoriasis could be viral.
However there are signs, that is research, that indicate that bacteria may be in involved.
There are also thoughts that psoriasis has to do with mitochondrial cells.

Caroline

Hi fellow itchers! Has anyone here tried secukinamub or been in the trials? They just approved it in the US today so i thought i'd ask before I call my derm.

This study looked into the role of vitamin D in psoriasis, it is an early view before publication in The International Journal of Dermatology.

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Background and objective:
Psoriasis is a common, chronic autoimmune inflammatory skin disorder, which has potential systemic complications and is clinically defined by sharply demarcated, erythematous patches and plaques covered by a characteristic silvery white scale. Topical corticosteroids have widely been regarded as the mainstay first line of treatment. Recently, topical vitamin D analogs have been added to the first-line treatment repertoire as well, either as monotherapy or in combination with topical steroids due to synergistic, complementary effectiveness. In this paper, we review the role of vitamin D in the pathophysiology and treatment of psoriasis.

Methods:
A comprehensive search of the Cochrane Library, MEDLINE, and pub med databases were performed to identify relevant basic science and clinical trial literature investigating the role of vitamin D in psoriasis. Primary endpoints in clinical trials were largely based on clinical improvement as assessed by the psoriasis area severity index score or physician's global assessment.

Results and conclusion:
The role of vitamin D in psoriasis is complex and extensive. Oral and topical vitamin D therapies provide comparable efficacies to corticosteroids when used as monotherapy and may be superior when used in combination with a potent topical steroid. Additionally topical vitamin D analogs demonstrate a favorable safety profile with “steroid-sparing” effects. Thus, topical vitamin D derivatives should be considered an indispensable component of the current physician's arsenal in the treatment of psoriasis.

US Food and Drug Administration (FDA) follow Japan and Europe and gives the go ahead for Cosentyx (secukinumab) to be used as a psoriasis treatment.

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Novartis today announced the US Food and Drug Administration (FDA) has approved Cosentyx™ (secukinumab) for the treatment of moderate-to-severe plaque psoriasis in adult patients who are candidates for systemic therapy (a drug that is absorbed into the bloodstream and distributed to all parts of the body) or phototherapy (light therapy). Cosentyx is the first approved psoriasis medication to selectively bind to IL-17A and inhibit interaction with the IL-17 receptor. The approval is based on the efficacy and safety outcomes from 10 Phase II and Phase III studies, including over 3,990 adult patients with moderate-to-severe plaque psoriasis, which demonstrated that Cosentyx resulted in clear or almost clear skin in the majority of patients and had an acceptable safety profile.

"The FDA's approval of Cosentyx signifies a turning point for psoriasis patients, who can now benefit from the first and only approved treatment targeting the IL-17 pathway, which is proven to play a key role in the development of plaque psoriasis," said David Epstein, Division Head, Novartis Pharmaceuticals. "This important milestone will now allow patients to receive a treatment that has the proven ability to offer clear or almost clear skin."

The FDA approval follows the unanimous vote by the FDA Advisory Committee in October 2014. Additionally, in January 2015, the European Commission (EC) approved Cosentyx as a first-line systemic treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy.

Affecting 7.5 million Americans and more than 125 million people worldwide, psoriasis is a chronic immune-mediated disease characterized by thick and extensive skin lesions (plaques), which can cause itching, scaling, and pain and may negatively impact daily life. Nearly 35% of psoriasis patients suffer from moderate-to-severe plaque psoriasis. Research shows IL-17A plays an important role in driving the body's immune response in disorders such as moderate-to-severe plaque psoriasis. Cosentyx selectively binds to IL-17A, inhibiting its activity.

The Phase III clinical program included four placebo-controlled studies which examined Cosentyx 300 mg and 150 mg in patients with moderate-to-severe plaque psoriasis. In these studies, Cosentyx met all primary and key secondary endpoints, including Psoriasis Area and Severity Index (PASI) 75 and 90 and Investigator's Global Assessment modified 2011 (IGA) 0/1 responses, showing significant skin clearance at Week 12. PASI measures the redness, scaling and thickness of psoriatic plaques, and the extent of involvement in each region of the body. Treatment efficacy is assessed by the reduction of the score from baseline (i.e. a 75% reduction is known as PASI 75 and a 90% reduction is known as PASI 90). PASI 90 is a higher standard of skin clearance compared to PASI 75.

Has anyone with psoriasis ever been told cats can have a very bad effect on your skin? I have never heard of such a thing from any dermatologist or physician. I was raised with cats and dogs.

Not an exiting piece of news as this study was funded by Amgen the makers of Enbrel (Etanercept) but it may be helpful to those who have failed on Remicade or Humira.

Quote:

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Background:
There is a paucity of data on the use of etanercept in patients who have previously failed a different tumour necrosis factor (TNF) alpha antagonist.

Objectives:
To study etanercept in patients who did not achieve a satisfactory response to adalimumab or who lost their response to adalimumab or infliximab and to explore the role of anti-adalimumab and anti-infliximab antibodies in etanercept response.

Methods:
Patients with psoriasis who did not achieve a satisfactory response to adalimumab or who lost their response to adalimumab or infliximab were included. All patients received etanercept 50 mg twice a week for 12 weeks followed by 50 mg once a week for 12 more weeks. Anti-infliximab and anti-adalimumab antibodies were measured at baseline. The primary objective was to study the efficacy of etanercept using the proportion of patients who achieved a physician global assessment (PGA) of 0 or 1.

Results:
A total of 81 patients were included. The proportion of patients who achieved a PGA of 0 or 1 after 24 weeks of etanercept was 20.0% (95% CI 4.8–35.2%) for patients who had an unsatisfactory response to adalimumab, 35.1% (95% CI 19.0–51.3%) and 35.7% (95% CI 7.0–64.4%) for patients who lost their response to adalimumab and infliximab respectively. The proportion of patients who achieved a PGA of 0 or 1 at week 24 was numerically higher for patients who had anti-adalimumab or anti-infliximab antibodies (36.5%) as compared to those without (17.2%; P = 0.08).

Conclusions:
Etanercept can be effective in patients with psoriasis who failed a previous TNF alpha antagonist.

Is Fumaderm any good for psoriatic arthritis ?

Caroline mentions in her thread Dimethylfumarates and Psoriasis that it can have a positive effect and I know she has psoriatic arthritis, I also know Fumaderm is a DMF but that's about all I've been able to find and she is using Psorinovo.

I've been reading through some threads about Fumaderm and I may be missing it, but does anyone have experience of using Fumaderm for psoriatic arthritis. ?

Howdy folks!  Glad I found this site. I have to ask;  What is the most ridiculous comment/question your dermatologist said while you there for a P visit?
Years ago, at the end of my visit which took all of three minutes, my then dermatologist said; "whatever you do, don't scratch".  It still makes me laugh today.  

Hi everybody! Im not really crazy! Ive had psoriasis for 44 years ago. Ran the gamut of treatment. Just wanted to see what y'all do.

Hi,
I've been recently been diagnosed with psoriatic arthritis in december at the age of 18 and i've had psorasis since 13. It has all hit me like a train and my life was ground to a halt. After my family saw how down in the dumps i've been they suggested this site. Where everyone seems lovely and informative since it's hard to find such an abundance of people all suffering with the same. So, after snooping around as a guest i finally became a member!

Following on from the announcement that Cosentyx (secukinumab) had been approved for use in Japan as a treatment for psoriasis, Novartis announced today that they have now been given approvel for Europe too.

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Novartis announced today that the European Commission (EC) has approved Cosentyx™ (secukinumab, formerly known as AIN457) as a first-line systemic treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy.

Cosentyx (at a dose of 300 mg) is the first and only interleukin-17A (IL-17A) inhibitor to be approved in Europe and this approval marks a significant milestone in the treatment of psoriasis, providing a new and important first-line biologic treatment option for patients. Currently, all biologic treatments for psoriasis, including anti-tumor necrosis factor therapies (anti-TNFs) and Stelara® (ustekinumab) are recommended for second-line systemic therapy in Europe[2-4].

"With this groundbreaking news from the European Commission, clear skin may now be a reality for patients living with psoriasis," said David Epstein, Division Head, Novartis Pharmaceuticals. "Nearly half of psoriasis patients are not content with current therapies, including biologic treatments, showing a significant unmet need for patients. Cosentyx, with a first-line systemic indication for treatment of psoriasis will provide patients a better chance of achieving clear or almost clear skin."

The key treatment goal for psoriasis patients is achieving clear skin. In clinical studies, 70% or more Cosentyx 300 mg patients achieved clear skin (PASI 100) or almost clear skin (PASI 90), during the first 16 weeks of treatment and importantly, this was maintained with continued treatment in the majority of patients up to Week 52. Data from the Cosentyx clinical trial program also showed a significant positive relationship between achieving clear to almost clear skin and psoriasis patients' health-related quality of life.

The EU approval follows the recent results of the Phase IIIb CLEAR study, which showed that Cosentyx was superior to Stelara® in clearing skin of patients living with moderate-to-severe plaque psoriasis. The CLEAR study was the second head-to-head study for Cosentyx. Cosentyx also showed superiority to Enbrel® (etanercept) in clearing skin in the FIXTURE study. In the Phase III clinical program the overall safety profile of Cosentyx was favorable, with minimal differences seen between etanercept and ustekinumab in head-to-head comparison.

In addition to the EU, Cosentyx has been approved in Australia for the treatment of moderate-to-severe plaque psoriasis and in Japan for the treatment of moderate-to-severe plaque psoriasis and active psoriatic arthritis (PsA).

The US Food and Drug Administration (FDA) decision in moderate-to-severe plaque psoriasis is anticipated early in 2015 following the unanimous recommendation of approval in October 2014 from the Dermatologic and Ophthalmic Drugs Advisory Committee (DODAC) to the US FDA.

Hi all!
 I hope I don't sound like too much of a know it all.     These are just some observations.
 
 This is really for the newbies. The basics of what to avoid and what to eat.  So here's some of what I've picked up over the years.  Years of IBS (Irritable Bowel Syndrome) leading to years of Psoriasis.

 The short version.  Avoid or cut back on:  Sugar, Salt, foods made with or containing Yeast, Grains and Dairy.
  Store bought salad dressing has chemical in it that is used in windshield washer fluid.  So my health food store friend tells me.

  I cannot comment on nightshade vegetables, I eat them, never really noticed a problem.  Maybe someone else can comment on them.
 
 If you must have a sweetener try black strap molasses or honey.  I think molasses is better, but not sure yet.

Cut back on salt.

   IMHO salt is harmful to Vitamin C.  There is a sailor who spent six months in the artic, no fruit and no Vitamin C, his ship locked in ice.  He wrote how he did not get scurvy and yet the sailors of old did.  The reason he believed was salt.  They preserved food with salt back then for long voyages.  Humans , guinea pigs and apes can't make Vitamin C.  We need this vitamin to heal and salt is in pretty much everything these days!

  Wine, beer and alcohol are made with yeast.  Candida is a yeast and under normal circumstances isn't a problem.  The good bacteria keeps it in check, but if you take broad spectrum antibiotics, look out!  I ended up IBS, along with a mental map of where every washroom in the city was!  Try to avoid broad spectrum antibiotics, if you do have to take them get a children's type of probiotic and eat lots of garlic.  Not all probiotics are the same, you have to start with the type that first colonizes the bowels.  

 I was watching a TV show on inflammation and "genetically modified wheat" was the culprit.  It also points out, we are not cows, we only have one stomach, you wouldn't normally go out in a field and eat wheat!


 Grains waiting to be shipped out are stored in silos were they get moldy.  I love bread though.  I can handle a breakfast bagel, but when I buy a loaf, I tend to eat too much of it during the day and my symptoms get worse.  

 Also people on here mention gluten.  I always toast my bagel/bread, since heat breaks down gluten and is less of a problem to digest.  And I sprinkle garlic powder on toast and just about everything else.  Garlic kills yeast and is a prebiotic (a food for the good bacteria).

 I take organic milk in my coffee.  Milk is known to be mucus forming in the bowels and caused me severe constipation and is generally, bad for the skin.  Humans are the only species to consume milk as adults except for mice they like cheese.  

 Ginger root is also very good and may be the reason my psoriasis was never all that bad.  I do drink lots of ginger ale.

 It is a potent antiviral.  If taken regularly it is known to thicken the epithelium layer ( that's the slimy layer on our intestinal tracts that keeps pathogens and their toxins out, "selective absorption".  Like the slime on a fish protects it from water borne diseases.   The epithelium layer starts to thin in your early twenties.  Asian folk eat ginger, like we in the west eat potatoes.  I wonder how many of the 1.3 billion Chinese have psoriasis?  If anyone knows please post it.  The ginger root in your grocery store is a product of China.

 I just did a quick search, didn't find any stats, but I did find this "GlaxoSmithKline Plc " is joining with the Chinese ...."The world’s biggest drug makers are turning to ancient Chinese remedies to boost product pipelines."

 And this.... "Glaxo’s herbal drugs efforts will focus initially on immune disorders such as psoriasis, a chronic disease that causes scaly skin, and drugs that treat inflammation of the digestive system, according to Zhang Xun, Shanghai-based head of research and development for the company’s global natural products unit."  This was in Dec 11, 2012 is their a drug from them out now and is ginger apart of it?  

 Ancient Chinese Secret is not just for laundry.     You go now, mind you own business.  

Fumaric acid esters (FAEs) are being used more as safe form of treatment for psoriasis, but 30–40% stop using it due to adverse effects. This small study looked at the use of cetirizine, an oral histamine-1 receptor antagonist as way of reducing those adverse effects.

Quote:

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Background:
Fumaric acid esters (FAEs) are considered an effective and safe long-term treatment for psoriasis. However, 30–40% of patients need to discontinue FAE treatment due to intolerable adverse events.

Objectives:
To assess whether the addition of cetirizine, an oral histamine-1 receptor antagonist, to FAEs would reduce the incidence of adverse events.

Methods:
In a randomized, double-blind, placebo-controlled trial, patients with psoriasis with a Psoriasis Area and Severity Index ≥ 10 starting an FAE up to a dose of dimethylfumarate 720 mg per day were randomized 1 : 1 to receive either additional cetirizine 10 mg once daily (n = 25) or placebo (n = 25) for 12 weeks. Randomization and treatment allocation were done at our hospital trial pharmacy. Primary outcomes were the incidence of adverse events and the proportion of patients discontinuing treatment.

Results:
Fifty patients (33 male, 17 female; median age 44 years) were enrolled. Addition of cetirizine did not reduce the incidence of adverse events compared with placebo (84% vs. 84%, P = 1·00). The types of adverse events were not different between the cetirizine and placebo groups, the most common being gastrointestinal complaints (68% vs. 64%) and flushes (60% vs. 48%). The proportion of patients discontinuing treatment was not statistically different between the cetirizine and placebo groups (24% vs. 32%, P = 0·53).

Conclusions:
Addition of oral cetirizine 10 mg once daily to FAE treatment did not reduce adverse events in patients with psoriasis during the first 12 weeks of treatment. The mechanisms underlying FAE-induced gastrointestinal and flushing symptoms likely involve mediators other than histamine.

Otezla (apremilast) has been given approval for the Treatment of both Patients with Psoriasis and Psoriatic Arthritis from the European Commission. This follows on from this report: Otezla soon to be available in Europe for psoriasis & psoriatic arthritis patients.

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Celgene International today announced that the European Commission (EC) has granted marketing authorisation for OTEZLA® (apremilast), the company's oral selective inhibitor of phosphodiesterase 4 (PDE4), in two therapeutic indications

   For the treatment of moderate-to-severe chronic plaque psoriasis in adult patients who failed to respond to or who have a contraindication to, or are intolerant to other systemic therapy including cyclosporine, methotrexate or psoralen and ultraviolet-A light (PUVA).
   Alone or in combination with Disease Modifying Antirheumatic Drugs (DMARDs), for the treatment of active psoriatic arthritis (PsA) in adult patients who have had an inadequate response or who have been intolerant to a prior DMARD therapy.

"The approval of OTEZLA® is an important new option for the treatment of patients who are not experiencing adequate relief for their conditions. OTEZLA® has shown significant and clinically meaningful improvements in psoriasis and psoriatic arthritis, including difficult to treat areas such as nail, scalp, and itch, which can all be the cause of great burden for patients," said Dr. Diamant Thaci, Professor of Dermatology and the Head of the Comprehensive Center of Inflammation and Medicine at the University of Lübeck, in Germany. "OTEZLA® has also been generally well tolerated and does not require routine laboratory monitoring, which can be beneficial for both physicians and patients."

OTEZLA® is the first in a new class of medicines for the treatment of both psoriasis and psoriatic arthritis, two diseases involving dysregulated immune system activity. Psoriasis is a systemic inflammatory condition characterised by raised scaly lesions on the skin. It affects approximately 14 million people across Europe4 and about 125 million people worldwide.5 Plaque psoriasis, also called psoriasis vulgaris, is the most common form of the disease, representing approximately 80 percent of cases.6 Additionally, up to 30 percent of people with psoriasis may develop psoriatic arthritis. Psoriatic arthritis, which is also an immune-mediated disease, is estimated to affect nearly 38 million people worldwide7. It is a chronic condition characterised by pain, stiffness, swelling and tenderness of the joints, and a decrease in physical functioning.8 Enthesitis (inflammation at sites where tendons or ligaments insert into bone) and dactylitis (inflammation of fingers and toes, commonly known as "sausage fingers and toes") are specific disease manifestations related to psoriatic arthritis, which can contribute to significant disability.8,9

"The approval of OTEZLA® in Europe marks an important juncture in Celgene's mission to follow the path of science and innovation where the greatest unmet need resides, and where we can make a considerable difference in the lives of people living with debilitating, inflammatory diseases," stated Tuomo Pätsi, President, Celgene Europe, the Middle East and Africa (EMEA). "Patients with psoriasis and psoriatic arthritis may require lifelong treatment due to the chronic nature of their conditions, and we believe it is our responsibility to offer them a new option which could significantly reduce their symptoms and allow them to live a better life."

The marketing authorisation is based on efficacy and safety data from two Phase III programs, ESTEEM AND PALACE, which demonstrate a maintained clinical response among patients with psoriasis (ESTEEM) and psoriatic arthritis (PALACE) treated with OTEZLA® through 52 weeks, across multiple endpoints.

In the ESTEEM studies, treatment resulted in significant and clinically meaningful improvements in plaque psoriasis as measured by PASI-75 (a 75 percent improvement in the Psoriasis Area Severity Index) scores at week 16, the primary endpoint. Patients on apremilast also benefited from significant improvements in difficult to treat areas, such as nail and scalp, and itch,1 known to have a marked impact on patients' quality of life and perception of disease severity.

In the PALACE program, treatment resulted in significant and clinically meaningful improvements in the signs and symptoms of psoriatic arthritis, as measured by the modified ACR-20 (a 20 percent improvement in the American College of Rheumatology disease activity criteria) response at week 16, the primary endpoint. Patients on apremilast showed improvement across multiple disease manifestations specific to psoriatic arthritis, such as swollen and tender joints, dactylitis, enthesitis and overall physical function and quality of life.

Consistently, across these Phase III clinical studies, the most commonly reported adverse reactions were diarrhoea, nausea, upper respiratory tract infection, tension headache and headache. Gastrointestinal (GI) adverse reactions were mostly mild to moderate in severity, with 0.3% of diarrhoea and 0.3% of nausea reported as being severe. These adverse reactions generally occurred within the first two weeks of treatment and usually resolved within four weeks. Overall, most adverse reactions were considered to be mild or moderate in severity.

The EC decision follows the positive opinion issued by the Committee for Medicinal Products for Human Use (CHMP) in November 2014.12 OTEZLA® will be launched in the European Union in the coming months in accordance with local requirements.

OTEZLA® was approved on March 21, 2014 by the U.S. Food and Drug Administration (FDA) for the treatment of adults with active psoriatic arthritis and on September 23, 2014 for the treatment of patients with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy. Marketing authorisation applications are ongoing in other countries, including Australia and Switzerland.

Hello

 I've had psoriasis on my face, for a few years now.  It's clearing up finally and mostly due to the video on youtube At first when I tried what he suggested, I didn't notice any changes.  It was only after increasing Vitamin C from 1,000mg daily to 3,000mg daily, that I noticed it clearing up.  I did not change my diet and I think I will, very soon, now psoriasis is in remission , but very itchy as I am recovering from a cold.  Plus I will also start taking the recommended probiotics ( he recommends DDS).

 I had it strictly on my face (sides of my nose and eyebrows and sometimes in or behind my ears).  It had been getting worse over the last few months.  I suspect since I switched to decaf coffee and would consume more along with honey for sweetner, but I'm not sure.  Point is for someone who has a bigger area to heal, I have no idea what amount of vitamin C you would need. You can take too much vitamin C, so best consult a healthcare proffessional.  Also check out Ester C it is more easily absorbed and stays in the body longer.

 People who get IBS are more likely to develop psoriasis, studies have shown, and kidney stones!  I treated my IBS with Udo's Toddlers Blend probiotics and garlic and am mostly cured.  Thank God! and don't get me started on kidney stones! Lemmon Juice.
 

Anyway, Big Thanks to the owner of this site for letting people speak their minds!

 Hi
 I'm a relative newbie to psoriasis, had it for the last ten years or so.  I'm in my late fifties.  I also had IBS and kidney stones.  Now that I'm basically retired from factory work, I would like to pursue artistic endeavors.  Love gag cartoons and inventing.  Anyway, you all seem like a great bunch and I'm glad to be here.
 John