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.

Quote:

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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

My Derm wants me to try Acitretin if my legs don't clear from UVB. But there seems to be quite a lot of side effects from acitretin. He also wants me to use it for 3 months then come off it, my concern is that coming off it will cause a flare up.

I'm considering discussing Fumaderm with him but have read that Psorinovo is a better pill since it's enteric coated. I was wondering if it possible to get Psorinovo in the UK?

If not, is it possible to go to the Netherlands to get treated and have the durg sent over?

Thanks

Hello peeps.
I am having real problems with my psoriatic arthritis at the moment.
Where the pain has normally been in my joints (knees, fingers, wrists) I am now getting what I can only describe as muscle pain in my upper arms. It got so bad last night that I couldn't lift my arms up without going 'aaaarrrrrrgggggggg!' or 'ooouuucchhhhh'! Got to laugh really
Still in agony now...

I don't know if I have pulled the muscles or whether it is another side effect of the arthritis.
Has anyone else experienced this at all? Haven't got an appointment with Rheumatologist for a few months.

Ta muchly
Charlotte

At Psoriasis Club we're often talking about the cost of our treatments, but we always look at as an individual. Imagine though that you was running a country and had to pick up the tab, this study set out to determine the US economic burden of psoriasis from a societal perspective.

Quote:

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Importance:  
The total cost of psoriasis in the United States is unknown. Defining the US economic burden of psoriasis is needed because it provides the foundation for research, advocacy, and educational efforts.

Objective:  
To determine the US economic burden of psoriasis from a societal perspective.

Evidence Review:  
pub med and MEDLINE databases were searched between January 1, 2008, and September 20, 2013, for economic investigations on the direct, indirect, intangible, and comorbidity costs of adult psoriasis in the United States. The base year costs were adjusted to 2013 US dollars using the Consumer Price Index for All Urban Consumers and multiplied by the estimated number of US patients with psoriasis in 2013 to determine the 2013 psoriasis cost burden.

Findings:  
Among 100 identified articles, 22 studies were included in the systematic review. The direct psoriasis costs ranged from $51.7 billion to $63.2 billion, the indirect costs ranged from $23.9 billion to $35.4 billion, and medical comorbidities were estimated to contribute $36.4 billion annually in 2013 US dollars. Patients with psoriasis would pay a lifetime cost of $11 498 for relief of physical symptoms and emotional health; however, intangible cost data are limited. The annual US cost of psoriasis amounted to approximately $112 billion in 2013.

Conclusions and Relevance:  
The economic burden of psoriasis is substantial and significant in the United States.

Not everyone knows how to get going on a new forum, and we like to encourage our members to share information with each other so I'm going to show you how to start a new thread
First we need to decide where to start our new thread, so let's say we want to talk about the use of Dovonex. We will be starting our new thread in Prescribed Treatments (Don't worry if you're not sure where to start your thread as we can always move it for you later)

From the front page click where it says in Blue "New Thread" on the section you want to use. (click image below to see full size)


Now you are in a new page and you will see some white box's, some smilies, and some buttons. (This is a basic tutorial just to get you going, so we wont be using the smiles or buttons)

It's good to see many new treatments coming forward to help us live with psoriasis, and here is another that expects to announce preliminary results in first half of 2015 of their phase 2 trial of KD025 for the treatment of psoriasis.

Quote:

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Kadmon Corporation, LLC, today announced that the first patient has been dosed in a Phase 2 clinical trial (Study 206) evaluating the safety, efficacy and tolerability of KD025, the Company’s orally bioavailable, potent and highly selective inhibitor of ROCK2 (Rho-associated coiled-coiled kinase 2), in patients with moderate to severe psoriasis vulgaris who failed first-line therapy. The open-label, dose-finding study will examine KD025 administered at doses of 200 mg twice daily and 400 mg once daily for three months in 24 patients at six sites in the United States.  

In a Phase 2a single-arm safety study, KD025 demonstrated encouraging pharmacodynamic activity at a lower dose of 200 mg once daily. Administration of KD025 at this dose was generally well tolerated, with all patients showing the previously demonstrated positive changes in inflammatory markers, including a specific decrease in the secretion of IL-17, a pro-inflammatory cytokine that plays a key role in psoriasis. In addition, three of the eight patients showed a decrease in Psoriasis Area and Severity Index (PASI) scores of up to 66 percent after only one month of treatment.    

“Therapies targeting IL-17 have shown significant efficacy in treating psoriasis,” said Mark G. Lebwohl, M.D., Professor and Chair of the Department of Dermatology at the Icahn School of Medicine at Mount Sinai and primary investigator of Study 206. “KD025 represents a novel oral approach to treating psoriasis by blocking IL-17 secretion while concurrently increasing the suppressive function of regulatory T-cells (Treg), helping to resolve inflammation with a minimal effect on the rest of the immune response.”

“Selective ROCK2 inhibition by KD025 has demonstrated activity in preclinical models of autoimmune and fibrotic diseases. We have also demonstrated clinical activity of KD025 in a Phase 2a trial of psoriasis,” said John Ryan, M.D., Ph.D., Executive Vice President and Chief Medical Officer at Kadmon. “We believe this Phase 2 study will provide further insight into the unique activity of KD025 and its potential in treating these diseases.”

About Kadmon Corporation:
Kadmon Corporation, LLC, is a vertically integrated biopharmaceutical company focused on developing innovative products for significant unmet medical needs. We have a diversified product pipeline in oncology, autoimmune and fibrotic diseases, monogenic diseases and metabolic disease.

A new Aerosol foam treatment for psoriasis has been submitted to the US Food and Drug Administration (FDA) by LEO Pharma, the aerosol foam formulation is a fixed combination calcipotriene/betamethasone dipropionate 0,005%/0,064%.

Quote:

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LEO Pharma announced it has submitted a New Drug Application to the US Food and Drug Administration (FDA)for calcipotriene/betamethasone dipropionate aerosol foam 0,005%/0,064% for the treatment of psoriasis vulgaris.

The novel aerosol foam formulation of the fixed combination calcipotriene/betamethasone dipropionate has been developed with the aim of improving treatment for patients with psoriasis vulgaris – the most common clinical form of psoriasis.

The regulatory submission in the US is based on studies of patients with psoriasis vulgaris. These include the Phase 3a PSO-FAST study which evaluated efficacy, safety, itch relief and itch-related sleep loss across a four week period, and the Phase 2 MUSE safety study.

Kim Kjøller, Senior Vice President, Global Development, commented:

“Psoriasis is a chronic, debilitating disease. Patients with inadequately managed psoriasis can experience substantial burden of illness, with similar reductions in quality of life to those experienced by patients with diabetes or cancer.

With the regulatory submission announced today, we are taking a step further in our mission towards reducing this burden by making calcipotriene/betamethasone dipropionate aerosol foam available for people living with psoriasis.”

Regulatory filings in Europe and other countries are planned during the course of 2015 and 2016.

With this latest submission LEO Pharma reinforces a strong commitment to dermatology.

Having psoriasis psoriatic arthritis has really been a challenge to say the least.As i said before i had the psoriasis long before I knew it.I had what I thought was dandruff during my teenage years and my nails were always weak.I didn't have pretty nails like the other girls at the time.Plus I used to bite them.About 9 or 10 years ago my scalp was so bad I went to a Dermatologist and she said I have Psoriasis and I had about 20 steroid shots in my scalp.Talk about painful but I got thru it.I showed her my knee which was double in size and she told me she thought I has Psa on top of the skin issues.So i started to see a Rheumatologist and sure enough I have both.They call it a double whammy just my luck to have both!I had tried all kinds of pills to help me but nothing seemed to help.One time was on Clinerol don't know how to spell it.Was generic for sulfasalazine and my hands swelled up like baloons from it.My Rhemmy was on vacation so I went to the ER they gave me a steroid shot plus steroid pills you take 7 day pres.and you keep tapering down.Was on Cymbalta,Lyrica.Celebrex and nothing helped finally the Dr said well Glenda looks like it time for biologics.Started out on Remicade was on it for about 8 months then I broke out in hives last Jan,not bad thought it was from a food allergy.March had another infusion hives again.Thought it was something else.Then May 1st had another infusion ended up in the ER.could't breathe they gave me an IV coctail of steroids,benadryl,pepcid.Finally figured it was from Remicade.So now I am on Enbrel for the past 3 months and so far so good.My PSA is better I am hoping after a while I'll see improvements in my skin.Keeping my fingers crossed.I try to go to the tanning bed a couple times a week not for the tan but to help with the psoriasis.I only stay in the bed for 7 minutes scared of getting skin cancer.Will keep all informed on my progress with Enbrel.

Hi all my name is Misty. I am 39 and been dealing with psoriasis and psoriatic arthritis. I have had psoriasis since I was 17 and dx 'ed with PsA for about 3 yrs. But, have had symptoms for many years.
I am a mother of two girls and expecting my first grandchild in June 2015. I have been married for 13 years.
So, that's a little about me to begin with.

Hello,
I'm Andy. I'm 44, live in Minnesota, USA.
I've had psoriasis since I was 30. (OK. It was on my head as a child, but I didn't know what it was. )
I found out about 4 years ago I have psoriatic arthritis.
If I recall correctly over 80 % of my spine.
I also have degenerative disk disorder.
Ha, and Add, and aspergers (that is technically undiagnosed, but I have taken several tests
and I score very high, and a clinical diagnosis won't do anything so, I assume I likely
have it.)
I'm going in soon to discuss treatment for psoriasis. It's spread wildly in the past few months,
from my elbows to total scalp, eyes and nose, ears, face, groin..
Anyway, I work everyday, I am married (2nd) to a wonderful woman.
I'm fairly quiet, I like to be alone. I love comics and cartoons, animals, anything that makes me laugh.
I guess I tend to be negative, I'm working on that. ... I wife to live in a happy home.
OK. I feel I am rambling.
So, hello! Nice to meet you all.
Andy.

This may seem a bit crazy but bare with me.
I recently had a blood test done and the phlebotomist commented on my skin (nothing unusual there) So I started doing my normal ramblings. Such as 'Oh I know. Don't it look 'orrible' etc (Sorry about the wording but I am from Essex)
But then she told me about her friend who had psoriasis who she said used a waxing strip on a small spot of skin and that it made it much better.
Now i'm willing to try most things in order to make it look better so I gave it a try.
I'm not saying it's a miracle cure or anything and wouldn't recommend it as a regular treatment but it did actually help. Probably because I was just ripping off all the dead skin and so it looked a bit smoother...

Anyway, just thought I'd share that with you but please don't go injuring yourselves! And please don't ban me either!!!  

Guess this all started earlier in the year. Started having cracks and dryness in my fingers and palms, then on to my feet. What's real bad is I'm a guitarist and I also build guitars and basses on the side. Talk about cruel. I think I could handle it anywhere else, but this is for the birds.

I went through all the usual self diagnosis for most of the year. Was it this chemical or that substance that I was exposed to at work (water plant operator)? I normally protect myself from harsh chemicals, but went above and beyond to rule everything out. Was down to a couple of things. One was the fluoride room door. I noticed my fingerprints on the window where the fluoride has etched to glass. Crap, so I wear vinyl gloves when I get near that room. Same with the silicone oil used on lab glassware. It seemed to cause my skin to itch. So on to protect myself and rule it out.

This went on for most of the year. Tried various crèmes and remedies until I was talking to a relative who had it bad in her feet. She had several jars of a topical steroid crème and swore by them to relieve her pain. She gave me a jar with a little left and I tried it out. Hoky smokes, seemed to clear up, almost. She said go see the Dermatologist in town, another friend confirmed he was good, so I made an apt and went.

Well it's been about a month and a half and the results are mixed. They prescribed  Triamcinolone Acetonide Cream 0.1%. I have also been using various other ointments, crèmes, oils and anything that looks like it could help. At first it seemed to clear right up. thought I had it licked. Then it came back with a vengeance. My next apt was upon me and I told them of what happened. They gave me a shot of cortosteroid (sp?) to help it out. It knocked me on my tail for two weeks, and really didn't do anything to clear it up. Not doing that again.

So I've lost my calluses on my fingertips from years of playing, which really ticks me off as I love jamming out the blues, SRV style. Well I don't know I can beat this thing or if it's something I'm going to live with the rest of my life. Well I have 2 guitars I'm building right now, one is an acoustic bass project and the other is a neck thru body strat. Gonna go ahead and finish them as my optimistic side says this is just another minor setback. I'll find a way.

Jim

Hi everybody,

I have just discovered the Psoriasis Club and would like to wish all members a very Happy New Year. I hope you all had a good Christmas and have now recovered!!!!

Best wishes

More good news today for Cosentyx (secukinumab) as they today announce receiving full approval for it's use in Japan for treating psoriasis.

Quote:

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Novartis announced today that the Japanese Ministry of Health, Labour and Welfare (MHLW) approved Cosentyx™ (secukinumab, formerly known as AIN457), for the treatment of both psoriasis vulgaris and psoriatic arthritis (PsA) in adults.

"We are pleased that Japan is the first country to approve Cosentyx for both psoriasis and psoriatic arthritis, providing an alternative treatment option for more than 400,000 Japanese citizens who are living with psoriasis, and those also living with psoriatic arthritis," said David Epstein, Division Head, Novartis Pharmaceuticals. "Nearly half of patients with psoriasis and PsA are unhappy with their current therapies. With this approval, we are able to address this critical unmet need and aim to make a real difference in the quality of life of these patients."

This approval was based on the safety and efficacy results from more than 10 Phase II and Phase III studies which included nearly 4,000 patients with moderate-to-severe plaque psoriasis and supported by two pivotal Phase III studies, FUTURE 1 and FUTURE 2, involving more than 1,000 patients with PsA. In all studies, Cosentyx demonstrated a favorable safety profile, with similar incidence and severity of adverse events (AEs) between Cosentyx treatment arms (300 mg and 150 mg).

The positive opinion from the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) recommending Cosentyx as a first-line treatment of moderate-to-severe psoriasis patients in Europe was obtained in November 2014. US Food and Drug Administration (FDA) approval in the same indication is anticipated in early 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'm a newbie and wondering if anyone else had their first major outbreak of psoriasis in their late 50s? I seem to have the type that effects mostly my feet and hands ... other spots occur when I get chafed or injured.

I've just started low dose Naltrexone -- up to 3 mg but can't really tell if it's working :( Anyone having much luck with a change in diet??

Merry Christmas to everyone -- no snow here -- just lots of rain.

Maud

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Hi I have seen many new members looking through the introductions.
If you are one and are new to forums this may help you with your first post.
.
#1 From main menu click on Introductions
.
#2 Above the introductions is a button new thread
.
#3 Click on this a box will open
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#4 On the left of the box second line down is Thread Subject write your description in here for instance " jimbos  Intro" or whatever you want to name it
.
#5 Below that is a big box to click on and write your introduction when you are happy with it and want to see what it looks like
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#6 At the bottom of the box past the green section it gives three options... Post thread ..... Preview post ... Or save as draft.
The first thing to do is click Preview Post ..... You can then see what others will see when posted... If there are changes to be made you can change it before you post it by clicking Post Thread
That's it its basic but simple if you follow the instructions.

If you want a more comprehensive instruction go here Starting a new thread
When you have done this and want to do more posts there is a tutorial here Posting A Reply