Daily Archives: May 24, 2021

Authors of a case report called for investigation of the possible relationship between nonischemic dilated cardiomyopathy (NIDCM) and psoriasis after they treated a man with the rare combination of diseases.

The case involved an active 58-year-old man with a history of untreated psoriasis and psoriatic arthritis (PsA) who presented with a sudden onset of shortness of breath in the emergency department, according to clinicians from a New Jersey hospital in The American Journal of Case Reports. The patient was ultimately diagnosed with acute congestive heart failure secondary to NIDCM.

The patient responded well to diuretics and was placed on guideline-directed medical therapy during his inpatient stay and was later treated with secukinumab (Cosentyx) for psoriasis. Three months later, his cardiac symptoms had improved and his psoriatic skin lesions had resolved; repeat echocardiography showed improvement in his ejection fraction (EF).

Studies have shown the prevalence of cardiovascular risk factors and diseases is higher in patients with psoriasis, especially in those with PsA. However, the authors said, reports are rare in psoriasis patients of nonischemic cardiomyopathy, especially dilated cardiomyopathy, which involves enlargement and weakening of the left ventricle. In the literature available, an association between psoriasis and NIDCM has been increasingly reported, with the incidence of DCM reported as 10 times higher in patients with psoriasis.

The authors urged clinicians of psoriasis patients to be aware of a higher risk of cardiovascular events, counsel them on the importance of eliminating traditional risk factors for cardiovascular disease such as obesity and smoking, and institute early treatment with antipsoriasis agents to reduce heart disease and prevent death.

The patient entered the hospital with extensive skin psoriasis (more than 50% of the body) with deformities in the joints of his hands and feet caused by PsA. Laboratory results were remarkable only for B-type natriuretic peptide (BNP) at 865 ph/mL (normal value 0-100 pg/mL). An electrocardiogram showed sinus tachycardia with left bundle branch block, and chest X-ray revealed acute bilateral pulmonary edema. The patient was placed on bilevel positive airway pressure and received furosemide (Lasix) and a beta blocker (labetalol). An echocardiogram the following day showed severely reduced left ventricular systolic function with an ejection fraction (EF) of 21% to 25%, grade III (severe) diastolic dysfunction, and severe global hypokinesis.

Treating physicians determined that either interleukin-17 (IL-17) or IL-12/23 inhibitors, or phosphodiesterase-4 inhibitor, were necessary to treat the psoriasis. Tumor necrosis factor inhibitors were avoided due to heart disease and low EF. The patient responded well to diuretics; was placed on losartan (Cozaar), cavedilol (Coreg), and spironolactone; and discharged with a defibrillator.

A cardiac MRI upon follow-up showed mild biventricular nonischemic cardiomyopathy.

At a 2-week follow-up with a rheumatologist, the patient was placed on secukinumab, a monoclonal antibody that inhibits IL-17A, via injection at a dosage of 300 mg weekly for 5 weeks and monthly thereafter.

A 3-month follow-up showed significant improvement in cardiac symptoms, with a normal BNP level, resolution of psoriatic skin lesions, and an EF of 41% to 45% on a repeat echocardiogram.

Reference

Alfraji N, Douedi S, Alshami A, et al. Nonischemic dilated cardiomyopathy in untreated long-term psoriatic arthritis: a newly recognized association: A case report with mini review. Am J Case Rep. Published online April 2, 2021. doi:10.12659/AJCR.930041

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Untreated Psoriasis and a Cardiac Connection: Lessons From a Case Report - AJMC.com Managed Markets Network

Generalized pustular psoriasis (GPP) may have therapies in a few years; how patients define remission in psoriatic arthritis (PsA).

Generalized pustular psoriasis (GPP) might be considered as a rare, angrier variant of psoriasis, according to a dermatologist presenting at a recent symposium.

However, Dermatology Times reported that there are no FDA-approved therapies for the disease; current treatments are off-label. That means they arent as accessible to patients given insurance policies around off-label use, said Bruce Strober, MD, PhD, cofounder of Central Connecticut Dermatology in Cromwell and clinical professor of dermatology at Yale School of Medicine in New Haven, Connecticut.

At the Symposium for Inflammatory Skin Disease last month, he spoke about targeted drugs that are in the early stages of development for GPP, including imsidolimab and spesolimab, both of which inhibit interleukin (IL)-36R; they are currently showing promise in phase 1 and phase 2 trials, he said.

Severe GPP can cause diffuse sterile pustules, significant skin pain, and systemic complaints such as fever, fatigue, and metabolic abnormalities.

Read more about the report in Dermatology Times.

Disease impact and disease activity are factors identified with the concept of patient-defined remission in psoriatic arthritis (PsA), according to a recent study.

Reported by Rheumatology Network, researchers used study data from ReFlaP data, an international PsA study. In PsA, the treatment goal is remission (REM) or low disease activity (LDA), but information about what patients think about REM is lacking.

In patients with PsA, patient-defined remission (REM) and low disease activity (LDA) are largely dominated by disease impact, including pain, as well as disease activity, chronicity and age, comorbidities, and symptoms related to other conditions, according to the results.

Read more about the study in Rheumatology Network.

Excerpt from:
Psoriasis Recap: Investigational Therapies for GPP; How Patients View Remission in PsA - AJMC.com Managed Markets Network

Psoriasis and psoriatic arthritis do share one common symptom: fatigue, which is likely due to high levels of inflammation, according to NYU Langone Health.

About 7 million Americans have psoriasis, and only a fraction of them will ever develop psoriatic arthritis, according to the Cleveland Clinic. Estimates vary depending on the source, but the Centers for Disease Control and Prevention (CDC) says that roughly 10% to 20% of people with psoriasis go on to develop psoriatic arthritis.

In contrast, the Cleveland Clinic estimates that up to 30% of people with psoriasis will develop psoriatic arthritis. That said, having psoriasis is the single most significant risk factor for developing psoriatic arthritis, Naomi Schlesinger, M.D., chief of the Division of Rheumatology at Rutgers Robert Wood Johnson Medical School, tells SELF.

If you have psoriasis, its extremely important to watch for any joint symptoms, such as swelling, pain, or stiffnessthe most common signs of psoriatic arthritisand report them to your physician, says David Giangreco, M.D., a rheumatologist at Northwestern Medicine Delnor Hospital. Psoriatic arthritis is a progressive disease, meaning it can get worse over time. And if you happen to get diagnosed with psoriatic arthritis in its early stages, then your doctor can prescribe treatments that slow the diseases progression and help preserve your joints.

Medical experts used to believe that people with psoriasis could only develop psoriatic arthritis within 10 years of their initial psoriasis diagnosis, according to the Cleveland Clinic. However, studies have shown that this isnt true. In fact, up to 15% of people with both diseases actually experienced their psoriatic arthritis symptoms first, according to the Cleveland Clinic. Some people may develop psoriatic arthritis before psoriasis, and others may have had psoriasis for years without realizing it, according to Dr. Giangreco. Psoriasis can remain hidden from patients on the back of the scalp or buttock area and go unnoticed for long periods of time, Dr. Giangreco tells SELF. If you have psoriatic arthritis and suddenly notice changes in your skin and nails, then you dont want to rule out the possibility of psoriasis. Rarely do people have psoriatic arthritis without getting psoriasis, too, according to the U.S. National Library of Medicine.

Psoriasis and psoriatic arthritis are clearly connected, but experts dont know why some people develop both conditions. However, genetics appears to be involved. Researchers have pinpointed a family of genes called the human leukocyte antigen (HLA) complex as a possible contributor to psoriasis and psoriatic arthritis, according to the U.S. National Library of Medicine. (The HLA complex helps your immune system recognize your bodys proteins compared to proteins from foreign pathogens such as viruses and bacteria, the organization explains.) People with psoriasis or psoriatic arthritis have HLA genes that are different from people who dont have either condition, according to a May 2021 paper published in The Journal of Rheumatology. And people with psoriasis who have a specific HLA gene mutation are more likely to develop psoriatic arthritis, according to the same paper.

Medical experts also believe that psoriatic arthritis may be inherited. About 40% of people with psoriatic arthritis have a family member with either psoriasis or psoriatic arthritis, according to the U.S. National Library of Medicine.

People with either condition frequently say that their health informs their decision-making, from the clothes they buy to their careers. Thats because both conditions can drastically change your life, making it difficult to sleep, work, and do the things you love, like playing with your children or baking. For example, when you have a psoriasis flare, even rolling over in bed or wearing tight clothing can be extremely painful. Some people with psoriasis choose clothing that hides their flares to avoid getting comments about their skins appearance. Similarly, joint pain from psoriatic arthritis can make it really hard to sit on the floor with your kids, get out of bed for work, or follow through on plans. This can all become overwhelming, and understandably make some people feel self-conscious about their health conditions.

There are no cures for either disease, but an effective treatment plan can minimize symptoms for both psoriasis and psoriatic arthritis. With psoriasis, doctors generally prescribe treatments that prevent your skin cells from growing too quickly, according to the Mayo Clinic. There are many treatment options for this, including creams, light therapy, or oral or injected medications, the Mayo Clinic explains.

As for psoriatic arthritis, treatments generally focus on controlling inflammation to minimize your joint pain and damage. Your doctor might suggest pharmacological options that target your immune system to lower inflammation, along with exercise or other lifestyle modifications, according to the Mayo Clinic. With each condition, the best treatment depends on your particular situation.

Both conditions can cause a lot of physical and emotional painbut you can find some relief with the right treatment plan. If you think you have psoriasis or psoriatic arthritis (or both), talk to your doctor about how you can live more comfortably.

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How Are Psoriasis and Psoriatic Arthritis Connected? - Self

@cienaraenelson / Instagram

Psoriasis is one of those conditions that can be easy to shrug off if youve never experienced it. Even though we write about skin issues all the time, even we have had fleeting thoughts along the lines of Kim Kardashian has it, and wed never have been able to tell.

Of course, the truth is that having psoriasis is more than getting occasional itchy red patches of skin. Its an autoimmune disease with symptoms that can be quite serious. And for more than five years, Los Angelesbased actress Ciena Rae Nelson has reminded the world of that on Instagram.

Nelson started sharing her journey with psoriasis in 2016, posting a selfie in which her skin is red and inflamed after a psoriasis flare-up. This is me 2 years ago just before I went to the hospital for severe dehydration and a fever, she wrote. Skin conditions are not cosmetic issues.

The same day, she shared a side-by-side selfie that showed her made up and nearly flawless in the left image, and red and blotchy in the right, thanks to photo editing that allowed her to increase the saturation of that picture to reveal the skin condition beneath. Most people looked at the left in person and didnt notice much but dry spots here and there, not noticing what was really underneath, she wrote. #psoriaticarthritis is an #invisibleillness and sometimes so is psoriasis (chronic itchiness and chronic fatigue). Not everything is as bad as it looks and sometimes things aremuch worse.

But while the posts were new, Nelsons psoriasis was anything but: Shes been living with psoriasis for nearly my entire life, she wrote in an Instagram post for the National Psoriasis Foundation, which means that I dont really know what life is like without it. As a child with psoriasis, she often felt isolated. I didnt know anyone who understood what I was going through, she wrote. And while her family was supportive, I always felt that unless they had it, theyd never really get it.

Story continues

After her first posts about it in 2016, there was an influx of support from people from all around the world who were going through something similar, she wrote. I started meeting up with people who reached out just to connect about psoriasis, which was something I had never done before. In fact, many of the people I met had neverspoken to someone with psoriasis before.

Since then Nelson has been a vocal social advocate for psoriasis awareness. She wants people to know theyre not alone. For people who suffer with chronic illness, it is so important to be able to connect with other people who have experienced what we have, in order to feel validated and understood, she wrote. Society tells us that we have to show up in the world, at work, at school, with our friends, just like everyone else does. But we are not like everyone else. And so if we are not careful, we can easily end up overexerting ourselves at the expense of our quality of life.

Nelson talks openly about how the condition affects not only her skin but also her mental health. Psoriasis can take a toll on your emotional well-being. Not only is stress a trigger for psoriasis, but, as Nelson shares, the disease can cause stress. Psoriasis can also cause depression.

In a 2019 post, Nelson shared that shed had a breakdown about my skin and thought very seriously for the first time in a long time about going back on medication, but I started therapy instead. Therapy, she writes, has been important in helping her learn to live with psoriasis. Are any of you in therapy? Nelson asked her followers. She pointed out that people with Psoriasis are twice as likely to become depressed as the rest of the population, and therapy can really help. So can meditation, exercise, plenty of sleep, and a nutritious diet, according to the National Psoriasis Foundation.

Nelson admits that sometimes psoriasis gets the better of her and makes her angry. I am losing days of my life to beds and antihistamines, she wrote last year. But that raw vulnerability helps her connect with other people who suffer with psoriasis and allows her to relate to them.

If you have felt this way, youre not alone, she wrote in another post last year. Theres no use in comparing your journey to anyone elses. Youre in a relay race all by yourself and you have to keep showing up for you. If today, it takes all the strength you can gather just to do your morning routine, and that takes you hours instead of minutes, dont worry. Youre winning. Keep going.

But that realness never comes without hope. Nelson knows she and those who have psoriasis will have good days and bad days. (And there are treatment options people can explore to have those good days!) But, she writes, they should never let psoriasis get in the way of living their lives.

Being chronically ill sometimes means you have to mourn the you that you were before your health began to decline, and accept a new normal, Nelson wrote last year. You have to do this because you cant live your life waiting to be normal. Viewing it as some purgatory between good and bad health. You have to live now, to the best of your ability, no matter the circumstance.

Originally Appeared on Glamour

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These Powerful Photos Capture What Its Really Like to Have Psoriasis - Yahoo Lifestyle

TOKYO--(BUSINESS WIRE)--First paragraph, third sentence of release dated May 20, 2021, should read: Those clinical trials are conducted in collaboration with Dong-A Socio Holdings (Headquarters: Seoul, Korea, CEO: JUNG Jae-Hun, Dong-A). (instead of Those clinical trials are conducted in collaboration with Dong-A Socio Holdings (Headquarters: Seoul, Korea, CEO: Jong Hyun Han, Dong-A).).

The updated release reads:

MEIJI SEIKA PHARMA: PROMISING RESULTS OF PHASE I CLINICAL TRIAL OF DMB-3115, A PROPOSED USTEKINUMAB BIOSIMILAR, AND INITIATION OF PHASE III CLINICAL TRIAL IN PATIENTS WITH PLAQUE PSORIASIS

Meiji Seika Pharma Co., Ltd. (Headquarters: Tokyo, Japan, President and Representative Director: Daikichiro Kobayashi, Meiji) today announced that the bioequivalence of DMB-3115, a proposed ustekinumab biosimilar, has been demonstrated in phase I clinical trial compared to the reference products marketed in Europe and the United States. Meiji also announced the initiation of phase III multi-regional clinical trial in patients with plaque psoriasis. Those clinical trials are conducted in collaboration with Dong-A Socio Holdings (Headquarters: Seoul, Korea, CEO: JUNG Jae-Hun, Dong-A).

DMB-3115 is a proposed biosimilar to ustekinumab, a recombinant monoclonal antibody for the treatment of patients with several inflammatory diseases such as plaque psoriasis, psoriatic arthritis, Crohns disease and ulcerative colitis. Meiji and Dong-A are co-developing DMB-3115 under the strategic collaboration partnership agreement on biosimilars signed in September 2011. DMB-3115 is produced by using Sp2/0 cells, the same as those used in reference products to achieve high similarity in quality aspects.

The Phase I clinical trial is a randomized double-blind, three-arm, single-dose study to compare pharmacokinetics, safety and tolerability of DMB-3115 with its reference products (US- and EU-marketed products) in 296 healthy volunteers at a single site in Europe. As a result, bioequivalence of DMB-3115 compared to reference products was demonstrated in terms of several pharmacokinetic parameters. A single subcutaneous injection of DMB3115 in healthy volunteers was well tolerated. The reported adverse events corresponded with the known safety profile of ustekinumab. There were no new unexpected adverse events.

The Phase III multi-regional clinical trials in patients with plaque psoriasis, with the target number of patient being 590, has been initiated in Europe and the United States. In this study, efficacy, safety, pharmacokinetics and immunogenicity of DMB-3115 and reference products (45 mg or 90mgsubcutaneous injection, respectively) are being compared in randomized, double-blinded controlled trial.

Meiji aims to contribute to medical care and society by developing and launching biosimilars with high quality as well as biologics products.

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CORRECTING and REPLACING Meiji Seika Pharma: Promising Results of Phase I Clinical Trial of DMB-3115, a Proposed Ustekinumab Biosimilar, and...

Before the modernization of medicine, symptoms of diseases like psoriatic arthritis (PsA) were addressed in interesting ways. In ancient Greece, symptoms were treated with tar and topical arsenic, prescribed by Hippocrates.1 In medieval times, PsA was thought to be contagious, and patients were put in isolation and treated with harmful, ineffective toxins, like sulfur and mercury.1

Medicine has come a long way since then, and although there is still no cure for PsA, weve witnessed significant breakthroughs in the scientific understanding of the disease since the coining of the term in 1860.1

In the US, more than 1 million people are living with PsA, a chronic rheumatologic disease characterized by joint pain, stiffness, and swelling.2,3 PsA can affect any part of the body, such as the fingertips and spine, or wherever your ligaments and tendons connect to the bone.3 Psoriatic arthritis affects approximately 30% of people with psoriasis (PsO), an inflammatory skin disease, and patients with PsA also experience PsO skin lesions and plaques.3

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As we experience rapid advancements in technology from wearables to data science, and combine these advancements with the recent influx of new scientific insights, we are on the verge of another revolution in rheumatic disease medicine.

During the last century, weve learned more about PsA manifestations and taken significant strides in patient care. Previously, physicians treated patients with PsA just as they would patients with rheumatoid arthritis, a more common and well-known rheumatic disease of the joints. In doing so, swollen joints were the only issue of PsA that were being addressed.

We now know that PsA is a heterogeneous disease affecting different domains of the body with varying degrees of severity for each patient some patients have minimal skin issues and more arthritis signs and symptoms, and others, vice versa. Symptoms of PsA go beyond skin and joints too, with many patients experiencing debilitating symptoms, like fatigue and anxiety, which are now being considered when establishing a treatment plan.

Treatment options for PsA can range from disease-modifying antirheumatic drugs (DMARDs) to nonsteroidal anti-inflammatory drugs (NSAIDs) to topical creams. Currently, these options focus on slowing the progression of joint pain to prevent permanent joint damage, combat inflammation, and attain skin clearance.

Although there are many treatment options available today, there is still an incredible unmet need in this space, and rheumatologists face the challenge of providing lasting remission to patients covering the whole diversity of disease manifestations.

To usher in the future of PsA therapy, we must cut across traditional disease area boundaries. First, we must continue to gain a better understanding of the patterns of this complex disease and its multifaceted symptoms. This will allow us to identify and unlock new pathways, mechanisms, and regimens for patients with limited or inadequate treatment options. We must continue to study our medicines in clinical practice settings and include patient, prescriber, and payer insights in our research efforts to reach a significantly broader population of patients with better and safer treatment approaches. Further, we must integrate patients into our decision-making process by engaging them in conversations about their treatment options.

Realworld evidence and patient-reported outcomes are leading to databases of information that are helping to advance therapeutic science. For example, we can now tap into these databases to gain new insights into a treatments safety and effectiveness and show trends across thousands of patients. We are also using connected devices to capture real-time patient health status, including monitoring movement, heart rate, and temperature. In rheumatic disease, wearable technology has enabled clinicians to assess patient flares using activity tracker data.4

A deeper understanding of disease patterns, pathogenesis, and patient-reported symptoms, paired with innovations in data and technology will create a winning combination that will lead to novel therapeutic options that restore immune balance and achieve remission.

Weve come a long way since the days of tar and arsenic treatment for PsA, but we still have a way to go. At Janssen, were driven by a relentless focus on the unmet patient need and are excited by the tremendous opportunity we have to alter the current immunology treatment landscape. Were rapidly advancing our data science capabilities, focusing on scientific insights and innovation, and keeping patients at the center of everything we do.

The future is exciting for us as scientists, but its especially meaningful and motivating to consider what the winning advancements could mean for the millions of people around the world living with PsA. How will we look back on todays treatments for PsA? I cant wait to find out.

Editors Note: To learn more about these efforts, please visit https://www.janssen.com/immunology.

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Redefining the Future of Psoriatic Arthritis Treatment - Rheumatology Advisor

The Chronic Plaque Psoriasis Market is expected to grow at a CAGR of 8.9% and is poised to reach US$XX Billion by 2027 as compared to US$XX Billion in 2020. The factors leading to this extraordinary growth is attributed to various market dynamics discussed in the report. Our experts have examined the market from a 360 degree perspective thereby producing a report which is definitely going to impact your business decisions.

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Key Companies Operating in this MarketNovartis International AGSun Pharmaceutical Industries Ltd.Eli Lilly & companyAmgen Inc.Abb Vie Inc.Merck & Co.Pfizer Inc.Boehringer Ingelheim GmbHJanssen Biotech Inc.

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Chronic Plaque Psoriasis Report, Forecast 2020 2027, Upcoming Trend Analysis and Key Players Novartis International AG, Sun Pharmaceutical...

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Psoriasis Treatment Market to Showcase Healthy Expansion of CAGR During 20202027 KSU | The Sentinel Newspaper - KSU | The Sentinel Newspaper