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The COVID-19 vaccines are here, and theyre being distributed by the millions. Chances are, you know at least one person who has received one. But as welcome as these long-awaited shots are, theyre also stirring up some controversyespecially among those in the chronic community, who (understandably) have some questions. Like are these vaccines safe for everyone? And will they interact with my medications? Also, what are the side-effect risks?

For more info on psoriasis and the COVID Vaccine, check out our Facebook Live event, here!

We hear you. And were taking your questions straight from our Facebook pages to the desks of top chronic disease experts as part of our original series #ChronicVaxFacts. Todays expert is Lisa Zaba, M.D., Ph.D., a dermatologist with Stanford Health Care in Palo Alto, CA. We asked Dr. Zaba to answer questions from psoriasis patients about the COVID vaccine.

HealthCentral: Could the COVID vaccine cause a psoriasis flare?

Lisa Zaba, M.D., Ph.D.: Single-stranded mRNA molecules, like those contained in the Pfizer and Moderna COVID-19 vaccines, are activators of innate immune cells. Binding of mRNA to innate immune cells produces a potent type I interferon (IFN) response that is thought to play a central role in inflammation in some patients with autoimmune disorders. [Specifically,] type I IFN is thought to play a role in the initiation phase of psoriasis when people first develop the disease, although chronic psoriasis is perpetuated by overactivation of a different pathway, the Th17 adaptive immune response.

So in short, it is unknown how these new vaccines will affect patients with psoriasis, but major rheumatologic societies, including the National Psoriasis Foundation COVID-19 task force and the American College of Rheumatology, have put out statements indicating that the benefits of vaccination outweigh the risks for patients with psoriasis.

HC: Could the vaccine interact with my medications in any way?

Dr. Zaba: People taking immunosuppressive medications for their autoimmune diseases need those medications to stay in a remission. However, it is possible that those drugs may blunt the immune response to the COVID-19 vaccines, [possibly making them less effective]. It is not currently recommended that people stop their immunosuppressive medications prior to getting vaccinated; however, this is a discussion that should be had on a case-by-case basis with your treating doctor.

HC: Is one vaccine better than the other for people with psoriasis?

Dr. Zaba: Pfizer and Moderna mRNA vaccines are similar in composition and structure, and it is therefore unlikely that there will be a significant difference is the side-effect profile for patients with psoriasis.

HC: Will the vaccine side effects be more severe because of my condition?

Dr. Zaba: It is currently not known if the vaccine side effects will differ in those with autoimmune conditions. Immunocompromised individuals or those requiring immunosuppressive therapy were excluded from phase III SARS Cov-2 vaccine trials. Therefore, safety and efficacy in this population is unknown.

HC: What are scientists doing to get that data on vaccine safety for people with our condition, and when will we have access to that information?

Dr. Zaba: Although vaccination is likely much safer for autoimmune patients than becoming infected with SARS CoV-2 virus, there are currently no NIH or pharmaceutical funded vaccine trials specifically looking at the question of safety and efficacy of COVID-19 vaccines in patients with autoimmunity. Our aim [at Stanford] is to conduct an observational study of COVID-19 vaccines in autoimmune patients under the close supervision of doctors specializing in autoimmunity.

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Sarah Ellis is a wellness and culture writer who covers everything from contraceptive access to chronic health conditions to fitness trends. She is originally from Nashville, Tennessee and currently resides in NYC. She has written for Elite Daily, Greatist, mindbodygreen and others. When shes not writing, Sarah loves distance running, vegan food, and getting the most out of her library card.

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COVID Vaccines & Psoriasis: What To Know

Secukinumab is the first biologic that inhibits interleukin-17A and has demonstrated rapid and long-lasting effectiveness in treating moderate-to-severe psoriasis. Yet there are instances where even increasing the dosage fails to provide a clinical response. The most common sites of recalcitrant psoriasis in patients treated with biologics are the anterior lower legs (49.3%), elbows (35.6%), and posterior lower legs (24.7%)

Acitretin is an oral retinoid derived from vitamin A with a history of use alone or in combination with phototherapy. It is the only systemic therapy for psoriasis that is not immunosuppressive, although it is not suitable for in women of childbearing age. It should be used in low doses due to common adverse effects including chapped lips, dryness of the nose and eye, hair loss, and hyperlipidemia.

Methotrexate is used by clinicians in most combination regimens with biologics, the authors said, but acitretin may be a good alternative with lower potential liver toxicity. In the absence of data evaluating the combination of secukinumab and acitretin, the authors presented a case series of patients with different types of psoriasis: chronic plaque, generalized pustular, and erthryrodermic. The patients each had multiple comorbidities and failed to respond to several conventional and biologic therapies, including escalated secukinumab in 2 patients.

The first case was a 64-year-old woman with a 13-year history of chronic psoriasis (PsO) and peripheral psoriatic arthritis (PsA). She also had type 2 diabetes (T2D), obesity, hypertension, and fatty liver disease complicated by liver fibrosis. The patient had generalized plaque lesions with a score of 29.6 on the Psoriasis Area and Severity Index (PASI) upon initiation of secukinumab at a dose of 300 mg/week for 4 weeks. The authors said skin and joint symptoms improved remarkably, but residual plaques on the forearms and shins persisted despite adding a topical steroid and keratolytic agent.

Within a year, despite significant improvement and a dose escalation of secukinumab, plaques persisted. Four weeks after adding acitretin 25 mg/day (0.3 mg/kg) to secukinumab, the plaques significantly improved without any adverse events. Regression of the lesions continued after 6 months.

The second case was a 37-year-old male with 20-year history of severe chronic PsO accompanied by intermittent erythrodermic attacks. She also had obesity, fatty liver disease, gout, and PSA with axial and peripheral involvement. At week 12, having been treated with 300 mg of secukinumab, his PASI score decreased by 50%-75% (PASI 12). However, at week 16, his PASI score worsened to 17.4. Escalation of the dose to every 2 weeks failed to achieve a response, with infiltrated plaques on the distal extremities persisting. Six weeks of acitretin (25 mg/every other day; 0.1 mg/kg) resulted in significant improvement, and after a year, there were no new lesions or adverse events.

The third case was a 76-year-old male with a 10-year history of chronic PSO and intermittent pustular attacks that often occurred after recurrences of leg cellulitis. He also had T2D, chronic obstructive pulmonary disease, hypertension, atrial fibrillation, obesity, and fatty liver disease.

Acitretin (50 mg/day) was started but discontinued after triple elevations of liver enzymes. After a brief trial of ustekinumab (Stelara), acitretin was reinstated at 25 mg/day; 0.25 mg/kg), yet pustular lesions progressed to widespread plaques. Adding in secukinumab, however, completely cleared the skin at 24 weeks with no side effects. He remained lesion-free after a year.

Reference

Polat Ekinci, A,Blk, KN,Babuna Kobaner, G.Secukinumab and acitretin as a combination therapy for three clinical forms of severe psoriasis in multidrug refractory patients: A case series of high efficacy and safety profile.Dermatol Ther.2021;34:e14704.doi: 10.1111/dth.14704

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Patients With Refractory Psoriasis Helped by Combination Therapy, Case Study Finds - AJMC.com Managed Markets Network

Jenny Parker partnered with us to talk about her personal journey and about Healthlines new app for those living with psoriatic arthritis.

PsA Healthline is a free app for people living with psoriatic arthritis. The app is available on the App Store and Google Play. Download here.

A gymnast and avid runner for most of her life, Jenny Parker was training 6 days a week with the goal of clocking in a 5-minute, 30-second mile.

She was close coming in at 5 minutes and 42 seconds when her body stopped moving at its usual speed in July 2019.

My hips just wouldnt move the way I wanted them to. It almost felt like I was rusted, and it was painful, says Parker.

Still, her inner athlete didnt let down.

Parker kept training for a few more months, then took some time off to give her body a break. When the symptoms didnt subside, she saw her primary care doctor.

Ive had psoriasis on my scalp, elbows, and knees since I was 12, and I had been warned that if something felt funny with my joints, I should see a doctor right away, so I finally did, she says.

After conducting a few tests that analyzed inflammation and arthritis, nothing came back positive, and the doctor recommended that Parker see a physical therapist.

That didnt help either, and at that point, my symptoms started looking like classic arthritis. I was stiff in the morning and it took a while to get moving, she says.

Her condition started affecting her at her nursing job, too.

I work 12-hour shifts, and the first 4 hours of my morning I was limping at work. I was afraid I wouldnt be able to run to another part of the hospital if there was an emergency. Thats when I knew I needed to see a specialist, Parker says.

In November 2019, she was referred to a rheumatologist, who diagnosed her with psoriatic arthritis (PsA).

She was 26 years old.

At first, Parker was an endurance athlete without an outlet. Even exercises like jumping jacks hurt.

However, she recognized the need to get her heart rate up, as both psoriasis and PsA come with an increased risk for heart disease.

She tried riding a stationary bike for a while but missed running.

Once she found a combination of medications that worked for her, her condition improved. That meant it was time to lace up her trusty running shoes again.

On medications, I cant run every day, but I can jog, she says. The fastest I can do on a really good day is a 9-minute, 30-second mile, and I can run as much as 4 miles.

To go from being afraid to run across the street in time before a car came, to this, makes me so happy, she says.

Wanting to connect with others her age who are also living with psoriatic arthritis, Parker created an Instagram account, @_cute_n_chronic, that was separate from her more filtered personal account.

On my personal account, I was posting to the void, where people didnt really understand me or engage with me, she says.

While she found many accounts of people with other forms of arthritis, she wasnt finding much that was specific to PsA.

I wanted to be able to put my experience out there so others who were in the place I was could have a less bumpy road with going on medication and not being able to work out, she says.

I wanted to show people it doesnt have to be as scary as our brains make it sometimes.

She began holding weekly morning coffee chats on Instagram Live to share her struggles and successes, and quickly gained nearly 2,000 followers.

Theres great engagement and I get messages from people saying they were in the same spot I was and I made them feel better, says Parker.

Parkers latest way to connect with those living with psoriatic arthritis is in her role as community guide for the free PsA Healthline app.

The app connects those diagnosed with psoriatic arthritis based on their lifestyle interests. By browsing member profiles, users can request to talk with other members within the community.

Members can also share whats on their mind and learn from others in a number of groups, including:

Theres also a live discussions group, where users can chat in real time with Parker or another PsA advocate on a daily topic.

This feature is Parkers favorite part of the app.

I love that there are different groups for different topics because I think it helps keep things organized and easy for people to figure out, she says.

As a community guide, she is especially happy to help users feel more connected with people going through the same thing.

I had such a rocky start with my diagnosis, not only navigating medication, but also feeling alone, and the mental health component of grieving what I had to give up and couldnt do anymore, says Parker.

Id like to help people know they have someone here who cares and who is here to listen.

As a nurse, being a compassionate listener comes naturally to her.

Im the empathizer, and that bleeds into the rest of my life, she says.

For those considering partaking in the apps features, Parker points out that it is a welcoming space filled with other people who really get it.

Its meant to be fun. Most importantly, its meant to add a positive thing to your life when PsA can sometimes add a lot of negative, says Parker.

Members can come exactly as they are with whatever struggles and triumphs theyre facing, she adds. This community is proof that youre never alone.

Cathy Cassata is a freelance writer who specializes in stories around health, mental health, medical news, and inspirational people. She writes with empathy and accuracy and has a knack for connecting with readers in an insightful and engaging way. Read more of her work here.

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How a New App Is Helping Connect People with Psoriatic Arthritis - Healthline

In these textbooks, the disease is often said to cause red or pink patches with a silvery scalebut this description really only applies to white skin.

One of the primary features of psoriasis is a finding called erythemaa sign of inflammation in the skin. The root of the word is actually from the Greek for red, but erythema can manifest in different ways, explains Dr. Landriscina.

In white skin, erythema is typically pink to redoften referred to as salmon pink. However, erythema can manifest differently in more melanin-rich skin tones. Overlapping the erythema of psoriasis with the brown color of melanin can lead to other colors, such as purple, Dr. Landriscina tells SELF. Also, inflammation can lead to increased or decreased pigment production in the affected area, resulting in dark or light spots in skin of color.

All of this means that it can be even more difficult for people of color to receive an accurate diagnosis of psoriasis, which can make this arduous process even more costly and discouraging.

Dermatology is all about pattern recognition, so unless you train and practice in an area with a diverse patient cohort you will not be familiar with identifying subtle signs of disease on patients with darker skin tones, Dr. Psomadakis adds.

My plaques have never been red, Bridges says. My flares are dark brown to purple. Due to this misinformation in texts, many doctors who are unfamiliar with darker skin have been more likely to speculate that I didn't have psoriasis, and that it was perhaps another disease.

Carina Linnane, 25, knows all about trial and error. First, it was moisturizer and coal tar treatment for my scalp, but that didnt help much, she tells SELF. Then she tried light therapy, but she stopped when her doctor had concerns about the risks of prolonged ultraviolet (UV) light exposure.

Linnane was then put on a course of topical steroids until they stopped working, then various other types of steroids until she decidedlast year, at the age of 25to focus on lifestyle changes. I eliminated a lot of foods (mainly dairy and gluten) and six weeks later my arms were [mostly] clear of psoriasis. I still have some patches on my legs, but its improving.

Dr. Psomadakis doesnt entirely agree that psoriasis treatment is all trial and error. There are scientifically backed ingredients and treatments that are effective in the majority of people, she says. But she agrees that finding what works can be a confusing process, because the disease is influenced and exacerbated by many external triggers.

Searching for the right treatment for your psoriasis may indeed require trying several different treatments, with varying levels of success, but the upside of treating psoriasis is that this wide range of treatments exists in the first place, says Dr. Landriscina, noting that there are dozens of FDA-approved medications for psoriasis.

Bridges currently manages her psoriasis symptoms with a combination of a biologic and topicals. Never in a million years would I have thought I would achieve clear skin, she says.

Many factors can affect whether a particular psoriasis treatment works for someone. These include how much of the body is affected, whether certain special sitessuch as the scalp or genitalsare affected, and whether or not the patient has psoriatic arthritis, Dr. Landriscina says. Each patients overall health also plays a role, he adds, so having a care team that you see regularly is crucial.

Dr. Klein agrees. It's about careful management that is both reactive and proactive and often involves working with a patient's medical team should they have other health conditions connected to the psoriasis, she says. The National Psoriasis Foundation estimates that up to 30% of people with psoriasis develop psoriatic arthritis. Due to increased inflammation, psoriasis patients are at greater risk of developing cardiovascular disease, and therefore optimizing cardiovascular health is of utmost importance. Psoriasis patients are also at greater risk of developing depression and other health conditions.

Read more here:
The Winding Road to Psoriasis Treatment - Self

ZUG, Switzerland, May 6, 2021 /PRNewswire/ -- MoonLake Immunotherapeutics AG, a clinical-stage biotechnology company focused on creating next-level therapies for inflammatory skin and joint diseases, today announced that full results of a Phase 2b study of its Tri-specific Nanobody Sonelokimab were published in The Lancet. Sonelokimab is an investigational IL-17A/IL-17F inhibitor with an albumin binding site, which has the potential to facilitate deep tissue penetration in the skin and joints. It has clinically demonstrated potential to allow better disease control in dermatology and rheumatology patients.Sonelokimab showed impressive efficacy with a favorable safety profile, and numerically outperformed active control secukinumab.

In the study, dosages up to 120 mg showed rapid and significant clinical benefit compared with placebo. In the highest dosage group, almost 6 out of 10 patients (57%) achieved total skin clearance (PASI 100 response) after 24 weeks. Rapid response was demonstrated with one of three patients already achieving almost clear skin (PASI 90 response) by week 4. Analysis of an individualized dosing scheme including off-drug periods in controlled patients revealed durable responses over one year. Sonelokimab was generally well tolerated, with a safety profile similar to the active control, secukinumab, and an overall candida rate of 7.4%. Although the highest dosage and schedule could be used for future clinical studies, additional assessment and modelling may aid in the final selection of the optimal dosage and schedule. The trial was conducted by Avillion LLP under a 2017 co-development agreement with Merck KGaA, Darmstadt, Germany.

Investigator Kristian Reich MD, PhD, Chief Scientific Officer and co-founder of MoonLake Immunotherapeutics, commented:"Sonelokimab is a remarkable Nanobody with game-changing potential in the treatment of a range of IL-17A/F-driven inflammatory diseases. This study shows very high response levels in the model disease psoriasis, with a favorable benefit-safety profile. MoonLake's aim is to also accelerate Sonelokimab's development in other inflammatory diseases driven by IL-17A and IL-17F like psoriatic arthritis, ankylosing spondylitis and hidradenitis suppurativa. Our aimis to elevate treatment goals in these diseases based on the unique characteristics of Sonelokimab, giving patients with common and burdensome skin and joint conditions a chance of better disease control."

Mark Weinberg, MD, MBA, co-author of the publication andChief Medical Officer of Avillion LLP, commented: "Following completion of our Phase 2b activities with Merck KGaA, we are excited to see Solenokimab continue in development. Data on this Tri-specific Nanobody demonstrates potential in major inflammatory diseases driven by IL-17A and IL-17F. These diseases have a profound effect on patients' lives not just physically but emotionally and socially. We've seen a continued evolution of biologic therapies in the last 25 years and I am looking forward to seeing further development of this novel nanobody biologic by MoonLake."

The randomized, double-blind, placebo controlled, multi-center, Phase 2b study was designed to assess efficacy, safety and tolerability of Sonelokimab in subjects with moderate-to-severe chronic plaque-type psoriasis. The trial enrolled 313 patients (age 18-75) with chronic plaque psoriasis for at least six months, with an Investigator Global Assessment (IGA) score 3, involved body surface area 10%, and Psoriasis and Severity Index (PASI) 12 at screening and at baseline. Patients were randomized to one of four dose regimens of Sonelokimab, or a placebo comparator arm, or a reference arm (secukinumab).

This clinical trial significantly expands the number of patients and duration of therapy evaluated for Sonelokimab in plaque psoriasis and represents the first Phase 2 evaluation of a Nanobody IL-17 A/F inhibitor in psoriasis. The study found Sonelokimab was efficacious in the treatment of plaque psoriasis. The safety profile reflects the mechanism of action with oral Candida as the most reported adverse event, in the same range as IL-17A inhibitors (7.4%).

MoonLake Immunotherapeutics was established by an international team of immunology specialists to accelerate the clinical development of Sonelokimab, building on robust clinical data generated by Merck KGaA,Darmstadt, Germany, and by Ablynx, a Sanofi company, which discovered the molecule.

MoonLake Immunotherapeutics plans to accelerate the development of Sonelokimab in multiple inflammatory diseases in dermatology and rheumatology driven by IL-17A and IL-17F. This group of IL-17A/F Inflammatory Diseases (introducing the novel concept of AFID) includes psoriatic arthritis, ankylosing spondylitis, and hidradenitis suppurativa conditions affecting millions of people worldwide with a large need for improved treatment options. MoonLake Immunotherapeutics plans to initiate multiple Phase 2 trials soon.

For enquiries, please contact:

MoonLake Immunotherapeutics AG

Arnout Ploos van Amstel

Kristian Reich MD PhD

E: [emailprotected]

Mo PR Advisory

Mo Noonan/ Jonathan Birt

Tel: +44 (0) 7876 444977 / (0) 7860 361746

For further information please visit our website http://www.moonlaketx.com

For the full announcement please see: http://www.moonlaketx.com/news/sonelokimab

SOURCE MoonLake Immunotherapeutics AG

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MoonLake Immunotherapeutics announces publication in The Lancet of impressive Phase 2b data showing its Tri-specific Nanobody Sonelokimab totally...

Theres no known cure for the autoimmune disease called psoriasis, but there are potential lifestyle changes that may help reduce its severity. Diet may be one of those factors, with a new study from Ghent University detailing a modified intermittent fasting diet that reduced psoriasis severity after a few weeks.

Intermittent fasting is an easier form of fasting that requires abstaining from food for a specific, typically short duration while limiting food intake to the non-fasting days. There are various intermittent fasting protocols, some that, for example, involve eating only once a day or only within a six-hour window.

According to the new study, adhering to a 5:2 intermittent fasting protocol in which one eats only five days a week may reduce the severity of psoriasis symptoms. The protocol involved not eating for two non-consecutive days per week, then eating ones usual diet the other five days.

The research involved 24 participants split into two groups; one group followed the 5:2 intermittent fasting diet while the other group ate their regular diets. The dieting duration of the study lasted for 12 weeks, with 22 of the 24 participants remaining for the full duration.

The researchers evaluated two aspects of psoriasis symptoms: PASI, which measured the extent and severity of psoriasis, and BSA, meaning the body surface area covered with psoriasis. According to the study, the fasting participants reported notable improvements in their psoriasis symptoms between six and 12 weeks during the study, including less itching, reduced patch thickness, and reduced scaling.

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Intermittent fasting protocol found to reduce psoriasis after a few weeks - SlashGear

PsA Healthline is a free peer-support app for people living with psoriatic arthritis. The app is available on the App Store and Google Play. Download here.

A 2018 study found that those who search online for health information use what they learn to make medical decisions.

While finding reputable information online can be helpful, running it past your doctor is always a safe way to verify what you learn.

Additionally, connecting with others who are going through exactly what you are can bring comfort and support you may not find from a medical team.

Elizabeth Medeiros received a diagnosis of juvenile idiopathic arthritis when she was 12. At 14, her condition was specified as juvenile psoriatic arthritis.

Her feet, hips, and knees were affected most. Over time, her jaw and other joints became impacted, too.

While her doctor put her on a treatment plan that works well, the emotional side of living with psoriatic arthritis (PsA) made it hard for her to cope.

When I was first diagnosed with PsA, I was desperate to meet others going through the same thing as me, says Medeiros.

To connect with others, she started a blog, The Girl with Arthritis, and also turned to Facebook and Instagram to find support groups.

Ive met a lot of wonderful people through the years, she says.

To expand her connections, she joined the free PsA Healthline app.

The thing I like so much about PsA Healthline is how personal it feels. All the different groups within the app where you can post make me feel like my posts and questions are going to the right place, she says.

For instance, if she wants to share insights on mental health-related topics, they land in the Mental and Emotional Health group.

The group feature is a favorite aspect of the app for Ashley Featherson, who got her psoriasis diagnosis at age 4.

Until Featherson joined PsA Healthline, she only connected with others in her community via social media, including Instagram.

I mainly follow others with psoriasis or holistic pages and follow their journey. PsA Healthline is different, with the different groups and being able to discuss all areas affected by psoriasis with those who understand, Featherson says.

As much as Medeiros agrees, she says her favorite part of the app is participating in evening live chats, which cover a new theme each night.

So many wonderful conversations are sparked from the questions, she says. And even if the topic is something thats not as applicable to me, I love reading about others experiences and learning new things.

Because having chronic pain can often make you feel isolated and alone, Medeiros says PsA Healthline helps bring comfort.

Theres a lot of pressure to hide your pain and not talk about it with others. Having a place that encourages you to post about your experiences and know others care and relate is amazing, she says.

Showing support for others is just as rewarding, Medeiros adds.

I also really love the reactions you can apply to posts: love, strength, or hug (or all three!). There are times I dont have any advice to give, but want to let a member know Im sending them lots of strength and hugs, she says.

If youre hesitant to try it, Medeiros suggests joining and simply reading what others have to say until you are comfortable engaging.

Im sure youll be inspired to join in when you see how helpful and caring the members can be, she says.

Featherson agrees, pointing out that the community is filled with people just like you.

Its a safe space for all areas surrounding psoriasis and PsA. It helps during moments of frustration or when looking for remedies or thoughts on treatments, she says.

Download the app here.

Cathy Cassata is a freelance writer who specializes in stories around health, mental health, medical news, and inspirational people. She writes with empathy and accuracy and has a knack for connecting with readers in an insightful and engaging way. Read more of her work here.

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How Technology and Social Media Help the Psoriatic Arthritis Community - Healthline