Category Archives: Psoriasis

New research from a Taiwanese insurance database suggests that some commonly used therapies against psoriasis may increase the risk of herpes zoster, although 2 other therapies lowered the risk.

Although biologic agents are frequently prescribed for patients with psoriasis, the resulting suppression of cell-mediated immunity can increase the risks of bacterial and viral infections, according to the research published in Scientific Reports. These potential links have been unproven, however, despite earlier study findings that patients with psoriasis face higher risks of herpes zoster infection.

To investigate this question, researchers identified 92,374 patients in the Taiwan National Health Insurance Research Database who were diagnosed with psoriasis between 2001 and 2013. They followed these patients for a median of 6.8 years and noted anti-psoriasis therapeutics as well as herpes zoster infection diagnoses.

According to their findings, etanercept, adalimumab, and methotrexate plus azathioprine were all associated with an increased risk of herpes zoster infection. The investigators also studied ustekinumab and found that none of these patients were diagnosed with herpes zoster. However, they said this could be because ustekinumab was not approved for use in Taiwan until 2011, so there was a limited amount of follow-up time for these patients.

In total, 5.2% of the patients were diagnosed with herpes zoster during the follow-up period. Older age, female sex, hypertension, dyslipidemia, psoriatic arthritis, and a high Charleston comorbidity index score were all associated with an increased risk of herpes zoster diagnosis. Concurrent exposures to steroids and statins were also linked with a higher risk.

Similar to previous studies on general population or on diabetic patients, the use of statin is associated with higher risk of [herpes zoster], the authors wrote. The actual mechanisms of these associations have not [been] fully understood, but may involve the effect of statin on T cell function.

Notably, however, the 3 anti-psoriasis therapies identified as increasing risk of herpes zoster were each associated with a more than quadrupled risk of infection. Etanercept had a hazard ratio of 4.78; adalimumab had a hazard ratio of 5.52; and methotrexate plus azathioprine had a hazard ratio of 4.17.

In addition to finding that methotrexate in combination with azathioprine increased the risk of herpes zoster, the researchers added that methotrexate combined with any biologic agent increased the risk, although not to a statistically significant level.

Two other treatmentsphototherapy and acitretinwere associated with a lower risk of psoriasis, with hazard ratios of 0.76 and 0.39, respectively. The lower risk associated with acitretin could be attributable to the lower level of immunosuppression associated with this monotherapy. Similarly, the benefit associated with phototherapy could be caused by the increased level of vitamin D associated with UV exposure. Earlier research has suggested that vitamin D therapy could lower the risk of herpes zoster, the authors said.

Although the effect of UV light on the skin is mainly anti-inflammatory, this may not imply an overt immunosuppressive effect, the authors wrote. Upon exposure to UV light, the human skin generates vitamin D, a vital nutrient for skeletal health and a well-known immunoregulator.

Based on these findings, the investigators concluded that patients with moderate to severe psoriasis who are prescribed certain biologic agents may have a higher risk of herpes zoster infection. This risk should be considered, and other treatments may mitigate this risk while allowing for effective anti-psoriasis treatment.

REFERENCE

Ting SW, Ting SY, Lin YS, Lin MS, Kuo G. Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study. Scientific Reports. June 3, 2021. Accessed June 30, 2021. https://www.nature.com/articles/s41598-021-91356-3

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Study: Some Systemic Anti-Psoriasis Therapies Increase Risks of Herpes Zoster - Pharmacy Times

Patients on kidney dialysis who also have psoriasis are at increased risk of infection, and psoriasis treatment can reduce both the risk of infection and death, investigators report.

They looked at data on nearly 9,000 patients with both conditions in the United States Renal Data System, which has information on essentially all patients in the country on dialysis, says Dr. Wendy B. Bollag, cell physiologist in the Medical College of Georgia Department of Physiology and the studys corresponding author.

What they found indicates psoriasis treatment, which likely helps restore the natural frontline barrier protection of the skin, reduces infection rates and improves survival, indicating its potentially important role in better managing kidney failure, corresponding author Bollag and colleagues at MCG and the Charlie Norwood VA Medical Center in Augusta write.

Prospective studies are needed to further examine these associations, they note in The American Journal of the Medical Sciences.

We looked at all causes of mortality in this study and also the effect of treatment, says Dr. Stephanie L. Baer, infectious disease physician in the MCG Department of Medicine and chief of Infection Control and Epidemiology at the Charlie Norwood VA. The most important thing in this paper is that treatment helped.

They recommend that physicians taking care of patients who have both conditions be aware of their increased infection risk, and ensure psoriasis treatment as well as vaccination for herpes zoster.

Both psoriasis and kidney failure are known to increase the risk of infection with herpes zoster, the virus that causes shingles and chickenpox, infecting nerves where it can lie dormant for years. The investigators already had shown the virus presence is associated with increased death rates in patients in kidney failure. This time they found that this infection actually surfaced more frequently in the face of psoriasis treatment, which supports current recommendations that kidney failure patients get a herpes zoster vaccine, they say.

They suspect the increased risk of infection by herpes zoster and other invaders results from the common, compounding denominator of chronic inflammation caused by both conditions, and the subsequent wear and tear on the vascular and immune systems.

Patients on dialysis are known to be at increased risk of infection because of their typically multiple, weekly visits to a dialysis center and permanent intravenous access lines needed for dialysis, Bollag says, and the loss of barrier protection caused by psoriasis compounds that risk.

They also knew that cardiovascular disease is the leading cause of death in patients on dialysis, that kidney disease is a downstream effect of vascular disease and they suspected psoriasis could further complicate the scenario.

We know that psoriasis is a proinflammatory syndrome, and we knew that it could increase cardiovascular complications in the general population, says co-author Baer.

The U.S. Renal Data System is a good system for exploring these kinds of associations, Bollag says, so they decided to find out.

In addition to herpes zoster, they focused on eight other infections common in patients on dialysis, and found psoriasis likely increased their risk of most of them.

They looked for problems like bacteremia, a common bacterial infection in the bloodstream that can result from even a slight injury like vigorous tooth brushing or medical procedures; septicemia, or blood poisoning, the more serious, body-wide illness resulting from significant bacterial infections; conjunctivitis, or pink eye; and cellulitis, a common but potentially significant bacterial skin infection that can occur in inflamed skin.

The most common infections they found were septicemia and cellulitis, which occurred in about half of kidney failure patients with psoriasis, and systemic inflammatory response syndrome, or SIRS, an overwhelming, body-wide inflammatory response to something like a severe bacterial infection or trauma, in 42%.

They also looked at three categories of treatment patients received, which have procedure codes so they could search for them in the huge national database. These include treatments with a body-wide, or systemic, impact like biologics, therapies made from living material like the RNA vaccines in use against COVID-19, or in the case of psoriasis, drugs that specifically block drivers of the immune response called T cells or block proteins immune cells produce like tumor necrosis factor alpha, which promote inflammation. Other treatments included were localized ones like corticosteroid injections directly into a psoriasis lesion, and light-based therapy like ultraviolet therapy that inhibits the immune response in the skin.

The investigators noted that information was not included in the database for all treatments, like self-administered topical creams, and it has been reported that overall a significant percentage of even moderate to severe psoriasis is undertreated or untreated, and that inadequate treatment can worsen the disease.

In this case, they found the therapies that work to suppress the effect of an overzealous immune response were effective at reducing both infection and death.

Now the investigators are pursuing associations between psoriasis and stroke as well as heart attack.

Baer notes that psoriasis may seem like a more chronic, secondary problem in the face of kidney failure, but the reality is both conditions put patients at increased risk for infections and have inflammation and vascular damage as major factors.

The federally funded U.S. Renal Data System collects, analyzes and makes available information on patients who require dialysis because of chronic kidney disease or end stage renal disease. MCG and VA investigators looked specifically at all patients in the database ages 18 and older starting dialysis between 2004-11 a total of 8,911 individuals who also had a diagnosis of psoriasis.

About 1% of the patients in kidney failure also had psoriasis and they tended to be older, white, tobacco users and had higher rates of all nine infections the investigators looked at. The investigators noted that its highly likely more patients in the database have psoriasis but that diagnosis was not noted.

Other recent population database studies have indicated that having psoriasis increases the risk of kidney disease.

About 7.5 million Americans are living with psoriasis, and 10-20% of patients will also develop psoriatic arthritis, according to the Centers for Disease Control and Prevention.

The typically cyclical, but chronic condition causes patches of thick, red, flaky, sometimes painful skin, most often in places like the elbows, knees and face, but can even surface inside the mouth and on the face, lips and soles of the feet.

Psoriasis is characterized as an immune-mediated disease, in which an overactive immune response dramatically accelerates skin cell growth, according to the National Psoriasis Foundation. While skin cells turn over comparatively rapidly, they go from being produced and shed in about a month to just a few days, which causes the raised pileup that looks distinctive from the rest of the skin.

More than half of patients report the disease to be a major problem in everyday life, the foundation says, and patients are known to be at increased risk for problems like heart attack, stroke and diabetes, in which inflammation also is a major factor.

The research was supported in part by a VA Merit Award (#CX001357).

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Psoriasis treatment reduces infections, death in patients on dialysis with the skin condition - Jagwire Augusta

HIGH POINT, N.C., June 29, 2021 (GLOBE NEWSWIRE) -- vTv Therapeutics Inc. (Nasdaq: VTVT) a clinical-stage biopharmaceutical company focused on the development of orally administered treatments for type 1 diabetes and psoriasis, today announced that it will be presenting data from the clinical development of HPP737 as a treatment for psoriasis in a poster presentation at the 6th World Psoriasis & Psoriatic Arthritis Conference held virtually June 30 July 3, 2021 in Stockholm, Sweden.

Poster Details:

Poster Title: Pharmacokinetics and Pharmacodynamics of the Phosphodiesterase 4 (PDE4) Inhibitor HPP737 Following Single-dose Oral Administration in Healthy Subjects

Presenting author: Aaron Burstein, PharmD

ID: 35201

Topic: 4. Current and new therapeutic modalities

The poster will be added to vTvs website following the presentation and will be available at: https://vtvtherapeutics.com/pipeline/hpp737/.

About HPP737

HPP737 is a novel, potent, orally administered PDE4 inhibitor discovered by vTv Therapeutics. PDE4 is a validated therapeutic target for the treatment of a variety of disorders including psoriasis. In the phase 1 single ascending dose study presented here and a subsequent multiple-ascending dose study, HPP737 was well tolerated, with little or no gastrointestinal adverse events, such as nausea, vomiting or diarrhea, across the range of doses tested. HPP737 has evidence supporting target engagement from an ex vivo LPS stimulation TNF-alpha production assay and has demonstrated very potent activity in the Th17 skin resident immune cell activation (sRICA) assay, in which HPP737 was 10-100 fold more potent than apremilast in inhibiting the generation of cytokines/chemokines, depending upon the analyte. HPP737 is currently being tested in an on-going multiple ascending dose phase 1 study that is expected to complete during the third quarter.

About vTv TherapeuticsvTv Therapeutics Inc. is a clinical-stage biopharmaceutical company focused on developing oral, small molecule drug candidates. vTv has a pipeline of clinical drug candidates led by programs for the treatment of type 1 diabetes (T1D) and psoriasis. vTvs development partners are pursuing additional indications in type 2 diabetes, chronic obstructive pulmonary disease (COPD), renal disease, and primary mitochondrial myopathy.

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For more information, please visit http://www.vtvtherapeutics.com or follow us on Twitter: @vTvTherapeutics.

Forward-Looking StatementsThis release contains forward-looking statements, which involve risks and uncertainties. These forward-looking statements can be identified by the use of forward-looking terminology, including the terms anticipate, believe, could, estimate, expect, intend, may, plan, potential, predict, project, should, target, will, would and, in each case, their negative or other various or comparable terminology. All statements other than statements of historical facts contained in this release, including statements regarding the timing of our clinical trials, our strategy, future operations, future financial position, future revenue, projected costs, prospects, plans, objectives of management and expected market growth are forward-looking statements. These statements involve known and unknown risks, uncertainties and other important factors that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Important factors that could cause our results to vary from expectations include those described under the heading Risk Factors in our Annual Report on Form 10-K and our other filings with the SEC. These forward-looking statements reflect our views with respect to future events as of the date of this release and are based on assumptions and subject to risks and uncertainties. Given these uncertainties, you should not place undue reliance on these forward-looking statements. These forward-looking statements represent our estimates and assumptions only as of the date of this release and, except as required by law, we undertake no obligation to update or review publicly any forward-looking statements, whether as a result of new information, future events or otherwise after the date of this release. We anticipate that subsequent events and developments will cause our views to change. Our forward-looking statements do not reflect the potential impact of any future acquisitions, merger, dispositions, joint ventures or investments we may undertake. We qualify all of our forward-looking statements by these cautionary statements.

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vTv Therapeutics to Participate at the 6th World Psoriasis & Psoriatic Arthritis Conference with Poster Presentation on HPP737 - Yahoo Finance

People can have dry skin anywhere on their body, including the scalp. Although dry scalp and dandruff have similar symptoms, they have different causes and treatments.

This article will describe what a dry scalp is and how it differs from dandruff. It will also look at some of the common causes of dry scalp, some available treatments, and a few prevention strategies.

People can have dry skin anywhere on the body, including the scalp. Dry skin occurs when the skin loses water too quickly.

A person with dry skin on the scalp may notice:

There are many potential causes of dry skin, such as low humidity or indoor heating. In fact, the American Skin Association notes that dry skin is not usually anything to worry about.

Sometimes, however, an underlying skin condition might be the cause of a dry scalp. When this is the case, a person might need medical treatment.

The American Academy of Dermatology (AAD) says that some people are more at risk of dry skin than others. These people include:

Lots of different things can lead to dry skin and a dry scalp. Some examples include:

Sometimes, underlying health conditions can also lead to a dry scalp. These might include the following.

Atopic dermatitis is the most common form of eczema.

In children, atopic dermatitis causes dry, itchy rashes anywhere on the body. In adults, rashes are less common, and a person may have skin that is extremely dry and easily irritated.

Contact dermatitis, which is another form of eczema, happens when the skin has an allergic reaction to something it comes into contact with.

On the scalp, hair care products, hair dye, and hair accessories can all lead to contact dermatitis. Contact dermatitis can cause itching and burning or blistering of the skin.

Around 50% of people with psoriasis experience flare-ups on the scalp. A person may also experience:

Learn more about scalp psoriasis here.

The best treatment for a dry scalp will depend on what is causing it.

In many cases, making healthy lifestyle choices will help. Some examples include:

Other causes may need additional treatment. If contact dermatitis is the cause, a person may require corticosteroids.

Treatments for other medical conditions that can cause a dry scalp include the following.

Doctors recommend that people with atopic dermatitis avoid triggers, or things that make the condition worse. Triggers are different for everyone, but some common ones include:

Sometimes, people may need medical treatment. Doctors might recommend special shampoos or biologic medications that help control the immune system.

Learn more about how to treat atopic dermatitis here.

Over-the-counter products can sometimes help treat scalp psoriasis.

According to the National Psoriasis Foundation, people should try to look for shampoos that contain salicylic acid or coal tar.

In more severe cases, doctors might recommend phototherapy, which uses UV light to slow skin cell growth, or biologic drugs, which help control the inflammation.

Dandruff is a common skin condition. It causes gray or white flakes of skin to appear on the scalp and in the hair.

Dandruff only affects the scalp, but people with a dry scalp tend to experience dry skin on other parts of the body as well.

According to the AAD, researchers are unsure of the exact cause of dandruff. However, it may be the result of other skin conditions, such as:

The above conditions can also lead to dry skin on the scalp.

Learn more about the difference between dry scalp and dandruff here.

A person can use medicated shampoos to treat dandruff.

Learn more about how to treat dandruff here.

There are lots of things that people can do to help prevent developing dry skin on the scalp. These include:

Anyone who suspects that they have an underlying skin condition should talk with a doctor. This is especially true if the symptoms are interfering with their everyday life.

The doctor will assess the persons skin and recommend the best treatment or course of action for them.

A person with a dry scalp may experience itching and flaking skin. Although it may look like dandruff, a dry scalp is different. The two conditions have different causes and different treatments.

Many dry scalp cases resolve on their own with a few lifestyle changes. These changes include drinking plenty of water and avoiding harsh shampoos and hair care products.

Sometimes, a dry scalp may be a symptom of an underlying skin condition. When this is the case, a person can talk with a doctor. They will be able to assess the skin and recommend the best course of action.

Link:
Dry scalp: Causes and treatment options - Medical News Today

A new study has found that eating a diet high in sugar and fat can increase your risk of developing autoimmune disorders like psoriasis. Read on to know if it can be reversed.

Written by Arushi Bidhuri | Published : June 30, 2021 6:22 PM IST

Food is one of the most modifiable factors that help regulate gut microbiota where a population of bacteria live in the intestines. And what you eat is important to maintain a healthy gut and keep diseases at bay. Studies have shown that eating too much sugar or foods rich in fat can be bad for your health. This is what experts have termed a Western diet. A study published in the Journal of Investigative Dermatology has found that eating a diet high in sugar and fat causes an imbalance in the gut's microbial flora, which can lead to inflammatory skin disorders like psoriasis.

Sam T. Hwang, professor and chair of dermatology at UC Davis and senior author on the study said that previous research has shown that a Western diet rich in sugar and fat can cause substantial skin inflammation and psoriasis flare-ups. He further added, "Despite having powerful anti-inflammatory drugs for the skin condition, our study indicates that simple changes in diet may also have significant effects on psoriasis."

Psoriasis is a skin disorder in which cells accumulate on the surface of the skin, resulting in itchy, dry, and painful red areas. It occurs when the immune cells mistakenly attack healthy cells and cause skin inflammation and the formation of scaly and red patches on the skin.

The microbial population and functions of the gut can alter quickly when you eat a Western diet. Dysbiosis, or a change in microbial equilibrium, contributes to gut inflammation. Since bacteria in the stomach may play a major role in determining inflammation, the researchers sought to see if intestinal dysbiosis impacts skin and joint inflammation.

For the study, the researchers investigated the effects of food on psoriasis and psoriatic arthritis using a mouse model. Interleukin-23 (IL-23) minicircle DNA was delivered into mice to produce a reaction that mimicked psoriasis-like skin and joint disorders. As per the study, many inflammatory autoimmune responses, such as psoriasis and inflammatory bowel disease, are caused by the protein IL-23, which is produced by immune cells (IBD). They found that eating a Western diet for the short term is enough to create microbial imbalance and increase vulnerability to IL 23-meditated psoriasis-like skin inflammation. "There is a clear link between skin inflammation and changes in the gut microbiome due to food intake," Hwang said. "The bacterial balance in the gut disrupted shortly after starting a Western diet, and worsened psoriatic skin and joint inflammation."

Despite the presence of IL-23 inflammatory proteins, the researchers sought to see if moving to a balanced diet might help restore the gut flora. They gave mice a Western diet for six weeks before generating psoriasis and psoriatic arthritis symptoms with an IL-23-producing chemical. The mice were then randomly separated into two groups: one that ate a Western diet for another four weeks, and another that ate a balanced diet for the same amount of time.

Their research found that mice that ate a high-sugar, high-fat diet for 10 weeks were prone to skin and joint inflammation. Mice that were shifted to a balanced diet had less skin scaling and thinner ears than mice who were on a Western diet. The reduction in skin inflammation in mice fed a Western diet suggests that the Western diet has a short-term effect on skin inflammation. This implies that dietary modifications might partially restore the proinflammatory effects of the Western diet as well as the altering of gut flora.

(with inputs from agencies)

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Limit Your Sugar And Fat Intake Before It Takes A Toll On Your Skin And Lead To Psoriasis - TheHealthSite

This article was originally published here

Transfus Apher Sci. 2021 Jun 26:103200. doi: 10.1016/j.transci.2021.103200. Online ahead of print.

ABSTRACT

Psoriasis is a chronic inflammatory skin disease that is characterized by well-demarcated erythematous plaques with a silver scale. Although many new and emerging therapeutic agents are often sufficient to control the disease, there is still a need for alternative treatment options in challenging cases. Extracorporeal photopheresis (ECP) has been applied to many T-cell-mediated diseases to restore immune homeostasis and treat psoriasis effectively. In this paper, we present a psoriasis patient who did not respond to methotrexate, narrowband ultraviolet B, or acitretin. Because of a diagnosis of non-Hodgkin lymphoma, the patient had contraindications for cyclosporine, fumaric acid esters, and biologics but achieved remission with a total of 12 sessions of ECP in two and a half months. Although exacerbation was recorded after polymerase chain reaction (PCR) confirmed coronavirus 2019 (COVID-19) disease infection at the end of the first month, scores from the psoriasis area severity index (PASI) and dermatological life quality index (DLQI) were regressed significantly within two and a half months. ECP seems to provide an effective and rapid response for psoriasis and should be considered for psoriasis patients who fail to respond or have contraindications to existing treatments.

PMID:34215520 | DOI:10.1016/j.transci.2021.103200

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A case of psoriasis successfully treated by extracorporeal photopheresis during COVID-19 pandemic - DocWire News

Around 30% of patients with psoriasis also develop psoriatic arthritis with symptoms such as joint pain, stiffness and swelling.

The Western Diet (WD), in particular, can lead to a rapid and detrimental impact on microbial community and function, contributing to systemic inflammation and other metabolically compromised phenotypes, the authors write.

Among the numerous factors known to influence gut microbiota composition, dietary composition has repeatedly been shown to be one of the most critical modifiable factors regulating the gut microbiota.

Tests have shown that a diet rich in sugar and fat induce spontaneous skin inflammation and therefore increase the odds of developing psoriasiform dermatitis (PsD). Gut microbiota is known to play a key part in controlling inflammation. Disruption of gut microbiome by external factors, such as a poor diet, promotes overproduction of harmful pathogens, destabilizes the immune system, and subsequently leads to inflammatory disease.

Perturbation of the gut microbiome by environmental factors such as diet promotes the overgrowth of harmful pathobionts, disrupts immune homeostasis, and leads to the development of inflammatory diseases, they explain.

The team used a mouse model to study the effects of WD on microbial imbalance (dysbiosis) and associated skin and joint inflammation. They also analysed whether dietary changes could reverse symptoms of dysbiosis.

The study included two groups of mice that were exposed to a short-term WD or Chow diet (CD) and subsequently injected with 10 g of interleukin-23 minicircle DNA (IL-23 MC DNA) - a protein linked to inflammatory autoimmune reactions - to induce psoriasis-like skin and joint conditions. The effects of IL-23 exposure were analysed and the results recorded.

Initial findings revealed the CD-fed group developed psoriatic inflammation but presented no other noteworthy symptoms. However, the second group (fed a WD) developed severe gut problems and the majority perished after two weeks. The IL-23 MC DNA dose was halved as a result, to ensure the WD-fed mice would tolerate treatment.

After a further six weeks on their respective diets the two groups were injected with IL-23 MC DNA or with a control. Their diets were maintained for another four weeks.

The researchers noted that after six weeks (before MC DNA delivery) the mice on the WD gained more weight than CD-fed mice and at 10 weeks WD intake led to higher weight gain in the control group. There was no significant weight gain in the IL-23 MC DNA treated mice.

Erythema (skin rash) and scaling were observed in the WD + IL-23 MC DNA group but were considerably milder in the CD + IL-23 MC DNA group and absent in the control. The control group also exhibited the least amount of ear swelling.

The data suggests that a WD can lead to increased intestinal permeability (or leaking gut), which has previously been observed in autoimmune diseases, including psoriasis. A loss of microbial diversity was also observed in WD-fed mice. Thus, the authors surmise that modulating gut microbiota was a viable option to help regulate intestinal permeability and control psoriatic inflammation.

Crucially, the researchers observed that a more balanced (CD) diet helped reduce gut dysbiosis and helped restore some balance to the gut microbiome.

Mice that were switched from a WD to a CD after 10 weeks had less scaling and reduced ear and epidermal thickness, compared with those that remained on the WD.

The researchers therefore concluded that the proinflammatory effects of a WD could be partially reversed with dietary changes.

Source: Journal of Investigative Dermatology

Authors: Zhenrui Shi, Xuesong Wu, Clarissa Santos Rocha, Yu-Jui Yvonne Wan, Satya Dandekar, Samuel T. Hwang

Short-Term Western Diet Intake Promotes IL-23-Mediated Skin and Joint Inflammation Accompanied by Changes to the Gut Microbiota in Mice

doi.org/10.1016/j.jid.2020.11.032

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Switching diet promotes healthy skin and joints, say scientists - NutraIngredients.com

If you have certain inflammatory conditions, your doctor might suggest Cimzia (certolizumab) as a treatment option for you.

Cimzia is a prescription medication thats used in adults to treat:

Cimzia is a type of drug called a tumor necrosis factor blocker. You receive it as an injection under your skin.

This article describes the dosages of Cimzia, including its forms, strength, and how to use the drug. To learn more about Cimzia, see this in-depth article.

Note: This article covers Cimzias typical dosages, which are provided by the drugs manufacturer. But when using Cimzia, always take the dosage that your doctor prescribes.

Cimzia is a medication that youll get as an injection under your skin. Your doctor may give you the injection in their office. Or they can teach you or your caregiver how to give yourself the injection at home.

Cimzia comes in two different forms:

Both forms of Cimzia contain one strength: 200 milligrams (mg).

Your Cimzia dosage will depend on the condition that youre treating. Other factors may include your body weight and how you respond to the treatment.

For most conditions, youll likely start treatment with a higher dose, called the starting dose or loading dose. This helps your body respond faster to the drug.

After a certain amount of time, your doctor may reduce your dose to what is called a maintenance dose. This is the dose that you take long term to keep your symptoms under control.

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

For plaque psoriasis, the typical dosage of Cimzia is 400 mg (two injections of 200 mg) once every 2 weeks.

If you weigh less than or equal to 90 kilograms (about 198 pounds), your doctor might reduce your dosage. Specifically, after your first three doses, you may have a 200-mg dose (one injection) once every 2 weeks.

For rheumatoid arthritis and psoriatic arthritis, the typical starting dosage of Cimzia is 400 mg once every 2 weeks.

After three doses at 400 mg, your doctor may switch you to a maintenance dose. This is typically 200 mg, which youll receive once every 2 weeks.

In some cases, your doctor may change your maintenance dosage to 400 mg once every 4 weeks. This would reduce the number of injections you have per month. Do not switch to this dosage without talking with your doctor first.

Ankylosing spondylitis and non-radiographic axial spondyloarthritis are forms of arthritis that affect the spine. For these conditions, the typical starting dosage of Cimzia is 400 mg once every 2 weeks.

After three doses at 400 mg, your doctor may switch you to a maintenance dose. This is typically 200 mg, which youll receive once every 2 weeks. Or it may be 400 mg, received once every 4 weeks.

For Crohns disease, the typical starting dosage of Cimzia is 400 mg once every 2 weeks for three doses.

If your symptoms have eased after this, your doctor will switch you to a maintenance dosage. This will likely be 400 mg once every 4 weeks.

Yes, Cimzia is typically used as a long-term treatment. If you and your doctor determine that Cimzia is safe and effective for you, its likely that youll use it long term.

Here are the answers to some frequently asked questions about Cimzias dosage.

The Food and Drug Administration (FDA) hasnt approved Cimzia to treat ulcerative colitis (a type of inflammatory bowel disease). But Cimzia is being studied to see if it could be effective for this use.

Because Cimzia isnt approved to treat ulcerative colitis, there isnt a recommended dosage for this condition. If youre interested in taking Cimzia to treat ulcerative colitis, talk with your doctor. This would be an off-label use of the drug. (Off-label drug use means using a drug for a purpose other than that approved by the FDA.)

It may take a few weeks before your symptoms start to ease. If you think Cimzia isnt working for you, dont change the dosage of Cimzia that your doctor has prescribed. Talk with your doctor if you have questions about whether Cimzia is working for you.

If you miss an appointment to have an injection of Cimzia, call your doctors office right away to reschedule.

If you usually inject Cimzia yourself and you miss a dose, call your doctors office to find out what to do. They may tell you to take the missed dose as soon as possible. But if its nearly time for your next dose, they may tell you to skip the missed dose.

Your doctor can also tell you if you need to adjust your dosing schedule after a missed dose.

If you need help remembering to take your dose of Cimzia on time, try using a medication reminder. This can include setting an alarm, downloading a reminder app, or setting a timer on your phone. It can also be helpful to write your Cimzia dosing schedule on a calendar.

The dosage of Cimzia youre prescribed may depend on:

If you have any questions about the dosage of Cimzia you should take, talk with your doctor.

Youll receive Cimzia as an injection under your skin. Your doctor can give you Cimzia injections in their office. They can also teach you or your caregiver how to do this at home using Cimzia prefilled syringes.

Youll take Cimzia either once every 2 weeks or once every 4 weeks. And you may need to take one or two injections each time. Always follow your doctors instructions.

You can inject Cimzia into these areas of your body:

Each time you give yourself Cimzia, you should rotate injection sites. This means injecting the drug into a different place in one of the areas mentioned above. Make a note of the date and the area you used for each injection. This way you can avoid injecting in the same place next time.

If you need to take two injections for your dose, the injections should be at least 2.5 centimeters (about 1 inch) apart.

Avoid injecting Cimzia into areas of skin that are tender, red, discolored, bruised, or hard. Also avoid areas where you have scars or stretch marks.

Dont use more Cimzia than your doctor prescribes. Using more than this can lead to serious side effects.

Call your doctor right away if you think youve used too much Cimzia. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, call 911 or your local emergency number immediately, or go to the nearest emergency room.

The sections above describe the typical dosages provided by the drug manufacturer. If your doctor recommends Cimzia for you, they will prescribe the dosage thats right for you.

Remember, you shouldnt change your dosage of Cimzia without your doctors recommendation. Only take Cimzia exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some questions you may want to ask your doctor:

You can learn more about the conditions Cimzia treats by subscribing to Healthlines newsletters for psoriasis, inflammatory bowel disease (IBD), and rheumatoid arthritis.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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Cimzia and Dosage: Strength, Forms, When to Use, and More - Healthline

Severe Psoriasis Marketresearch report is the new statistical data source added byOneup Business Insights.

In 2019, the global Severe Psoriasis Market size was xx million US$ and it is expected to reach xx million US$ by the end of 2025, with a CAGR of xx% during 2020-2025.

The current environment of the ever-evolving business sector, as well as the existing and prospective implications of COVID-19 on the market, are examined in this research. Each business covered in the research report is examined in terms of product and application portfolios, market share, growth potential, future plans, and development activities such as mergers and acquisitions, product introduction, and so on.

Note In order to provide more accurate market forecast, all our reports will be updated before delivery by considering the impact of COVID-19.

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Top key players @ Amgen, Inc., AbbVie Inc., Novartis AG, Johnson & Johnson, AstraZeneca, Eli Lilly and Company, UCB, Celgene Corporation, Merck

The main goal for the dissemination of this information is to give a descriptive analysis of how the trends could potentially affect the upcoming future of Severe Psoriasis market during the forecast period. This markets competitive manufactures and the upcoming manufactures are studied with their detailed research. Revenue, production, price, market share of these players is mentioned with precise information.

This report provides pinpoint analysis for changing competitive dynamics. It offers a forward-looking perspective on different factors driving or limiting market growth. It provides a five-year forecast assessed on the basis of how they Severe Psoriasis Market is predicted to grow. It helps in understanding the key product segments and their future and helps in making informed business decisions by having complete insights of market and by making in-depth analysis of market segments.

Key questions answered in the report include:

What will the market size and the growth rate be in 2026?

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Who are the key vendors in the Global Severe Psoriasis Market?

What are the market opportunities and threats faced by the vendors in the Global Severe Psoriasis Market?

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It helps in making informed business decisions by having complete insights of market and by making in-depth analysis of market segments

TABLE OF CONTENT:

1 Report Overview

2 Global Growth Trends

3 Market Share by Key Players

4 Breakdown Data by Type and Application

5 United States

6 Europe

7 China

8 Japan

9 Southeast Asia

10 India

11 Central & South America

12 International Players Profiles

13 Market Forecast 2019-2025

14 Analysts Viewpoints/Conclusions

15 Appendix

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Severe Psoriasis Market 2021 Size, Status and Global Outlook Amgen, Inc., AbbVie Inc., Novartis AG, Johnson & Johnson, AstraZeneca, Eli Lilly and...

Corresponding author Rubn Queiro, MD, PhD, of the Central University Hospital of Asturias, in Spain, and colleagues explained that secukinumab (SEC), a human monoclonal antibody targeting interleukin 17A, had a favorable safety profile in clinical trials. In addition, postmarketing surveillance has shown the therapy has a low frequency of discontinuation.

However, we currently have no consistent data on long-term survival of SEC in patients with AxSpA and PsA in routine clinical practice, the investigators wrote.

They therefore performed a multicenter retrospective observational study of patients with AxSpa or PsA who were prescribed and received at least 1 dose of SEC. The primary end points were AEs and drug retention rates.

Altogether, 154 patients were included in the study: 59 had PsA and the remaining 95 patients had AxSpA. The overall disease duration was 6.5 years, and most of the enrollees (61%) had previously been treated with at least 2 biologics before being prescribed SEC.

After 1 year, the data showed that 66% of patients were still taking SEC. However, by the end of the second year, the retention rate was 43%. Those who quit primarily stopped taking SEC due to lack of efficacy (59%), and 36% said they stopped the therapy because of AEs. Nearly three-quarters (71%) of patients who quit the therapy due to AEs did so in the first 6 months of treatment.

The most common AEs were gastrointestinal (GI) disorders, which occurred in 6 patients and included symptoms such as nausea, vomiting, and abdominal pain. There were 2 cases of Crohn disease. All 6 patients with GI AEs withdrew, as did 4 of 5 patients who reported infections. Five patients had disorders of the skin and subcutaneous tissue, and all 5 withdrew as well.

Queiro and colleagues found a number of factors that made a patient less likely to discontinue SEC, and these included male gender, obesity, hypertension, and diabetes. The investigators said the finding that obesity was linked with better drug survival was interesting, since previous reports have suggested patients who are obese and who have psoriasis tend to have a poor therapeutic response to SEC.

However, we found that obesity, and other components of metabolic syndrome, were predictors of longer survival for SEC therapy, they wrote. Therefore, SEC could be a good therapeutic choice in obese patients with AxSpA and PsA as opposed to [tumor necrosis factor inhibitor] agents.

Factors associated with discontinuation included number of previous biologics and depression.

Queiro and colleagues acknowledged some limitations, including the relatively small sample size and the retrospective nature of the study. They said their findings ought to be replicated in larger cohorts, but that they still show SEC appears to be performing well in clinical practice.

Treatment persistence has been optimal even in third line treatment, independent of underlying disease, and obesity does not seem a marker of poor treatment response, they concluded.

Reference

Alonso S, Villa I, Fernndez S, et al. Multicenter study of secukinumab survival and safety in spondyloarthritis and psoriatic arthritis: SEcukinumab in Cantabria and ASTURias study. Front Med (Lausanne). Published online May 26, 2021. doi:10.3389/fmed.2021.679009

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Secukinumab Retention High in Real-world Study of Patients With PsA, AxSpA - AJMC.com Managed Markets Network