Category Archives: Psoriasis

Emerging research from an international dataset of pediatric psoriasis patients is revealing much needed information about how children fare with commonly used systemic treatments, says dermatologist Amy S. Paller, M.D., M.S.

And she says the collaborative effort is powered by pediatric dermatologists not industry.

Dr. Paller, professor and chair of dermatology at Northwestern University Feinberg School of Medicine and pediatric dermatologist at Ann and Robert H. Lurie Childrens Hospital of Chicago, presented findings from the PeDRA-EPPWG Study of Systemic Therapy in Pediatric Psoriasis at the July World Congress of Pediatric Dermatology in Chicago. She not only talked about the soon-to-be-published studys findings, but also how a retrospective analysis could inform a prospective registry.

Dr. Paller and colleagues launched the Pediatric Dermatology Research Alliance, or PeDRA, in 2012, recognizing that pediatric dermatologists needed to work as a group to research dermatologic conditions in children because many of the conditions are rare and lack pediatric-specific data.

Thats exactly what has happened in this work with pediatric psoriasis, Dr. Paller says.

Colleagues in the European Pediatric Psoriasis Working Group, or EPPWG were willing to buy in. The groups shared goals to better understand dermatologists experiences with systemic drugs for pediatric psoriasis, and to get experience with a joint registry, which hopefully would pave the way for a prospective pediatric psoriasis registry, according to Dr. Paller.

Ten centers from PeDRA in North America and 10 centers in Europe came together to perform the study.

It was a tremendous learning experience about some of the challenges of retrospective data collection and the benefit to prospective research using common data collection, Dr. Paller says.

The researchers extracted 54 different items from charts of patients treated with systemic therapy or phototherapy, but only allowed patients to be included who had at least a minimum dataset that could provide important information on demographics, clinical characteristics and severity, systemic agents used, treatment duration and efficacy, side effects and reasons for discontinuation of medications.

A review of thousands of patient records revealed 446 which met criteria for the minimal dataset; of those, 390 involved systemic therapy for pediatric psoriasis. In this joint PeDRA-EPPWG study, which was funded by the International Psoriasis Council, data was collected using the Research Electronic Data Capture, or REDCap, web-based data capture tool.

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Dermatologists collaborate on data-driven pediatric psoriasis research - ModernMedicine

The National Institute for Health and Care Excellence has issued draft guidelines backing NHS use of Almiralls Skilarence to treat moderate to severe plaque psoriasis.

The Institute is recommending the drugs use only in adults who have severe disease and have not responded to, or cannot take, other systemic non-biological treatments.

According to NICE, clinical trial results showed that Skilarence (dimethyl fumarate) improves severe psoriasis more than placebo but, when compared indirectly, is less effective than systemic biological therapies and apremilast (Celgenes Otezla).

The incremental cost effectiveness ratio for the drug followed by best supportive care compared with best supportive care alone was 23,115 per QALY gained, thus falling within the threshold for what is considered a cost-effective use of NHS resources in this setting.

Another condition of the recommendation is that treatment with Skilarence (dimethyl fumarate) is stopped at 16 weeks if the psoriasis if the response has not been adequate, defined a 75 percent reduction in the PASI score from when treatment started or a 50 precent reduction in the PASI score and a 5-point reduction in the Dermatology Life Quality Index.

It is estimated that 951,000 people in England have psoriasis, of whom about 90 percent have plaque psoriasis.

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NICE backs new treatment option for psoriasis - PharmaTimes

A currently approved antibody for the treatment of plaque psoriasis, ixekizumab, targets a cytokine that may also play a role in the pathogenesis of inflammatory bowel disease. This has led to concerns that ixekizumab increases the occurrence of inflammatory bowel disease in patients with psoriasis. A recent study published in the American Journal of Dermatology have now put those concerns to rest.

Plaque psoriasis is an inflammatory skin disorder, characterized by the appearance of raised red scales, which are often itchy and painful. Whats worse is that psoriasis has a significant genetic overlap with inflammatory bowel disease (IBD), and patients often develop IBD as a co-morbidity. Crohns disease and ulcerative colitis are the two most common manifestations of IBD, characterized by chronic and recurrent inflammation of the intestines.

Animal and human studies have suggested a potential role of the cytokine interleulin-17 (IL-17) in the pathogenesis of IBD, although the results have often been confounding. So far, clinical trials using antagonists of IL-17A have failed to show efficacy in treating Crohns disease, or worsened prognosis.

Ixekizumab, an antibody against IL-17A, is an effective monoclonal antibody approved for the treatment of plaque psoriasis. Considering the genetic overlap between psoriasis and IBD, and prior reports of adverse events in Crohns patients receiving IL-17A antagonists, Eli Lilly and Company, the pharmaceutical giant that helped developed ixekizumab, conducted a study to gain a better understanding of IBD incidence in psoriasis patients treated with ixekizumab.

The company set up an independent external committee to look at data from 4029 patients with moderate to severe psoriasis who have received ixekizumab. Participants were previously enrolled in one of 7 different randomized clinical trials for ixekizumab. Adjudication of IBD was performed according to an internationally recognized classification system, combining reviews of radiographic, endoscopic, pathological, clinical and laboratory features.

Published in the American Journal of Dermatology, the study found that rates of new IBD cases (comprising both Crohns disease and ulcerative colitis) were uncommon (<1%) in psoriasis patients receiving ixekizumab. They reported that flares of preexisting disease were also rare.

The authors, however, acknowledged one major limitation of the report: the post-hoc nature of the adjudication process, which may have limited the amount of data collection necessary for IBD confirmation. Also, no information on patient or family history of IBD was collected at the time of the trials. Furthermore, the study lacked information on the duration of earlier therapies that may have led to IBD symptoms i.e. before exposure to ixekizumab.

Albeit, the authors suggest that dermatologists monitor patients with concomitant psoriasis and IBD who are receiving IL-17 antibody therapy and advocate for providing full warnings and precautions when prescribing IL-17A antagonists.

Written By: Debapriya Dutta, PhD

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Therapy for Psoriasis May Not be Triggering Inflammatory Bowel Disease - Medical News Bulletin

Now, experts have said routine prescribing of UV light treatment for severe skin conditions could significantly reduce the use of steroid creams and tablets, according to new research from the University of Dundee.

Patients who experience the most severe forms of diseases such as psoriasis or eczema can find their lives affectged by their conditions.

Steroid creams are frequently prescribed but these can cause quite serious side effects and can prove inadequate to bring the disease under control.

In such instances patients may be referred to a dermatologist for more intensive treatment, which may take the forms of pills, injections or filtered UV light, known as phototherapy.

Experts from Dundee Universitys School of Medicine, examined the outcomes of 1800 patients with severe psoriasis who received UV treatment over a six-year period.

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They found that three-quarters of patients experienced significant improvements in their condition and that the need for steroid creams was reduced by 25 per cent.

Phototherapy involves safe, controlled delivery of narrow wavebands of ultraviolet radiation in specially constructed cabins.

It has been known to help skin disease sufferers for decades but this study is the first to demonstrate that its use can reduce the need for steroids in the treatment of psoriasis in routine practice and not just in a short-term clinical study.

Importantly, the findings also suggest that many patients can delay or avoid altogether the need for oral or injection treatments which can cause side effects such as gastric upset, liver dysfunction and infections.

Physicians have been using phototherapy or even direct sunlight to treat skin conditions for 50 years, said Dr Foerster.

We know that it helps patients with psoriasis and eczema but until now we did not know that it actually causes a reduction in the use of steroid creams and can reduce the need for patients to have their conditions controlled by tablets or injections.

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Resist the itch - Eczema is almost always itchy no matter where it occurs on the body and although it may be tempting to scratch affected areas of the skin, this should be avoided as much as possible

Phototherapy could reduce the need for eczema and psoriasis creams

These can work very well but can also have a downside.

The form of treatment we are talking about is targeted, non-dangerous exposure to filtered light to treat skin conditions that are so severe that they cant be contained with creams.

We were able to exploit a uniquely complete set of anonymised prescribing records that exists in Tayside and found that there was a very significant reduction in the amount of steroid cream prescribed to people who underwent phototherapy for up to 12 months after their treatment.

Access to phototherapy across the UK largely depends on a patients location.

Sadly phototherapy is not equally available around the UK, said Dr Foerster.

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Tablet treatments can be effective and safe with proper monitoring but it would be fantastic if everyone had the opportunity to try something that circumvents the need for any laboratory monitoring in the first place.

There are other risks resulting from a lack of access to phototherapy.

Sufferers of psoriasis or eczema may take matters into their own hands and seek out a sun-filled holiday or use sun beds.

I have seen this on several occasions and it brings with it the many well-known dangers arising from skin exposure.

The research is published in the journal PLOS ONE.

FIVE TIPS TO BEAT PSORIASIS

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Eczema and psoriasis treatment: THIS therapy could reduce the need for creams and tablets - Express.co.uk

At AAD 2017, Joel M. Gelfand, MD, MSCE, was honored as the recipient of the Marion B. Sulzberger, MD, Memorial Award and Lectureship. In his talk titled Getting to the heart (and other comorbidities) of psoriasis, Dr. Gelfand discussed the findings from research investigating associations between psoriasis and comorbidities and their relevance for providing comprehensive medical care for patients with psoriasis.

Concluding his talk, Dr. Gelfand expanded on a quote from Dr. Francis Peabodys essay, The Care of the Patient, written 90 years ago.

Dr. Peabody stated, the secret of the care of the patient is in caring for the patient. For the patient with psoriasis, that means we need to look beyond the skin, said Dr. Gelfand, Professor of Dermatology and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Establishing evidential support

Focusing primarily on associations between psoriasis and cardiovascular disease, Dr. Gelfand highlighted results from population-based epidemiological studies, including those from his own clinical research laboratory analyzing data in a prospectively maintained medical record database in the United Kingdom.

Our studies showed an independent, dose-response relationship between psoriasis severity and risks of major adverse cardiovascular events, ie., myocardial infarction, stroke, and cardiovascular disease-related mortality. Subsequently, numerous papers have been published investigating the association between psoriasis and cardiovascular risk, and results from nine meta-analyses covering more than 500,000 patients with psoriasis and more than 29 million controls largely confirm our initial findings, he said.

Findings from laboratory investigations provide insights into the potential biological mechanisms underlying the association between psoriasis and cardiovascular disease and provide proof of principle that inflammation restricted to the skin can lead to systemic vascular complications, Dr. Gelfand said.

In addition, clinical studies using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography imaging show that as psoriasis severity increases so does aortic and subcutaneous fat inflammation.

A finding that subcutaneous fat under psoriatic plaques expresses miRNAs that modulate lipid metabolism suggests there is communication between the skin and the fat and that it plays a role in mediating some of the connections we are seeing between psoriasis and cardiometabolic disease, Dr. Gelfand said.

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Sulzberger lecturer provides in-depth look at psoriasis comorbidities - ModernMedicine

Dr. KruegerDermatologists' appreciation of the central role that the interleukin (IL)-23/Th17 pathway plays in psoriasis has developed gradually, through research and serendipity, according to James Krueger, M.D., Ph.D., who spoke on the topic at the MauiDerm 2017 meeting.

"When I started researching psoriasis in the early 1990s, there was considerable debate about pathogenesis. But the dominant hypothesis was that keratinocytes were growing autonomously by overproduction of growth factors (transforming growth factor alpha) that would interact with overactive EGF receptors, producing a proliferative reaction." In this hypothesis, "A few immune cells came along for the ride," Dr. Krueger explained. He is D. Martin Carter Professor in Clinical Investigation at Rockefeller University.

Based on biopsies, "It's clear that psoriasis represents a big change in biology from background skin. There's a tremendous epidermal thickening reaction, on a bed of mononuclear inflammatory cells in the infiltrate." Immunohistochemical (Ki67) staining of hyperkeratotic skin invariably shows that virtually every basal cell is in cycle, versus very few basal cells in background skin. This growth activation is also associated with incomplete differentiation this is a wound-healing program called regenerative maturation."

The second invariable feature in psoriasis is a large infiltrate of T cells mostly CD4+ in the dermis, and CD8+ in the epidermis, Dr. Krueger says. Consistent overexpression of T cells led immunologists to theorize that psoriasis must involve an inductive reaction provoked by T cells with abundant high-affinity IL-2 receptors, he says.

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How psoriasis arises - ModernMedicine

What are the best weed strains for psoriasis? Recent studies suggest that cannabis can be effective in treating various skin disorders such as eczema and psoriasis. This is partially due to the anti-inflammatory nature of marijuana. Another study shows that cannabis is an effective treatment because the cannabinoids interact with the endocannabinoid system in a way that regulates the immune system. This helps prevent flare-ups.

Now that this information is available, we have to ask: how can we use cannabis to treat psoriasis?

Psoriasis is an autoimmune disorder that is characterized by a high cell turnover rate, which leads to a build-up of dry, flaky, and scaly skin. The dry skin is usually in patches along the persons body, and are often itchy and painful. About thirty percent of people with psoriasis also develop psoriatic arthritis, which is characterized by the painful swelling and stiffening of joints.

Due to the highly visible nature of the disease, psoriasis causesanxiety and depression in the people who suffer from it.

Psoriasis is incurable. However, it is treatable. Usually, doctors recommend managing mild to moderate psoriasis with topical treatments, like prescription corticosteroids and vitamin D analogs. For more severe cases, topical treatments are combined with light therapy and/or medication.

When it comes to treating psoriasis with cannabis, topical treatment is quite effective. CBD topicals, such as salves or creams, can directly and gently target the affected areas without irritating the skin further.

While ingesting cannabis to treat psoriasis, its critical to remember one thing: do not smoke it. While cannabis smoke isnt nearly as harmful as other kinds of smoke, like cigarettes, it can still be detrimental when treating psoriasis. So, when considering the following strains, make sure to use a vaporizer or cook some edibles.

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This is an indica-dominant strain with a fruity and floral scent. While its not the best for treating inflammation it is a great stress reliever. It can also be effective at easing depression and physical pain.

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10 Best Weed Strains For Psoriasis - Green Rush Daily

PORTLAND, Ore., Aug. 1, 2017 /PRNewswire-USNewswire/ --The National Psoriasis Foundation (NPF) is transforming August from Psoriasis Awareness Month to Psoriasis Action Month.

Twenty years ago, NPF hosted the first Psoriasis Awareness Month to educate the public about a disease that was often misunderstood and stigmatized. Since then, NPF has made great strides in increasing awareness about psoriatic disease. With tremendous advancements in the number of treatment options available today for people living with psoriasis, now more than ever, it's easier to treat psoriasis and the results can be life-changing.

NPF wants people with psoriasis to take an active role in treating their disease. With the theme of "Set Goals, Take Control," Psoriasis Action Month focuses on empowering people with psoriasis to take control of their disease. NPF is providing information and tools to set achievable treatment goals, track symptoms and help patients talk with their health care providers about treating psoriasis.

NPF has launched http://www.psoriasis.org/psoriasis-action-month, a website to educate patients, caregivers and health care professionals about the resources available to treat psoriatic disease. Throughout August, people impacted by psoriasis can participate in interactive quizzes that will help them better understand and manage their disease. Quiz topics will range from how to set goals and treat psoriasis to achieve skin clearance, understanding your personal communication style, and testing your knowledge of psoriasis treatment options. Participants can opt in to receive an NPF journaling kit to help track symptoms and receive resources to guide conversations with their health care providers. All quiz participants have the option to have a NPF Patient Navigator contact them directly to discuss finding a specialist in their area and getting started on treatment.

NPF will host two Facebook Live interviews. The first, which will be held on Thursday August 10, will be a discussion between NPF Vice President of Research Programs, Michael Siegel, and April Armstrong M.D., NPF medical board member and associate dean of Clinical Research at the Keck School of Medicine at the University of Southern California. They will discuss setting achievable treatment goals using a specific treatment strategy spearheaded by the NPF Medical Board. The second Facebook Live interview, which will be held on Thursday, August 24, will be a discussion between Siegel, NPF volunteer Howard Chang, and his doctor, Emanuel Maverakis, M.D., associate professor at the University of California, Davis. The discussion will focus on how Chang and Maverakis have implemented and are tracking Chang's psoriasis after utilizing the effective treatment strategy discussed with Dr. Armstrong on August 10. Follow NPF on Facebook or go to http://www.psoriasis.org/psoriasis-action-month for the exact time of each interview.

Ways to Participate in Psoriasis Action Month

Go to http://www.psoriasis.org/psoriasis-action-month to access information, tools and to participate in interactive quizzes on treating psoriasis.

Follow the National Psoriasis Foundation on Facebook, Twitter and Instagram to find information, memes and other resources to treat and manage psoriasis. Show support by sharing NPF social posts and updates with friends; use the hashtag #PsoriasisActionMonth

Donate to NPF to help support advancements in psoriatic disease research and NPF programs and services.

Check out TeamNPF to find a Walk, Run or Cycle event in your area. Not into sports? Host a DIY event and turn your hobby or passion into a fund raising and awareness event for psoriatic disease.

If you believe you may have psoriasis or psoriatic arthritis, consult a dermatologist for a formal diagnosis and get started on a treatment plan. To answer questions, or for help in finding a dermatologist in your area, contact the National Psoriasis Foundation Patient Navigation Center at: http://www.psoriasis.org/navigationcenter

Psoriasis is a chronic, immune mediated disease that most often appears on the skin as painful, raised, red, itchy patches. Men and women develop psoriasis at equal rates, and the disease occurs in all racial groups, however at varying rates. Psoriasis is not contagious. It is not something one can "catch" from another person as psoriasis lesions are not infectious.

Living with psoriasis can be an everyday battlefrom aches and pains, exhaustion, risk of comorbid conditions, such as cardiovascular disease and diabetes, to dealing with the stigma associated with such a visual disease. The best way for patients to fight psoriasis is to work with a health care professional to fully understand the physical and emotional impact of the disease and the various treatment options available for managing the disease.

Over the last 50 years, the National Psoriasis Foundation (NPF) has become the world's leading nonprofit patient advocacy organization fighting for individuals with psoriasis and psoriatic arthritis. NPF leads this fight by driving efforts for a cure and improving the lives of the more than 8 million Americans affected by this chronic disease. To date, NPF has funded more than $15 million in research grants and fellowships, and to commemorate 50 years, NPF plans to raise an additional $2 million for early scientific career research programs in 2017 alone. Each year, NPF strives to support, educate and advocate on behalf of more individuals living with or caring for someone with the disease than ever before. As part of that effort, NPF established the Patient Navigation Center to offer personalized assistance to everyone with psoriasis or psoriatic arthritis. Join our community today and help drive discovery and create community for all living with psoriatic disease.

View original content with multimedia:http://www.prnewswire.com/news-releases/psoriasis-action-month----set-goals-take-control-300498049.html

SOURCE National Psoriasis Foundation

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Psoriasis Action Month -- Set Goals, Take Control - Markets Insider

A new study details the successful reprogramming of certain immune cells that could lead to treatments for autoimmune diseases like psoriasis. The work was performed by researchers with the Gladstone Institutes, and it is made possible by a small-molecule drug that essentially converts immune cells from the type that attack the body to the type that keep things in check. It could also prove effect for treating cancers.

Immune cells are known as T cells, and they come in two varieties: regulatory, which keeps the immune system from running rogue and attacking a healthy body, and effector, which trigger the immune system into action. Autoimmune disorders are the result of a dysfunction with these cells, often resulting in the body attacking some healthy part of itself, such as causing inflamed, scaly skin in the case of psoriasis.

Immune system dysfunction can go the other way, as well, resulting from a suppression of it that causes different sorts of diseases or cancers. Because these T cells are so greatly involved in the function of the immune system and its balance, it makes sense that tweaking the presence of these cells in the body could address diseases, and thats exactly what researchers have done for the first time ever.

Using the aforementioned drug, the potentially damaging effector cells can be reprogrammed into regulatory T cells, which would then bring the immune system under control and stop it from attacking a healthy body. It is thought that producing more regulatory T cells in the body could also keep the immune system from rejecting transplanted cells in the case of stem cell therapies.

As far as cancer is concerned, the drug could also be used to boost regulatory T cells so that the immune system can better find and attack cancer cells, the aim being to treat or prevent cancers. Future plans for this research werent stated, however, it is a milestone discovery that could lead to treatments for many diseases.

SOURCE: Nature, EurekAlert

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Researchers reprogram immune cells to treat psoriasis and more - SlashGear

Twenty-four people have now received the multiple sclerosis and psoriasis therapy KY1005 in a Phase 1 clinical trial, according to its developer,Kymab.

The Cambridge, England, company createshuman antibody drugs for autoimmune diseases. The trial will focus on KY1005 as a psoriasis therapy, although its mechanism of action should work in MS as well, Kymab said.

KY1005 is the first of a series of products we are developing focused on autoimmune diseases, immune-oncology, hematology and infectious disease, Dr. David Chiswell, Kymabs CEO, said in a press release.

Our vision is to build Kymab into a major global biopharmaceutical company, he said. This, the first of what will be a steady stream of clinical trials, is an important step towards realizing our vision. Indeed, the potential of KY1005 is such that, on its own, it could treat a number of immune and inflammatory disorders. We are confident that this will be the first of several trials on this antibody alone.

KY1005 prevents a protein known as the OX40-Ligand from activating the protein it binds to, OX40. When activated, OX40 triggers the proliferation of memory and effector T lymphocytes, cells that regulate immune system responses.

OX40 plays a crucial role in the development of MS, studies in mice have shown.KY1005 blocks OX40L, allowing OX40 to rebalance the immune system and prevent autoimmune responses.

I am delighted that we have reached another important milestone for Kymab, said Professor Allan Bradley, a Kymab co-founder. Since the companys founding only seven years ago, we have generated a number of best-in-class drug candidates using our exquisite antibody platform, he said. Kymabs platform contains the entire repertoire of human antibodies, making it the most comprehensive antibody development platform available.

To now have our first antibody firmly on its clinical [trial] development pathway, with a rich pipeline of future products following, is a significant milestone and a testament to the unique qualities of the antibody drugs produced by ourproprietary antibody platform as well as the performance of the Kymab team in progressing them rapidly through development, he said.

The Phase 1 trial (NCT03161288) will evaluate the effects of single and multiple ascending doses of KY1005 versus a placebo in healthy volunteers and people with a mild-to-moderate psoriasis, an autoimmune diseasecharacterized by patches of abnormal skin.

Link:
24 People in Phase 1 Trial Focusing on Psoriasis Have Received KY1005, Which Is Also an MS Therapy - Multiple Sclerosis News Today