Category Archives: Psoriasis

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La La Anthony's Secret to Fighting Psoriasis Is Probably in Your Kitchen PEOPLE.com It is just gentle enough on my sensitive skin, which is really hard to find when you do have psoriasis, the star, who says she confides in close friend and fellow psoriasis-sufferer Kim Kardashian West about which medications work and which don't ...

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La La Anthony's Secret to Fighting Psoriasis Is Probably in Your Kitchen - PEOPLE.com

Novartis AG (NVS - Free Report) announced positive data on arthritis drug Cosentyx from two phase III studies at the Annual European Congress of Rheumatology (EULAR 2017), in Madrid.

Cosentyx, fully human monoclonal antibody, is already approved in the U.S. and EU for the treatment of moderate-to-severe plaque psoriasis. The drug is also approved in the EU for the treatment of adults with ankylosing spondylitis (AS) who have responded inadequately to conventional therapy, such as non-steroidal anti-inflammatory drugs. The drug is also instrumental for the treatment of active psoriatic arthritis (PsA) in adults when the response to disease modifying anti-rheumatic drug therapy is unsatisfactory.

In Jan 2016, Cosentyx obtained the FDA approval for the treatment of adults with active ankylosing spondylitis and for the treatment of adults with active psoriatic arthritis.

The data shows sustained improvement in the signs and symptoms for active AS at three years. The new data also revealed that Cosentyx provides rapid and sustained pain relief in patients with PsA out to 2 years.

Data from the phase III study, MEASURE 1 extension study, showed 80% of AS patients consistently achieved an ASAS 20 response at 3 years, in tandem with previous findings from the FUTURE 1 study on Cosentyx for active PsA. Additionally, a 2-year post-hoc analysis of the FUTURE 2 study evaluated Cosentyx in PsA, where 99% patients reported moderate-to-extreme pain or discomfort before initiating treatment. At week 3, half of the treated with Cosentyx reported clinically meaningful improvements in pain of over 20%, as measured by Visual Analogue Scale.

Meanwhile, patient recruitment is underway for the new head-to-head clinical trial, EXCEED, to evaluate the superiority of Cosentyx versus AbbVies (ABBV - Free Report) Humira in PsA.

Novartis has outperformed the Zacks classified industry over the last six months. The stock has rallied 12.2% compared with the Large Cap Pharmaceuticals industrys gain of 4.5%.

The uptake of Cosentyx has been strong and the company has grabbed market shares from rivals, Humira and Amgens (AMGN - Free Report) Enbrel. Cosentyx achieved blockbuster status in 2016 recording over $1 billion of sales.

Novartis expects the next growth phase to begin in 2018 driven by Cosentyx (in all three indications psoriasis, psoriatic arthritis and ankylosing spondylitis) Entresto, and Kisqali and a deep pipeline with candidates like CTL019, BAF312, AMG 334, RTH258. Going forward, we expect that the approval of new drugs and label expansion of existing ones will bode well for Novartis.

Zacks Rank & Key Pick

Novartis currently carries a Zacks Rank #3 (Hold).

A better-ranked stock in healthcare sector include VIVUS, Inc. (VVUS - Free Report) which sports a Zacks Rank #1 (Strong Buy). You can seethe complete list of todays Zacks #1 Rank stocks here.

VIVUSs loss per share estimates lessened from 50 cents to 39 cents for 2017 in the last 30 days. The company posted positive earnings surprises in all four trailing quarters with average beat of 233.69%.

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Novartis (NVS) Announced Positive Data on Psoriasis Cosentyx - Zacks.com

1. In a posthoc analysis of 2, phase 3 randomized controlled trials of over 1000 patients with moderate-to-severe plaque psoriasis, tofacitinib (an oral Janus kinase inhibitor) treatment demonstrated significantly improved clinical nail psoriasis severity scores at 16 weeks compared to placebo.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Psoriasis is a chronic, inflammatory skin disease associated with clinical manifestations of the nail that include pitting, onycholysis, subungual hyperkeratosis, and discoloration. Nail psoriasis may severely impair function and is associated with significantly greater disease severity and impact on patient quality of life than psoriasis without nail involvement. Tofacitinib is an oral Janus kinase inhibitor that has previously demonstrated efficacy and tolerability in phase 3 clinical trials of moderate-to-severe chronic plaque psoriasis. The purpose of this study was to assess the effect of tofacitinib on nail psoriasis.

This study is a post-hoc pooled analysis of two phase 3 clinical trials evaluating the efficacy of tofacitinib in 1196 patients with nail psoriasis. At the conclusion of the study, both the 5mg and 10mg twice-daily administrations of tofacitinb demonstrated clinically significant improvement in nail psoriasis compared to placebo at 16 weeks with effects maintained at 52 weeks. The results of this study support the use of tofacitinib as a potential treatment modality for nail psoriasis. This study is strengthened by its large sample size, multiple trial sites, randomization, double blinding, and comparison to placebo. The interpretation of study results is limited by the use of only objective measures to assess severity without incorporating subjective patient-reported outcomes. Moreover, non-responders were discontinued from the study at 28 weeks and not included in analysis. Multi-center prospective trials that include patient-reported outcome measures to assess improvements in severity may help improve the validity and of the study.

Click to read the study in JAAD

Relevant Reading: Tofacitinib, an oral Janus kinase inhibitor, for the treatment of chronic plaque psoriasis: results from two randomized, placebo-controlled, phase III trials

In-Depth [randomized controlled trial]: This study conducted a pooled posthoc analysis of two identical 52-week multi-site phase 3 randomized controlled trials evaluating the efficacy of tofacitinib in patients with moderate-to-severe chronic plaque psoriasis with nail involvement. Patients in both trials were randomized 2:2:1 to receive tofacitinib 5mg or 10mg, or placebo twice daily. Overall, this study identified 1196 patients with nail involvement of the original 1859 patients with psoriasis recruited in the initial studies. Patients were determined to be moderate-to-severe via a Psoriasis Area and Severity Index score 12, Physicians Global Assessment of moderate or severe, and affected body surface area 10%. Improvements in severity were assessed using the Nail Psoriasis Severity Index (NAPSI). The proportion of patients that demonstrated a 50%, 75% or 100% reduction from baseline in NAPSI score (NAPSI50, NAPSI75 and NAPSI100) were calculated and compared between treatment arms. Patients treated with tofacitinib demonstrated improvement in pitting, onycholysis, subungual hyperkeratosis, and discoloration. Moreover, treatment with tofacitinib demonstrated significantly greater proportions of patients that achieved NAPSI50, NAPSI75 and NAPSI100 compared to placebo at 16 weeks (p < 0.05). Furthermore, the mean number of affected nails decreased from 7.3 at baseline to 3.5 and 2.7 at 52-weeks for the 5mg and 10mg doses, respectively.

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2 Minute Medicines The Classics in Medicine: Summaries of the Landmark Trials is available now in paperback and e-book editions.

This text summarizes the key trials in:General Medicine and Chronic Disease, Cardiology, Critical and Emergent Care, Endocrinology, Gastroenterology, Hematology and Oncology, Imaging, Infectious Disease, Nephrology, Neurology, Pediatrics, Psychiatry, Pulmonology, and Surgery.

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Tofacitinib may be an effective treatment for nail psoriasis - 2 Minute Medicine

June 12, 2017 by Kevin Mccullough Space-filling model of the Cholesterol molecule. Credit: RedAndr/Wikipedia

A new Northwestern Medicine study published in the Journal of Clinical Investigation has demonstrated how a specific class of immune cells represent a previously unknown link between high cholesterol and the development of symptoms characteristic of psoriasis.

Scientists have long known that patients with psoriasisan inflammatory disease that causes itchy, dry and red skinoften have high cholesterol levels, also known as hyperlipidemia. Up until now, however, the cause of this association has been poorly understood.

In the current study, Chyung-Ru Wang, PhD, professor of Microbiology-Immunology, and her colleagues created a strain of mice that contain a category of immune cells called self-lipid reactive T-cells, and also have higher-than-normal amounts of cholesterol in the blood.

"To our surprise, these mice spontaneously developed skin lesions, which were caused by the activation of self-lipid reactive T-cells only under conditions of hyperlipidemia. The skin disease closely matched the symptoms and progression of psoriasis in humans," Wang said.

The findings, according to the authors, may represent an important link between the presence of high cholesterol and the development of psoriasis, a connection that has not previously been explained.

In a separate experiment, Wang and her team examined blood samples from human patients with a psoriasis diagnosis, and found that the levels of those same self-lipid reactive T-cells were elevated in those patients, compared to those without psoriasis.

Taken together, the scientists say the findings of the study are important because they may point to why hyperlipidemia might be linked to the onset of some autoimmune diseases, like psoriasis. Identifying and targeting the antigens that provoke the T-cells in question may represent a future avenue for developing treatments for psoriasis and other hyperlipidemia-associated inflammatory diseases.

Explore further: Psoriasis may up risk of melanoma, hematologic cancer

More information: Sreya Bagchi et al. CD1b-autoreactive T cells contribute to hyperlipidemia-induced skin inflammation in mice, Journal of Clinical Investigation (2017). DOI: 10.1172/JCI92217

(HealthDay)Patients with psoriasis may have a higher risk of melanoma and hematologic cancers than the general population, according to a study published in the April issue of the Journal of the American Academy of Dermatology.

The fact that men are overrepresented in psoriasis registers and consume more psoriasis care have long led researchers to believe that the common skin disease disproportionally affects men. A unique study with 5,438 Swedish ...

Psoriasis sufferers may face a higher risk of developing abdominal aortic aneurysms, according to new research in Arteriosclerosis, Thrombosis and Vascular Biology, an American Heart Association journal.

Different types of dendritic cells in human skin have assorted functions in the early and more advanced stages of psoriasis report researchers in the journal EMBO Molecular Medicine. The scientists suggest that new strategies ...

Psoriasis is a common, long-lasting disease that causes itchy or sore patches of thick, red skin with silvery scales. Environmental contaminants can trigger psoriasis and other autoimmune disorders, and it is thought that ...

Psoriasis is a chronic inflammatory disease of the skin and cardiovascular risk factors, including hypertension, are more prevalent among patients with psoriasis compared to those patients without. Previous studies suggest ...

A new Northwestern Medicine study published in the Journal of Clinical Investigation has demonstrated how a specific class of immune cells represent a previously unknown link between high cholesterol and the development of ...

Building on insights from an HIV vaccine regimen in humans that had partial success during a phase 3 clinical trial in Thailand, a Duke-led research team used a more-is-better approach in monkeys that appeared to improve ...

Globally, an estimated 71 million people are living with chronic hepatitis C virus (HCV). Over decades of infection, chronic HCV infection results in progressive damage to the liver and an increased risk for end stage liver ...

Five percent of women in the US territories who were infected with the Zika virus while pregnant had fetus or babies with defects, including microcephaly, government health data said Thursday.

It was long thought that gastric ulcers and other digestive woes were brought about by stress. But in 2005, clinical fellow Barry J. Marshall and pathologist J. Robin Warren were awarded the Nobel Prize in Physiology or Medicine ...

Being depressed may have little impact on flare ups for patients with inflammatory bowel disease (IBD), researchers have found.

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Exploring high cholesterol's link with psoriasis - Medical Xpress

Dr. LeonardiThe ongoing rush of safe, highly effective systemic agents for psoriasis has created a new era in which substantial numbers of patients may achieve complete clearance, said an expert at the American Academy of Dermatology 75th Annual Meeting, held here.

In the year 2000, said Craig Leonardi, M.D., two authors called complete skin clearance an unrealistic expectation for patients with psoriasis.1

The fact is that right now, we have many drugs that are so far different from what we used to use even five years ago that complete clearance is a realistic possibility in many of our patients, says Dr. Leonardi. He is adjunct professor of dermatology at St. Louis University and a St. Louis, Missouri-based dermatologist in private practice.

As a reference point, he says, Finally, we have numbers for how methotrexate performs in modern measurement systems. In a well-designed 120-patient trial with modest dose escalation, 41% of patients achieved psoriasis area and severity index (PASI) 75, and 66% achieved PASI 50 at week 16.2 This settles the issue of how well methotrexate indeed performs, Dr. Leonardi says. Although no study patients developed pancytopenia, Its always an issue in the back of my mind. At any one time Ill have hundreds of patients on methotrexate. Based on research in rheumatoid arthritis, he says, risk factors include renal disease, hypoalbuminemia, infection, age and concomitant medication use.

New targets

Since the demise of T-cell inhibitors such as alefacept and efalizumab, Dr. Leonardi says, Weve been concentrating on cytokines and cytokine inhibitors. And its been a very busy time in the pharmaceutical industry and for those of us who do this research.

Among tumor necrosis factor alpha (TNFa) inhibitors that dermatologists may not have heard much about, Certolizumab is one you should definitely remember. It is a pegylated TNF-alpha inhibitor, not a monoclonal antibody. In trials, it is a high-performance skin-clearing drug. In phase 3 testing, 81% and 82% in separate cohorts achieved PASI 75.3 Thats functionally equivalent to infliximab. This is a drug you might be able to reach for. You can prescribe it currently for psoriatic arthritis its approved. And based on phase 3 results in psoriasis, We expect it to sail through the approval process.

Recent approvals in the TNF inhibitor category include biosimilar versions of infliximab, etanercept and adalimumab. And there are others in the pipeline.

New indications for existing drugs include hidradenitis suppurativa and uveitis (adalimumab) and pediatric psoriasis (etanercept). Physicians use golimumab mainly for psoriatic and rheumatoid arthritis, he says. It offers very modest results in psoriasis.

We know that psoriasis is a significant cardiovascular risk factor. Patients with severe psoriasis have a marked increased relative risk of myocardial infarction (MI) compared to mild psoriasis4 and, in another analysis, control subjects.

More recently, research analyzing cardiovascular risk in various treatment groups has shown that TNF inhibitors and methotrexate reduce risk of MI around 50%.5 This is the first time we are seeing evidence that treatments can reduce the risk of myocardial infarction, Dr. Leonardi says.

Additionally, an analysis of cardiovascular risk in patients on TNF inhibitors showed a statistically significant, marked decrease of MI risk, starting at around month 12 and lasting several months thereafter, versus patients on methotrexate.6 Even more amazing, cumulative use of TNF antagonists serially reduced the risk of myocardial infarction. Predicted hazard rate reductions at one, two and three years were 21%, 38% and 51%. And theres probably more to be gained beyond three years. What a wonderful story. Were treating their skin and joints and giving them an increased benefit from a cardiovascular risk perspective, he says.

Among interleukin (IL)-23 inhibitors, he says, a straightforward phase 3 study of tildrakizumab (two doses, versus placebo or etanercept) showed that the higher dose outperforms the lower dose 66% versus 61% in terms of both PASI 75 and physician assessments, without noteworthy safety issues.7 With regard to severe infections, malignancies, major adverse cardiovascular events and drug hypersensitivity reactions, all of these issues are comparable to placebo or to etanercept. This drug appears to be safe and well tolerated.

The phase 3 study of guselkumab did not even consider PASI 75 a primary endpoint, Dr. Leonardi says. Rather, 73% of patients reached PASI 90 at 16 weeks, versus 2.9% of placebo-treated patients.8 This is a significant drug. It distinguishes itself quite clearly from adalimumab in terms of efficacy, with comparable safety findings.

In phase 2 testing, a single dose of risankizumab allowed 87% of patients to reach PASI 75, and 58% to reach PASI 90, at 12 weeks.9 And one-third of these patients remained clear for more than 66 weeks. James Krueger, M.D., Ph.D., has called the drug and immunologic disruptor, says Dr. Leonardi, because its pharmacodynamic effect far exceeds its pharmacokinetic effect. Dr. Krueger is D. Martin Carter Professor in Clinical Investigation at Rockefeller University.

IL-17 inhibitors

In secukinumab four-year data, Efficacy whether its PASI 75 (88.5%), PASI 90 (66.4%) or PASI 100 (43.5%) seems to be maintained.10 The caveat is that this is an as-observed analysis. In other words, the denominator is dropping over time as patients achieving lesser efficacy and tolerability drop out. For most patients, Its not surprising that the efficacy should seem stable over time. It would have been a real problem if we saw efficacy dropping off. Regarding serious adverse events, he adds, There are a lot of zeros in the table, including for Crohns disease. There were two cases of ulcerative colitis. This issue of ulcerative colitis and its association with IL-17 antagonists is ongoing, and were going to have to see how that plays out. Its a rare event less than one in 1000 patients in the secukinumab data.

Unpublished five-year data for ixekizumab, in an analysis which accounted for dropouts over time, shows stable PASI 75, 90 and 100 results (approximately 80%, 70% and 47%, respectively), he says. As for AEs that led to drug discontinuation (13), There were many one-off events that dont seem to have any pattern. All adverse events also appear uncommon and stable over time, he added.

The IL-17 receptor antagonist brodalimumab showed efficacy similar to that of ixekizumab in phase 3 trials (86%/85% PASI75, and 37%/44% PASI 100).11 But early in these trials, he says, concerns for depression, suicidal ideation and behavior appeared. There were six suicides in these trials four in the skin trials and two in psoriatic arthritis trials. The FDA remarked that this was an unprecedented collection of serious issues for any psoriasis trial to date. I would take that to heart.

Amgen abandoned the products development in 2015, and Valeant took it to an FDA hearing in July 2016, at which all 18 FDA reviewers recommended approval although 14 advised implementing a strong risk management program. So this drug has a boxed warning for depression and suicide coming out of the gate, and a risk-management system reminiscent of iPLEDGE, he said.

We must wait and see how our specialty reacts to this, how onerous this will be in our offices and whether or not this drug will gain any traction given that equally efficacious drugs with fewer hassles already exist. Moreover, Dr. Leonardi noted that patients with psoriasis have elevated baseline levels of suicidal ideation and depression versus the general population.12

Development of tofacitinib in dermatology has stopped, said Dr. Leonardi. The FDA has returned the application to Pfizer. The problem with this drug is that patients needed a big dose 15 mg twice a day to have outstanding efficacy. But there was a hard safety signal that occurred much earlier at lower doses. FDA officials noted that in rheumatoid arthritis trials, 14 of the 15 patients who died were on tofacitinib. And there were 34 opportunistic infections, he added, all in tofacitinib-treated patients. In the psoriasis trials, there were more than 1,000 cases of herpes zoster.

However, he said, tofacitinib can be useful off-label for indications including alopecia areata, alopecia-associated nail dystrophy, vitiligo and severe atopic dermatitis. When he prescribed 5 mg of tofacitinib twice-daily for a patient with a 15-year history of alopecia universalis and steroid induced adrenal suppression, One year later, she had more hair than I did.

Disclosures: Dr. Leonardi has been a consultant, researcher and/or speaker for Abbvie, Amgen, Celgene, Coherus, Dermira, Eli Lilly, Galderma, GlaxoSmithKline, Janssen, Leo, Merck, Merck-Serono, Novartis, Pfizer, Sandoz and Vitae. He also provides phototherapy and has an infusion center.

References

1. Al-Suwaidan SN, Feldman SR. Clearance is not a realistic expectation of psoriasis treatment. J Am Acad Dermatol. 2000;42(5 Pt 1):796-802.

2. Warren RB, Mrowietz U, von Kiedrowski R, et al. An intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe plaque-type psoriasis (METOP): a 52 week, multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017; 389(10068):528-537.

3. http://www.ucb.com/stories-media/press-releases/article/CIMZIA-certolizu... http://www.ucb.com/stories-media/press-releases/article/CIMZIA-certolizu.... Published October 3, 2016. Accessed April 7, 2017.

4. Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14):1735-41.

5. Wu JJ, Poon KY, Channual JC, Shen AY. Association between tumor necrosis factor inhibitor therapy and myocardial infarction risk in patients with psoriasis. Arch Dermatol. 2012;148(11):1244-50.

6. Wu JJ, Gurin A, Sundaram M, Dea K, Cloutier M, Mulani P. Cardiovascular event risk assessment in psoriasis patients treated with tumor necrosis factor- inhibitors versus methotrexate. J Am Acad Dermatol. 2017;76(1):81-90.

7. Reich K, et al. Tildrakizumab, selective IL-23p19 antibody, in the treatment of chronic plaque psoriasis: results from two randomized, controlled, Phase 3 trials (reSURFACE 1 and reSURFACE 2) [abstract]. Presented as a late breaking abstract at the European Academy of Dermatology and Venereology 2016. October 1, 2016.

8. Blauvelt A, Papp KA, Griffiths CE, et al. Efficacy and safety of guselkumab, an anti-interleukin-23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: Results from the phase III, double-blinded, placebo- and active comparator-controlled VOYAGE 1 trial. J Am Acad Dermatol. 2017;76(3):405-417.

9. Krueger JG, Ferris LK, Menter A, et al. Anti-IL-23A mAb BI 655066 for treatment of moderate-to-severe psoriasis: safety, efficacy, pharmacokinetics, and biomarker results of a single-rising-dose, randomized, double-blind, placebocontrolled trial. J Allergy Clin Immunol. 2015;136(1):116124; e117. 29.

10. Bissonnette R, et al. Secukinumab maintains high levels of efficacy through 4 years of treatments: Results from an extension to a phase 3 study (SCULPTURE). Paper presented at: European Academy of Dermatology and Venereology Annual Meeting.; October 01, 2016; Vienna, Austria.

11. Lebwohl M, Strober B, Menter A, et al. Phase 3 studies comparing brodalumab with ustekinumab in psoriasis. N Engl J Med. 2015;373(14):1318-28.

12. Gupta MA, Schork NJ, Gupta AK, Kirkby S, Ellis CN. Suicidal ideation in psoriasis. Int J Dermatol. 1993;32(3):188-90.

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New systemic psoriasis treatments keep raising bar - ModernMedicine

Psoriasis is a chronic skin disease which results in the person developing red, scaly patches all over their body. Some of the common areas of the body affected the most by the disease are scalp, knees and elbows.

It is a noncontagious disease that has become fairly common among people of all ages and is triggered by inflammatory chemicals produced by white blood cells called lymphocytes, Medicine Netreported.

Although its symptoms may range from small rashes to the entire body covered with thick, red plagues, depending on the level of the disease, it is the incurable nature of the disease that makes it one of the most intimidating skin diseases.

Read: Drug For Psoriasis Shows Results After 4 Weeks: Study

While it cannot be passed from one person to the next via direct contact or transfer of body fluids, it has been known to affect more than one member of the same family, indicating the hereditary nature of the disease, Web MD reported.

Many eminent personalities have previously opened up about suffering from the disease, eroding the social stigma attached to it.

Kim Kardashian

Kim Kardashian West attends the NBCUniversal 2017 Upfront in New York City, May 15, 2017. Photo: Getty Images/Angela Weiss

Reality star and fashionista Kim Kardashian has been perhaps the most vocal when it comes to addressing the struggles of psoriasis. She repeatedly spread awareness regarding the problem on her family reality show, Keeping Up With The Kardashians. However, Kardashian wasnt always as accepting of her chronic skin disease initially, according toHealthline.

She first realized she had psoriasis at the age of 30, incidentally the same age her motherKris Jenner discovered she suffered from the same skin disease. The socialite had almost given up on her career at that point.

Read:Biocon Launches Psoriasis Drug In India; To File IND Application With US FDA This Fiscal

"People don't understand the pressure on me to look perfect," she lamented on the show, Everyday Health reported. "When I gain a pound, it's in the headlines. Imagine what the tabloids would do to me if they saw all these spots?"

But all of that is in the past as the reality star, married to Kanye West, has now embraced her skin abnormality and is even seen advising step-sisterKylie Jenneron how best to tackle the problem as she too has inherited psoriasis.

Kardashian also posts pictures of her skin spots on Twitter.

Art Garfunkel

Grammy Award-winning American singer Art Garfunkel performs on stage at the Bloomfield Stadium in the Israeli city of Tel Aviv, Israel, June 10, 2015. Photo: Getty Images/Gil Cohen Magen

The singer who was one half of Simon & Garfunkel, bringing to the world 60s classics such as "Bridge Over Troubled Water" and "Sound of Silence,"Art Grfunkel also famously suffered from psoriasis and left no stones unturned when it came to treating the same. He had incorrectly learned water from the Dead Sea could help heal the disease. So he decided to try it out, but to no avail.

Ive been told that if you float in the salty, buoyant water, its very good for the skin. Its not so much therapeutic as beautiful, he wrote onhis website.

Britney Spears

Singer Britney Spears performs onstage at the iHeartRadio Music Festival at T-Mobile Arena in Las Vegas, Nevada, Sept. 24, 2016. Photo: Getty Images/Kevin Winter

Although the former teenage popstar secretly suffered from psoriasis for a long time, it was only in 2012 the skin condition of the Toxic singer hit the public eye.

Spears was booked as a judge on X Factor, a job which came with unprecedented stress, causing her skin to breakout in angry red rashes, which were clearly visible when she stepped out on the red carpet at the X Factor premiere party in Los Angeles.

"Britney has had the skin condition for a long time, but it only flares up when she's under extreme pressure, a source told National Enquirer, News reported. Now she can't seem to stop scratching and picking at the sores. She has a psoriasis skin cream, but she says it burns, so she stopped using it."

Dara Torres

Olympian Dara Torres waits for the start of the practice session for the 42nd Toyota Grand Prix of Long Beach Press Day in Long Beach, California, on April 5, 2016. Photo: Getty Images/Frederick M. Brown

Swimmer Dara Torres is one of the very few people who braved the chlorine-filled waters of the swimming pools while most others would remain wary of the same if they were diagnosed with psoriasis. The 12-time Olympic winner instead claimed the water actually soothedthe red spots on her skin, according to Health.

Torres has also been vocal against the stigma attached to the disease, saying athletes who suffer from psoriasis should not be self-conscious of their skin condition, especially when they are out in front of the world, competing to win.

"Psoriasis isn't contagious and it isn't just cosmetic," she says in a public service announcement. "It's a serious disease."

Jon Lovitz

Comedian/actor Jon Lovitz performs during the kickoff of his 20-show residency 'Reunited' with Dana Carvey at The Foundry at SLS Las Vegas in Las Vegas, Nevada, Jan. 6, 2017. Photo: Getty Images/Ethan Miller

Comedian Jon Lovitz is another celebrity who battled psoriasis for years now. The body of the Saturday Night Live and Rat Race star had 75 percentof his body covered in psoriasis spots at one point. However, he refused to give up and worked with a number of dermatologists to find a cure for his condition.

"Don't be embarrassed," he said in an interview with the National Psoriasis Foundation, according to the Health report. "See a dermatologist. A lot of people with psoriasis give up, but don't. Find out what works best for you.

LeAnn Rimes

LeAnn Rimes attends Luli Fama fashion show during Mercedes-Benz Fashion Week Swim 2015 at Cabana Grande at The Raleigh in Miami, Florida, July 20, 2014. Photo: Getty Images/Aaron Davidson

LeAnn Rimes, the country singer, was diagnosed with psoriasis at the age of two, and she proceeded to hide the condition from the world most of her life. At the age of six, 80 percent of her body was covered in red spots, and people around her started referring her as the scaly girl.

She would refrain from wearing short dresses which showed skin on red carpets. However, healthy lifestyle choices and medication prescribed by her dermatologist helped her recover from the problem.

By finally getting control over it instead of it having control over me, I wanted to speak out and let people know that there is hope, Rimes told Shape.

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What Is Psoriasis? Kim Kardashian, Britney Spears And Other Celebrities Suffering From The Skin Disease - International Business Times

GETTY

However, having a shower could be making them worse - if you live in a hard water area, that is.

This type of water is supplied to 60 per cent of UK homes, including the south east and east midlands.

However its been suggested that it aggravates skin conditions like eczema and psoriasis.

There are currently 1.7 million people in the UK with eczema, and cases have risen by 40 per cent in recent years.

GETTY

When the skin's barrier function is compromised, such as in eczema, the minerals can enter the skin as allergens causing inflammation and worsening eczema.

Dr Sharon Wong

Its a condition that causes the skin to become itchy, red, dry and cracked, according to the NHS.

Dr Sharon Wong, consultant dermatologist (www.drsharonwong.com), said: Hard water does not directly cause eczema but is a common aggravating factor in those who are genetically predisposed to developing eczema.

Hard water, which has a greater mineral content - mainly calcium and magnesium ions - has been linked to an increased risk of eczema and more severe disease in children.

When the skin's barrier function is compromised, such as in eczema, the minerals can enter the skin as allergens causing inflammation and worsening eczema.

Getty Images

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Similarly, psoriasis - which affects two to three per cent of the UK population - causes red, flaky, crusty patches of skin covered with silvery scales.

Whilst there is no evidence that hard water causes psoriasis, the fact that the minerals in hard water have a drying effect on the skin can worsen psoriasis and other dry skin problems, she explained.

Whether the water that comes out of your tap is soft or hard depends on the geology of your area, but there are ways to minimise or stop its negative effects on your skin.

Dr Wong added: This can be minimised by installing a water softener, using bath oils not bubble bath and using emollient/cream washes instead of soap.

GETTY

Both bubble bath and soaps contain surfactant which strips away the natural oils of your skin. Finally, using a regular and good moisturiser helps because it forms a protective layer on the skin thus preventing further fluid loss.

Sukhbinder Noorpuri, GP and CEO of i-GP, said: Hard water contains dissolved minerals such as calcium and magnesium. When used with soaps and detergents, this leaves a skin residue which blocks pores trapping oil, leading to irritation, dryness, blemishes and itching.

A water softener will reduce these skin issues, and convert the minerals found in hard water, into more soluble minerals that are less harmful for the skin.

Ecocamel have created the Shower Head ORB SPA which can convert hard water into soft water.

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Eczema and psoriasis? THIS part of your morning routine could be triggering skin problems - Express.co.uk

Psoriasis increases the chances of myocardial infarction in younger psoriasis patients by three folds.

This press release was orginally distributed by SBWire

New York, NY -- (SBWIRE) -- 06/08/2017 -- Plaque psoriasis is a chronic, autoimmune inflammatory disorder which leads to overproduction of skin cells. The skin is characterized by inflamed, raised, scaly, red plaques and lesion. The intensity and frequency of psoriasis are affected by environmental factors such as sun exposure, smoking, HIV infection, and alcoholism. Metabolic syndrome and cardiovascular disease are common in psoriasis patients. Psoriasis increases the chances of myocardial infarction in younger psoriasis patients by three folds.

Moreover, severe psoriasis leads to 3.5 years reduced life expectancy in males relative to individuals without psoriasis. Psoriasis arthritis is a distinct syndrome which occurs in one-third of psoriasis patient with the onset of rheumatic arthritis.

Psoriasis plaque are distinguished by three features, an infiltrate featuring T-cells, the extravagant growth of poorly differentiated keratinocytes and the presence of dilated dermal blood vessels. Most of the introduced therapies for psoriatic were developed as to target T-cells or their inflammatory mediators including cytokines, receptors, and ligands.

Plaque Psoriasis Treatment Market: Dynamics

The demand for plaque psoriasis treatment market is expected to boom with the increasing number of pipeline psoriasis molecule and the number of biologics being launched. Janssen Biotec is seeking for the market approval of Guselkumab. The molecule is in the Phase III trial as a subcutaneous administered therapy for the treatment of plaque psoriasis.

Moreover, Gelantin Therapeutics Inc. announced positive data from its phase 2 study of its drug GR-MD-02 to treat moderate-to-severe plaque psoriasis. The company is now seeking for strategic partnership for its drug development program.

The advent of biologics has also shifted the preference from systemic therapy to meet the existing need. The systemic therapy suppresses the entire immune system as the clinician needs to do routine laboratory monitoring because of myelosuppression, hematologic side effects and increased renal and liver toxicity. Moreover, the systemic therapy is also contraindicated in nursing mothers, pregnant women, and individuals with kidney and liver diseases.

Around 125 million people worldwide have psoriasis out of which 80%, have plaque psoriasis. The need for safe plaque psoriasis therapy in children is essential as about one-third of the psoriasis cases are in children. Etanercept was approved by the DA as an extended indicated for children of age 4 and above.

Phototherapy and systemic therapy should only be used in cases where a topical treatment is inadequate. Novel systemic treatments are now being introduced where a range of biologics are sed. The mode of treatment follows a psoriasis treatment ladder. Initially, topical treatment is given, if the skin fails to respond then phototherapy is given. The third step involves the use of systemic treatment which may be through the administration of pills or injection.

TNF-? inhibitor was the first class of biologics which were successful in delivering the treatment while still maintaining the safety profile. Enbrel was the first molecule to be approved followed by Remicade and Humira. The introduction of these molecules increased the overall sales of the psoriasis drugs and also increased the physician's comfort and familiarity.

Plaque Psoriasis Treatment Market: Region-wise Outlook

North America region dominates the plaque psoriasis market owing to the increasing approval of pipeline drugs and supplemental biologics. In November 2016, the FDA approved supplemental biologics license for the use of Etanercept for children aged four and older having moderate-to-severe plaque psoriasis. The approval is the first of its kind indicated for the treatment of adults with moderate-to-severe plaque psoriasis. Amgen had performed a year-long phase 3 study and 5-year open-label extension testing for the approval.

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AsiaPacific is expected to be the fastest-growing region owing to the huge population base and changing lifestyle habits such as smoking. Moreover, the global market players are also exploring the developing market. Novartis launched its Cosentyx in Japan for the treatment of psoriasis arthritis in adults who are not adequately responding to systemic therapy.

Plaque Psoriasis Treatment Market: Market Players

Company manufacturer is converting innovative research into a new therapy by constantly investing in research activities. The number of drugs approved for plaque psoriasis is constantly increasing the number of treatment options for the physician and patients. Eli Lilly's interleukin inhibitor was approved by the FDA, second molecule to be approved after Novartis Cosentyx.

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Some of the plaque psoriasis treatment market contributors are Allergan, Johnson and Johnson, Amgen, Abbvie, Eli Lilly, Dermira Inc., Novartis, Galectin Therapeutics, Cellceutix Corporation and Biogen Inc., Bayer.

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Plaque Psoriasis Treatment Market Estimated to Flourish by 2017 ... - Digital Journal

June 2, 2017

Psoriasis is an incurable chronic disease with a hereditary component, in which the body's immune system attacks parts of the skin. This leads to scaly red patches, which can be very itchy. About two million people in Germany have psoriasis, and 400 000 of them have a moderate to severe form of the disease.

Since 2015, the monoclonal antibody secukinumab (trade name: Cosentyx) has been approved for patients with moderate to severe plaque psoriasis. Since 2016, the monoclonal antibody ixekizumab (trade name: Taltz) has also been approved. The German Institute for Quality and Efficiency in Health Care (IQWiG) now examined in two early benefit assessments whether these drugs offer an added benefit for patients in comparison with the appropriate comparator therapies. For both drugs, there are indications of considerable added benefit for certain patients.

Secukinumab: drug manufacturer submitted new dossier for one patient group

The older of the two drugs had already undergone an early benefit assessment in 2015. At that time, IQWiG had derived indications of a minor and of a non-quantifiable added benefit - but only for patients with no or inadequate response to previous systemic treatments or with contraindication or intolerance to such treatments. There are also those patients who are candidates for systemic treatment, but who have not yet received such treatment. The manufacturer applied for a new benefit assessment for this group because of new scientific findings.

No negative effects

For this new early benefit assessment, the manufacturer presented data from the study PRIME, in which fumaric acid esters were used in the comparator arm. In comparison with this comparator therapy, secukinumab showed very large positive effects in remissions, which resulted in an indication of an added benefit.

In addition, there was a hint of an added benefit in health-related quality of life and hints and indications of lesser harm in some side effects. There were no negative effects in any outcome. In summary, this resulted in an indication of considerable added benefit of secukinumab in patients who are candidates for systemic treatment.

Ixekizumab: only one of both studies usable

The other drug, ixekizumab, has been approved since 2016, but was not introduced into the market and subjected to an early benefit assessment before now because the manufacturer wanted to wait for new study results for this drug as well. The Federal Joint Committee (G-BA) again distinguished between two patient groups: patients who can receive systemic and/or phototherapy and patients with no or inadequate response to previous systemic treatments.

IQWiG could only analyse the data for the latter patient group because numerous participants who had already had phototherapy, i. e. a systemic treatment, had apparently been included in the study submitted by the manufacturer for patients eligible for systemic treatment. This specific research question of the benefit assessment can only be answered on the basis of patients who have not received previous systemic treatment, however.

Large positive effects also for this drug

For patients with no or inadequate response to previous systemic treatments, ixekizumab was compared with ustekinumab in the study IXORAS. The study is ongoing; data are available from an interim analysis after 24 weeks. Since there were notably more remissions under ixekizumab than in the comparator arm, there is an indication of a considerable added benefit in the outcome category "morbidity".

There is an indication of a minor added benefit for health-related quality of life. This is accompanied by an indication of greater harm in the outcome "general disorders and administration site conditions", which does not raise doubts about the positive effects, however. In the overall consideration, there is an indication of a considerable added benefit of ixekizumab in comparison with ustekinumab for adults with moderate to severe plaque psoriasis with no or inadequate response to previous systemic treatments.

Symptom analysis inadequate for course of the disease

"Both assessments show that there are notable advances for patients also outside oncology", says the Institute's Deputy Director Stefan Lange in view of the results. "This is good news. We have one suggestion for improvement, however: In both studies, disease-related symptoms were analysed only for fixed time points and only improvements were reported. This is inadequate for the typical course of the disease with its ups and downs. It would be better to present and analyse the burden of symptoms for each patient over the total study duration. There are simple methods for this purpose. This would also make temporary flare-ups and permanent improvements or deteriorations visible, which are generally of greater importance to the patients than their condition on a single fixed day."

G-BA decides on the extent of added benefit

The dossier assessments are part of the early benefit assessment according to the Act on the Reform of the Market for Medicinal Products (AMNOG) supervised by the G-BA. After publication of the dossier assessments, the G-BA conducts commenting procedures and makes final decisions on the extent of the added benefit.

Explore further: Secukinumab in plaque psoriasis: Manufacturer dossier provided no hint of an added benefit

More information: More English-language information will be available soon (extracts of the dossier assessments as well as easily understandable information on informedhealth.org). If you would like to be informed when these documents are available, please send an e-mail to info@iqwig.de.

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Secukinumab and ixekizumab in psoriasis: Considerable added benefit for certain patients - Medical Xpress

Clinical Advisor

Coal tar: an anti-inflammatory treatment for psoriasis Clinical Advisor Coal tar products are most often used topically for a variety of skin conditions, including psoriasis. Coal tar is one of the oldest known treatments for psoriasis, as it reduces scaling, itching, and inflammation. Its exact working mechanism is not known.

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Coal tar: an anti-inflammatory treatment for psoriasis - Clinical Advisor