Category Archives: Psoriasis

Two independent surveys of 200 rheumatologists and dermatologists have unveiled recent developments

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In psoriasis, report shows Taltz closing in on Cosentyx - The Pharma Letter (registration)

April 03, 2017

No differences in medication use before enrollment could explain these gender differences

HealthDay News Women have lower median Psoriasis Area and Severity Index (PASI) scores than men, according to a study published online March 24 in the American Journal of Clinical Dermatology.

David Hgg, from Ume University in Sweden, and colleagues examined the sex differences in the severity of psoriasis using the PASI and the distinct elements of the PASI score in a cross-sectional study involving 5,438 patients experiencing moderate-to-severe psoriasis.

The researchers found that across all ages, women had statistically significantly lower median PASI scores than men (5.4 versus 7.3; P<0.001). Women had significantly lower scores in all areas of the body than men, except for the head, in itemized PASI analyses. There were no differences in medication use prior to enrollment that could have caused these differences.

"These findings motivate a gender perspective in the management of psoriasis and in the prevention and management of its comorbidities," the authors write.

Abstract/Full Text

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PASI Scores Differ Between Sexes in Psoriasis - Monthly Prescribing Reference (registration)

Dear Dr. Roach: I have psoriasis. I have used clobetasol for 22 years. The psoriasis is not severe, but its constant. Should I be concerned about using this treatment for so many years? The only time it cleared up (and that was for two years) was when I had to take steroids for poison ivy. The doctor would not put me on a low dose of steroid to see if the psoriasis would stop completely and will not use other treatments, because both my brother and sister died of cancer. Any suggestions? I had two co-workers with psoriasis that was much worse than mine, and for some reason it disappeared for both of them after 20 years. R.M.

Dear R.M.: For mild to moderate psoriasis, a skin disorder that most commonly manifests with scaly plaques, the goal of care is to control symptoms using the least toxic therapies available. That means topical therapies, like clobetasol cream or ointment, and other treatments for instance, vitamin D-like or vitamin A-like drugs. These are very safe to use long-term for most people, if used correctly under supervision (clobetasol, a powerful steroid, used in the wrong place, especially the face, can cause permanent atrophy). If you have had good response to these, they are your best choice. However, it sounds like you havent had as good a response as you want.

I am curious about your response to the oral steroids you took for poison ivy. Normally, we treat moderate to severe poison ivy with a week or so of oral steroids. If just that much gave you two years of freedom from psoriasis, then I dont understand why your doctor cant give you a short course of steroids on a very-infrequent basis.

For severe psoriasis, systemic treatments are essential; however, they do have risks. Steroids are not a usual systemic treatment for psoriasis. Methotrexate, a drug used for cancer and in serious autoimmune diseases, is well-studied and tolerated by most. Vitamin A relatives, like acitretin (Soriatane), are very effective. Biological therapies, like etanercept (Enbrel), also have a clear place in treating severe psoriasis, but all of these drugs have potential for harm, including an increased risk of certain types of cancer.

In your case, I would consider getting a second opinion from a dermatologist with expertise in psoriasis. If the advice is the same, you can feel confident in the advice; if not, you will need to decide which course to follow.

Dear Dr. Roach: You recently had a column where you did not recommend alprazolam (Xanax) as a long-term sleep aid. What are the negative effects of using it that way? A.T.

Dear A.T.: Alprazolam is in the class of drugs called benzodiazepines, which includes Valium, Klonopin and Halcyon. They are effective at getting people to sleep more quickly, and increase total sleep time by 30-60 minutes. Alprazolam is very short-acting (although there is a long-acting form now) and is not indicated for insomnia.

I dont recommend benzodiazepines because they increase the rate of falls, especially in the elderly, because they can cause memory loss and because they can cause confusion and dependence.

I try to avoid prescribing sleeping medications, and most people with occasional difficulty sleeping do well with sleep hygiene advice: Having a regular sleep schedule, not trying to force sleep, avoiding alcohol and caffeine near bedtime and not using bright lights or computer screens before bed are part of this. If I do prescribe a sleep medication, I recommend using it no more than every other day and for no more than two weeks. People who need more than that, I refer to a sleep specialist.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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Goal of psoriasis care is symptom control with least toxic treatment ... - Sarasota Herald-Tribune

Miami Herald

Psoriasis, often misdiagnosed, may lead to heart disease and other serious ailments Miami Herald For many people, this can lead to a misdiagnosis or undertreatment of psoriasis, which can lead to serious health complications including an increased risk for heart disease. Fortunately, there are many new medications that can help treat skin symptoms ... 7 Things People With Psoriasis Want You to Know - SheKnowsSheKnows.com Lower Psoriasis Area, Severity Scores for Women Versus MenDoctors Lounge all 3 news articles »

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Psoriasis, often misdiagnosed, may lead to heart disease and other serious ailments - Miami Herald

Uncategorized

Apr 2, 2017

Dear Dr. Roach: I have psoriasis. I have used clobetasol for 22 years. The psoriasis is not severe, but its constant.

Should I be concerned about using this treatment for so many years? The only time it cleared up (and that was for two years) was when I had to take steroids for poison ivy.

The doctor would not put me on a low dose of steroid to see if the psoriasis would stop completely and will not use other treatments, because both my brother and sister died of cancer.

Any suggestions? I had two co-workers with psoriasis that was much worse than mine, and for some reason it disappeared for both of them after 20 years.

R.M.

Answer: For mild to moderate psoriasis, a skin disorder that most commonly manifests with scaly plaques, the goal of care is to control symptoms using the least toxic therapies available. That means topical therapies, like clobetasol cream or ointment, and other treatments for instance, vitamin D-like or vitamin A-like drugs.

These are very safe to use long-term for most people, if used correctly under supervision (clobetasol, a powerful steroid, used in the wrong place, especially the face, can cause permanent atrophy).

If you have had good response to these, they are your best choice. However, it sounds like you havent had as good a response as you want.

I am curious about your response to the oral steroids you took for poison ivy. Normally, we treat moderate to severe poison ivy with a week or so of oral steroids.

If just that much gave you two years of freedom from psoriasis, then I dont understand why your doctor cant give you a short course of steroids on a very-infrequent basis.

For severe psoriasis, systemic treatments are essential; however, they do have risks. Steroids are not a usual systemic treatment for psoriasis.

Methotrexate, a drug used for cancer and in serious autoimmune diseases, is well-studied and tolerated by most.

Vitamin A relatives, like acitretin (Soriatane), are very effective. Biological therapies, like etanercept (Enbrel), also have a clear place in treating severe psoriasis, but all of these drugs have potential for harm, including an increased risk of certain types of cancer.

In your case, I would consider getting a second opinion from a dermatologist with expertise in psoriasis.

If the advice is the same, you can feel confident in the advice; if not, you will need to decide which course to follow.

Dear Dr. Roach: You recently had a column where you did not recommend alprazolam (Xanax) as a long-term sleep aid. What are the negative effects of using it that way? A.T.

Answer: Alprazolam is in the class of drugs called benzodiazepines, which includes Valium, Klonopin and Halcyon.

They are effective at getting people to sleep more quickly, and increase total sleep time by 30-60 minutes.

Alprazolam is very short-acting (although there is a long-acting form now) and is not indicated for insomnia.

I dont recommend benzodiazepines because they increase the rate of falls, especially in the elderly, because they can cause memory loss and because they can cause confusion and dependence.

I try to avoid prescribing sleeping medications, and most people with occasional difficulty sleeping do well with sleep hygiene advice: Having a regular sleep schedule, not trying to force sleep, avoiding alcohol and caffeine near bedtime and not using bright lights or computer screens before bed are part of this.

If I do prescribe a sleep medication, I recommend using it no more than every other day and for no more than two weeks. People who need more than that, I refer to a sleep specialist.

Here is the original post:
Psoriasis care goal is control with least toxic treatment - Altoona Mirror

Merck KGaA is partnering Phase II and Phase III development of its therapeutic anti-interleukin-17 (IL-17) A/F Nanobody (M1095; ALX-0761) for treating plaque psoriasis, with Avillion, a U.K.-based firm focused on financing and co-developing late-stage drug candidates. Financial details of the deal were not disclosed, but the firms said Avillion will take on the responsibility for developing the anti-IL-17A/F Nanobody through Phase II and Phase III trials and will also finance the clinical program through to regulatory submission.

Merck acquired global rights to develop the bispecific anti-IL-17A/F Nanobody from Ablynx in 2013. Earlier this month, the firm reported positive data from a Phase Ib study with the Nanobody in patients with moderate-to-severe chronic plaque psoriasis.

"The collaboration announced today with Avillion will allow us to optimally deliver on the potential of IL-17, a compound that could address several areas of unmet need for patients today," said Beln Garijo, M.D., member of the Executive Board of Merck and CEO, Healthcare. "In parallel, we have several highly promising priority clinical assets in our pipeline, all of which we must continue to drive in-house. By partnering appropriately, not only can we maintain the internal focus on our R&D innovation strategy, but also maximize other opportunities that emerge from our pipeline."

Avillion teamed up with Pfizer in 2014 to fund and carry out the Phase III BEFORE study with the latters Bosulif (bosutinib) as first-line therapy for chronic-phase Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML). Positive data from the study were reported in December 2016.

Commenting on the latest deal with Merck KGaA, Allison Jeynes-Ellis, M.D., Avillion CEO, said We are delighted to embark on this new clinical co-development project with Merck and its innovative nanobody candidate. This agreement is a further endorsement of our innovative business model and follows the success of our Phase III program with Pfizer for Bosulif in CML. We are very encouraged that our collaborative approach to advancing the development of clinical candidates and boosting our partners' R&D productivity is gaining such awareness in the biopharma industry."

Originally posted here:
Avillion to Fund Late-Stage Development of Merck KGaA's Plaque Psoriasis Nanobody - Genetic Engineering & Biotechnology News (press release)

Dear Dr. Roach: I have psoriasis. I have used clobetasol for 22 years. The psoriasis is not severe, but it's constant. Should I be concerned about using this treatment for so many years? The only time it cleared up (and that was for two years) was when I had to take steroids for poison ivy. The doctor would not put me on a low dose of steroid to see if the psoriasis would stop completely and will not use other treatments, because both my brother and sister died of cancer. Any suggestions? I had two co-workers with psoriasis that was much worse than mine, and for some reason it disappeared for both of them after 20 years.

A: For mild to moderate psoriasis, a skin disorder that most commonly manifests with scaly plaques, the goal of care is to control symptoms using the least toxic therapies available. That means topical therapies, like clobetasol cream or ointment, and other treatments -- for instance, vitamin D-like or vitamin A-like drugs. These are very safe to use long-term for most people, if used correctly under supervision (clobetasol, a powerful steroid, used in the wrong place, especially the face, can cause permanent atrophy). If you have had good response to these, they are your best choice. However, it sounds like you haven't had as good a response as you want.

I am curious about your response to the oral steroids you took for poison ivy. Normally, we treat moderate to severe poison ivy with a week or so of oral steroids. If just that much gave you two years of freedom from psoriasis, then I don't understand why your doctor can't give you a short course of steroids on a very-infrequent basis.

For severe psoriasis, systemic treatments are essential; however, they do have risks. Steroids are not a usual systemic treatment for psoriasis. Methotrexate, a drug used for cancer and in serious autoimmune diseases, is well-studied and tolerated by most. Vitamin A relatives, like acitretin (Soriatane), are very effective. Biological therapies, like etanercept (Enbrel), also have a clear place in treating severe psoriasis, but all of these drugs have potential for harm, including an increased risk of certain types of cancer.

In your case, I would consider getting a second opinion from a dermatologist with expertise in psoriasis. If the advice is the same, you can feel confident in the advice; if not, you will need to decide which course to follow.

Dear Dr. Roach: You recently had a column where you did not recommend alprazolam (Xanax) as a long-term sleep aid. What are the negative effects of using it that way?

A: Alprazolam is in the class of drugs called benzodiazepines, which includes Valium, Klonopin and Halcyon. They are effective at getting people to sleep more quickly, and increase total sleep time by 30-60 minutes. Alprazolam is very short-acting (although there is a long-acting form now) and is not indicated for insomnia.

I don't recommend benzodiazepines because they increase the rate of falls, especially in the elderly, because they can cause memory loss and because they can cause confusion and dependence.

I try to avoid prescribing sleeping medications, and most people with occasional difficulty sleeping do well with sleep hygiene advice: Having a regular sleep schedule, not trying to force sleep, avoiding alcohol and caffeine near bedtime and not using bright lights or computer screens before bed are part of this. If I do prescribe a sleep medication, I recommend using it no more than every other day and for no more than two weeks. People who need more than that, I refer to a sleep specialist.

Here is the original post:
Dear Dr. Roach: Goal of psoriasis care is symptom control with least toxic treatment - Herald & Review

Results from three trials indicate that the use of ixekizumab could serve as an effective alternative for patients with moderate to severe plaque psoriasis. Promisingly, those who have not responded to similar therapy in the past are still likely to achieve an adequate response.

Psoriasis is an autoimmune skin condition that can be life-altering for many of those diagnosed. Particularly when the disease presents in a moderate or severe form, patients are at risk of deteriorating mentally and socially, as well as physically. Due to the less predictable nature of psoriasis, and autoimmune diseases in general, it is important that there is a wide range of treatment options available to patients.

One option used in moderate to severe plaque psoriasis is antibodies, known as biologicals. These specific antibodies target inflammatory cytokines and are reserved for use in patients that have either not responded to standard therapies, or for whom such therapies are unadvisable. Evidence for a new biological treatment, ixekizumab, has been submitted by pharmaceutical company Eli Lilly to the UKs National Health Service (NHS) appraisal committee for review. An economic model for cost effectiveness of ixekizumab was also submitted.

Results from three trials, enlisting 3,866 subjects with moderate to severe plaque psoriasis, was used to support the introduction of ixekizumab. These trials are known as UNCOVER 1, 2, and 3. The first compared ixekizumab to a placebo drug, whilst the second and third compared ixekizumab to both etanercept, a biological currently used to treat plaque psoriasis, and a placebo. The clinical effectiveness of the medication was evaluated using the Psoriasis Area and Severity Index (PASI) which pertains to the size, redness and thickness of plaques, and the Dermatology Life Quality Index (DLQI). Upon 12 weeks of treatment, at least a 75% reduction in PASI score or a 50% reduction in PASI score plus a 5-point reduction in DLQI is considered an adequate response.

Based on results from all three trials, it was concluded that ixekizumab is more effective than both placebo and etanercept. Ixekizumab was also found to produce better outcomes than placebo and etanercept for patients that had previously been treated with biologicals. Lastly, it was determined that ixekizumab was similar to other biologicals in terms of tolerability. Given the extensive data available on biological treatments, long-term safety is of less concern. A meta-analysis was then carried out in order to compare ixekizumab to a list of currently used biologicals; adalimumab, ustekinumab, secukinumab, and infliximab. It was determined that the probability of ixekizumab producing a 75% reduction in PASI score within 12 weeks is substantially higher than with adalimumab and ustekinumab, whilst infliximab and secukinumab were deemed similar in effectiveness.

To conclude, the presented evidence indicates ixekizumab is an effective treatment for patients with moderate to severe plaque psoriasis. Given the acceptable economic model, it has been agreed that the drug will be available on the NHS, as is already the case in various other parts of the world.

Written By:Saran Amin, MPharm

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Ixekizumab for Treatment of Psoriasis - Medical News Bulletin

Psoriasis is a visible skin condition, but to Janssen that's only half the story. The Johnson & Johnson pharma arm wantsto tell the story of how psoriasis impacts the lives and thinking of people who have it.

"Psoriasis: The Inside Story" is an online initiative featuringactress Katie Lowes, who currently stars on TV show Scandal, and two psoriasis advocates, Todd Bello and Sabrina Skiles. All three have psoriasis and will write blog posts and lead video discussions at psoriasisinsidestory.com about living life with psoriasis.

For Lowes, it's the first time she's speaking out about her struggles with psoriasis and doing media interviews with mainstream channels, including ABC and Self, to promote the Inside Story effort.

The campaign comes through a Janssen partnership with the National Psoriasis Foundation as well as lifestyle brands Fodor's Travel, ClassPass and Burlington, celebrity psychologist Michelle Callahan, and hair stylist Scott Cunha to tackle topics from fitness and travel to love and relationships.

Megan Farina, director of product communications at Janssen, said in an email interview that through shared stories,the group hopes to "raise awareness of the challenges of living with this chronic autoimmune disease and offer advice that can help remove barriers that may be holding people back."

J&J is marketing psoriasis fighter Stelara and has submitted an application to the FDA for experimental med guselkumab for moderate to severe psoriasis. In phase 3testing, the candidate has performed well against AbbVie's Humira and placebos.

J&J isn't the only pharma with a new psoriasis med on its hands, though, and it's not the only one with a new psoriasis marketing initiative, either. Novartis and Eli Lilly have each recently launched efforts in conjunction with their own next-gen meds: Last year, Novartis, which markets Cosentyx, enlistedbody painters to showcase patient stories, while Lilly, maker of Taltz, spent more than $21 million on TV advertising between late September and early December.

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J&J looks for the inside story with new online psoriasis campaign - FiercePharma

Home Skin Health Psoriasis more common in women than men: Study

Psoriasis is an abnormal skin disorder that often manifests as scaly patches that are typically red and itchy. It is considered an autoimmune disorder and it occurs more often in men than in women, according to a new study conducted by researchers at Ume University and Karolinska Institutet.

Published in the American Journal of Clinical Dermatology, Swedish researchers studied 5,438 men and women with psoriasis who were native to Sweden and learned that women had a statistically lower incidence of severe psoriasis than men. This is surprising, considering that autoimmune disorders tend to favor females more than males. Other autoimmune disorders such as systemic lupus erythematosus (SLE), multiple sclerosis (MS), and rheumatoid arthritis (RA) are all more prevalent in women than they are in men.

Our results tell us that the well-established gender differences in the utilization of psoriasis care can at least partially be explained by a higher prevalence of more severe disease in men, says Marcus Schmitt-Egenolf, who is a researcher at the Department of Public Health and Clinical Medicine at Ume University and senior author of the study.

The researchers stress that no differences between men and women in the use of medications before enrolment in the PsoReg register explained the difference in severe psoriasis cases observed. This new finding of increased prevalence in men has the possibility to motivate sex-specific treatments for the management of severe psoriasis and its comorbidities, such as cardiovascular and metabolic disease.

For over 70 years, psoriasis researchers have speculated that women have less severe psoriasis compared to men. Our study is the first to investigate sex differences in psoriasis severity using the golden standard of severity measurement, the PASI score. Furthermore, we have also looked more in-depth at distinct elements of the PASI score. The results allow us to verify this thesis in a nationwide population. However, further research is needed to substantiate our findings in different populations, says Marcus Schmitt-Egenolf.

Related: Psoriasis vs. vitiligo, differences in symptoms, causes, and treatments

Related Reading:

Psoriasis diet: What foods to eat and what foods to avoid?

Psoriasis vs. lupus, differences in symptoms, causes, and treatments

http://www.medfak.umu.se/english/about-the-faculty/news/newsdetailpage//severe-psoriasis-predominantly-affects-men.cid280801 https://link.springer.com/article/10.1007%2Fs40257-017-0274-0

See the rest here:
Psoriasis more common in women than men: Study - Bel Marra Health