Psoriasis sufferers have an increased frequency of a variety of cardiovascular risk factors including diabetes, obesity, high blood pressure, elevated blood cholesterol levels, and smoking, results of a study confirm.
In particular, the current results suggest that psoriasis is associated with key components of the metabolic syndrome -- a clustering of heart risk factors -- and that this association is stronger in cases of severe psoriasis.
This finding is important, say the investigators, given that individuals with as few as one or two metabolic syndrome risk factors are at heightened risk for death due to cardiovascular disease.
"Our other studies suggest that, independent of other risk factors, severe psoriasis itself may be a risk factor for heart attack," Dr. Joel M. Gelfand from the University of Pennsylvania, Philadelphia told Reuters Health. "Therefore, patients with psoriasis should be screened for cardiovascular risk factors, and if these risk factors are present, they should be managed appropriately."
Gelfand and colleagues identified 127,706 patients with mild psoriasis and 3,854 with severe psoriasis. Each psoriasis patient was matched to up to five psoriasis-free control subjects.
Diabetes was present in 7.1 percent of patients with severe psoriasis and in 4.4 percent of those with mild psoriasis compared with just 3.3 percent of controls.
High blood pressure was present in 20 percent of patients with severe psoriasis, 14.7 percent of those with mild psoriasis and 11.9 percent of controls. Elevated cholesterol or "hyperlipidemia" was documented in 6 percent, 4.7 percent, and 3.3 percent, respectively.
Nearly 20.7 percent of individuals with severe psoriasis and 15.8 percent of those with mild psoriasis were obese compared with roughly 13.2 percent of controls. Thirty-one percent of those with severe psoriasis were smokers compared with 28 percent of those with mild psoriasis and 20.7 percent of psoriasis-free controls.
Compared with controls, patients with mild psoriasis had higher adjusted odds of diabetes, hypertension, hyperlipidemia, obesity, and smoking. Patients with severe psoriasis had higher adjusted odds of diabetes, obesity, and smoking.
Additionally, diabetes and obesity were more prevalent in patients with severe psoriasis than in those with mild psoriasis.
Patients with psoriasis should be encouraged to identify and manage their modifiable cardiovascular risk factors, the authors conclude.
SOURCE: Journal of the American Academy of Dermatology, December 2006.
Monday, December 04, 2006
Tuesday, November 07, 2006
The History Of Psoriasis
Psoriasis is probably one of the longest known illnesses of humans and simultaneously one of the most misjudged and misunderstood. Some scholars believe psoriasis to have been included among the skin conditions called tzaraat in the Bible.
Tzaraat was a punishment for sin whose cure could only be found in repentance and forgiveness. In more recent times psoriasis was frequently described as a variety of leprosy. It became known as Willan's lepra in the late 18th century when English dermatologists Robert Willan and Thomas Bateman differentiated it from other skin diseases and provided the first rational nomenclature based on the appearance of lesions. Willan identified two categories: leprosa graecorum and psora leprosa.
While it may have been visually, and later semantically, confused with leprosy it was not until 1841 that the condition was finally given the name psoriasis by the Viennese dermatologist Ferdinand von Hebra. The name is derived from the Greek word psora which means to itch.[3]
It was during the 20th century that psoriasis was further differentiated into specific types.
Tzaraat was a punishment for sin whose cure could only be found in repentance and forgiveness. In more recent times psoriasis was frequently described as a variety of leprosy. It became known as Willan's lepra in the late 18th century when English dermatologists Robert Willan and Thomas Bateman differentiated it from other skin diseases and provided the first rational nomenclature based on the appearance of lesions. Willan identified two categories: leprosa graecorum and psora leprosa.
While it may have been visually, and later semantically, confused with leprosy it was not until 1841 that the condition was finally given the name psoriasis by the Viennese dermatologist Ferdinand von Hebra. The name is derived from the Greek word psora which means to itch.[3]
It was during the 20th century that psoriasis was further differentiated into specific types.
Wednesday, November 01, 2006
Psoriasis Awareness Week 6th - 10th November 2006
Psoriasis is a relapsing skin condition that affects around 2% of the population in the UK. Unlike normal skin, with psoriatic skin the cells renew every 2-3 days compared to normal skin cells which mature every 21-28 days. This fast turnover of cells can result in raised itchy red patches of skin covered with silvery scales.
Psoriasis can have a major impact on many different aspects of day to day life. Coping with treatment, dealing with other people's reactions to the condition and even doing things we take for granted like swimming and sunbathing can be awkward for sufferers.
Psoriasis can have a major impact on many different aspects of day to day life. Coping with treatment, dealing with other people's reactions to the condition and even doing things we take for granted like swimming and sunbathing can be awkward for sufferers.
Tuesday, October 31, 2006
Understanding Plaque Psoriasis
Plaque psoriasis is the most common form of psoriasis. It is characterized by raised, inflamed (red) lesions covered with a silvery white scale. The scale is actually a buildup of dead skin cells. The technical name for plaque psoriasis is psoriasis vulgaris (vulgaris means common).
Plaque psoriasis may appear on any skin surface, though the knees, elbows, scalp, and trunk are the most common locations. Sometimes the patches of infected skin are large, extending over much of the body. The patches, known as plaques or lesions, can wax and wane but tend to be chronic. These can be very itchy and if scratched or scraped they may bleed easily. The plaques usually have a well-defined edge and, while they can appear anywhere on the body, the most commonly affected areas are the scalp, knees and elbows. However, if the scalp is involved, you may develop psoriasis on the hairline and forehead. The actual appearance of the plaques can depend on where they are found on the body. Plaques found on the palms and soles can be scaly, however they may not be very red in color. This is due to the thickness of the skin at these sites. If the plaques are in moist areas, such as in the creases of the armpits or between the buttocks, there is usually little or no scaling. The patches are red and have a well-defined border. Chronic (or common) plaque psoriasis affects over 90% of sufferers. It appears usually on the scalp, lower back, elbows, arms, legs, knees and shoulders. It is very much an adult condition.
Plaque psoriasis may appear on any skin surface, though the knees, elbows, scalp, and trunk are the most common locations. Sometimes the patches of infected skin are large, extending over much of the body. The patches, known as plaques or lesions, can wax and wane but tend to be chronic. These can be very itchy and if scratched or scraped they may bleed easily. The plaques usually have a well-defined edge and, while they can appear anywhere on the body, the most commonly affected areas are the scalp, knees and elbows. However, if the scalp is involved, you may develop psoriasis on the hairline and forehead. The actual appearance of the plaques can depend on where they are found on the body. Plaques found on the palms and soles can be scaly, however they may not be very red in color. This is due to the thickness of the skin at these sites. If the plaques are in moist areas, such as in the creases of the armpits or between the buttocks, there is usually little or no scaling. The patches are red and have a well-defined border. Chronic (or common) plaque psoriasis affects over 90% of sufferers. It appears usually on the scalp, lower back, elbows, arms, legs, knees and shoulders. It is very much an adult condition.
Wednesday, October 11, 2006
Psoriasis Linked to Higher Risk of Heart Attack
Psoriasis sufferers may face an increased risk of having a heart attack, a new study suggests.
The risk appears to be most pronounced among younger patients with more severe forms of the disease, according to a paper appearing in the Oct. 11 issue of the Journal of the American Medical Association.
"This study is really quite important," said Liz Horn, director of research for the National Psoriasis Foundation. "There have been a few other studies, but this one is important because it uses such a large database. This is just one more very important study that gives more evidence."
While more studies are needed to confirm the findings, "the potential is there for someone who has severe psoriasis who is in their 50s or 40s, of having a heart attack," said lead researcher Dr. Joel Gelfand, an assistant professor of dermatology at the University of Pennsylvania School of Medicine, in Philadelphia.
"The relative risk due to severe psoriasis is similar to the relative risk of having a heart attack from having diabetes," he said. "But the absolute risk [to any one person] is low. If you have severe psoriasis and are in your 40s, the risk of having a heart attack due to psoriasis is about one in 600 per year."
Psoriasis is thought to be an autoimmune disorder, occurring when the body inexplicably begins overproducing skin cells. The extra cells pile up on the surface of the skin before they have a chance to mature, creating bright red patches that cause itching, burning and stinging. The disease affects 2 percent to 3 percent of the adult population.
Some previous studies had shown an association between psoriasis and cardiovascular diseases but those studies could not rule out obesity, smoking and other risk factors as the true culprits.
In this study, the authors examined medical records from a large sample of patients aged 20 to 90 in the United Kingdom. The sample included more than half a million controls (people without psoriasis), more than 125,000 patients with mild psoriasis and almost 4,000 with severe psoriasis.
Heart attacks were more common in patients with severe psoriasis (five heart attacks per 1,000 person-years) and mild psoriasis (four heart attacks per 1,000 person-years) compared with the controls (about 3.6 heart attacks per 1,000 person-years).
Individuals who were younger and had more severe disease had the highest relative risk, with a 30-year-old patient with mild disease having a 29 percent greater risk than a person without psoriasis. A 30-year-old patient with severe psoriasis had about triple the risk and a 60-year-old patient with severe disease had a 36 percent increased risk.
It is thought that earlier-onset psoriasis (before age 40) is more severe than later-onset disease (after age 40). About three-quarters of patients will develop psoriasis before they turn 40.
"People with psoriasis have a bigger tendency to smoke, be obese, have high blood pressure and other things we know are risk factors for cardiovascular disease," Gelfand said. "The thing we've done, which hadn't been done before for psoriasis, was to control for these risk factors. We found that psoriasis still increases the risk of having a heart attack."
The common denominator may be inflammation, the researchers said.
"Immune activity is important for establishing atherosclerosis or blockage of the arteries and promoting them to rupture into a heart attack," Gelfand explained. "The same immune cells involved in this are involved in psoriasis. Other diseases, like rheumatoid arthritis -- which share common immune factors -- [also] have an increased risk of heart disease. This is a scientific theory that has been evolving over the last decade or so but still needs additional studies to confirm."
In the meantime, patients with psoriasis should not be alarmed but should see a physician and be screened for cardiovascular risk factors, Gelfand said. And, if you do have risk factors, you should treat them according to current guidelines. This includes stopping smoking and losing excess weight.
"There needs to start being a conversation between patients and physicians about the risk of cardiovascular disease and what psoriasis patients should be doing to decrease risks," Horn said.
"This is really important information," she said. "But it's still very early in understanding what all this means. I do think general health issues about cardiovascular disease and lifestyle modification is probably a good starting place."
"This study is of great concern and it underscores why we believe the National Institutes of Health should be increasing research on psoriasis," Michael Paranzino, president of Psoriasis Cure Now, said in a staement. "Unlocking the apparent link between psoriasis and heart attack risk may help us improve treatments both for psoriasis and heart attack prevention. The 'heartbreak of psoriasis' is supposed to be a tired punch line, not a literal truth."
"This study suggests that estimates of the impact of psoriasis, both in terms of dollars spent and lives lost, may be undercounting the true burden of this disease," Paranzino added. "With NIH funding having doubled over the last decade but psoriasis funding down 20 percent, this study should serve as a wake-up call that increasing psoriasis research funding should become a national priority. One of the key questions that patients need answered is whether aggressive treatment of psoriasis can reduce this increased heart attack risk."
The risk appears to be most pronounced among younger patients with more severe forms of the disease, according to a paper appearing in the Oct. 11 issue of the Journal of the American Medical Association.
"This study is really quite important," said Liz Horn, director of research for the National Psoriasis Foundation. "There have been a few other studies, but this one is important because it uses such a large database. This is just one more very important study that gives more evidence."
While more studies are needed to confirm the findings, "the potential is there for someone who has severe psoriasis who is in their 50s or 40s, of having a heart attack," said lead researcher Dr. Joel Gelfand, an assistant professor of dermatology at the University of Pennsylvania School of Medicine, in Philadelphia.
"The relative risk due to severe psoriasis is similar to the relative risk of having a heart attack from having diabetes," he said. "But the absolute risk [to any one person] is low. If you have severe psoriasis and are in your 40s, the risk of having a heart attack due to psoriasis is about one in 600 per year."
Psoriasis is thought to be an autoimmune disorder, occurring when the body inexplicably begins overproducing skin cells. The extra cells pile up on the surface of the skin before they have a chance to mature, creating bright red patches that cause itching, burning and stinging. The disease affects 2 percent to 3 percent of the adult population.
Some previous studies had shown an association between psoriasis and cardiovascular diseases but those studies could not rule out obesity, smoking and other risk factors as the true culprits.
In this study, the authors examined medical records from a large sample of patients aged 20 to 90 in the United Kingdom. The sample included more than half a million controls (people without psoriasis), more than 125,000 patients with mild psoriasis and almost 4,000 with severe psoriasis.
Heart attacks were more common in patients with severe psoriasis (five heart attacks per 1,000 person-years) and mild psoriasis (four heart attacks per 1,000 person-years) compared with the controls (about 3.6 heart attacks per 1,000 person-years).
Individuals who were younger and had more severe disease had the highest relative risk, with a 30-year-old patient with mild disease having a 29 percent greater risk than a person without psoriasis. A 30-year-old patient with severe psoriasis had about triple the risk and a 60-year-old patient with severe disease had a 36 percent increased risk.
It is thought that earlier-onset psoriasis (before age 40) is more severe than later-onset disease (after age 40). About three-quarters of patients will develop psoriasis before they turn 40.
"People with psoriasis have a bigger tendency to smoke, be obese, have high blood pressure and other things we know are risk factors for cardiovascular disease," Gelfand said. "The thing we've done, which hadn't been done before for psoriasis, was to control for these risk factors. We found that psoriasis still increases the risk of having a heart attack."
The common denominator may be inflammation, the researchers said.
"Immune activity is important for establishing atherosclerosis or blockage of the arteries and promoting them to rupture into a heart attack," Gelfand explained. "The same immune cells involved in this are involved in psoriasis. Other diseases, like rheumatoid arthritis -- which share common immune factors -- [also] have an increased risk of heart disease. This is a scientific theory that has been evolving over the last decade or so but still needs additional studies to confirm."
In the meantime, patients with psoriasis should not be alarmed but should see a physician and be screened for cardiovascular risk factors, Gelfand said. And, if you do have risk factors, you should treat them according to current guidelines. This includes stopping smoking and losing excess weight.
"There needs to start being a conversation between patients and physicians about the risk of cardiovascular disease and what psoriasis patients should be doing to decrease risks," Horn said.
"This is really important information," she said. "But it's still very early in understanding what all this means. I do think general health issues about cardiovascular disease and lifestyle modification is probably a good starting place."
"This study is of great concern and it underscores why we believe the National Institutes of Health should be increasing research on psoriasis," Michael Paranzino, president of Psoriasis Cure Now, said in a staement. "Unlocking the apparent link between psoriasis and heart attack risk may help us improve treatments both for psoriasis and heart attack prevention. The 'heartbreak of psoriasis' is supposed to be a tired punch line, not a literal truth."
"This study suggests that estimates of the impact of psoriasis, both in terms of dollars spent and lives lost, may be undercounting the true burden of this disease," Paranzino added. "With NIH funding having doubled over the last decade but psoriasis funding down 20 percent, this study should serve as a wake-up call that increasing psoriasis research funding should become a national priority. One of the key questions that patients need answered is whether aggressive treatment of psoriasis can reduce this increased heart attack risk."
Wednesday, September 27, 2006
Remicade Receives Expanded Approval To Treat Psoriatic Arthritis
The FDA has granted an additional indication for infliximab (Remicade) for inhibiting the progression of structural damage and improving physical function in patients who have psoriatic arthritis. This indication is in addition to Remicade’s already approved indication in dermatology for reducing the signs and symptoms of active arthritis in patients who have psoriatic arthritis. The expanded indication is based on data from the double-blind placebo-controlled IMPACT and IMPACT 2 trials. Here are the key findings from those trials upon which approval was based:
• IMPACT 2 — an analysis of 1 year of radiographs revealed that patients treated with Remicade experienced significant inhibition of the progression of structural damage as compared with patients who received placebo, according to their van der Heijde-Sharp scores.
• IMPACT — By week 16 in this trial, patients who received Remicade experienced significant improvement in functional status with a median improvement of 50% in their scores on the Health Assessment Questionnaire-Disability Index, as compared to a 2% improvement in this score for study participants in the placebo group. These scores were typically the same throughout the nearly 2-year study.
• Improved Skin Symptoms — In addition to the above findings, 64% of patients in the IMPACT study achieved a 75% improvement from baseline in their psoriasis symptoms. These improvements also were maintained throughout the nearly 2-year study.Remicade is administered in a dose of 5 mg/kg every 8 weeks during a 2-hour infusion.
• IMPACT 2 — an analysis of 1 year of radiographs revealed that patients treated with Remicade experienced significant inhibition of the progression of structural damage as compared with patients who received placebo, according to their van der Heijde-Sharp scores.
• IMPACT — By week 16 in this trial, patients who received Remicade experienced significant improvement in functional status with a median improvement of 50% in their scores on the Health Assessment Questionnaire-Disability Index, as compared to a 2% improvement in this score for study participants in the placebo group. These scores were typically the same throughout the nearly 2-year study.
• Improved Skin Symptoms — In addition to the above findings, 64% of patients in the IMPACT study achieved a 75% improvement from baseline in their psoriasis symptoms. These improvements also were maintained throughout the nearly 2-year study.Remicade is administered in a dose of 5 mg/kg every 8 weeks during a 2-hour infusion.
Monday, September 25, 2006
Aims And Purposes Of World Psoriasis Day, October 29th
World Psoriasis Day is an evolving project with more and more individuals, experts and patient associations from around the world getting involved over time.
The aims for WPD were defined by the Steering Committee as follows:
1. Raise awareness about psoriasis: World Psoriasis Day communication and activities should for example explain that psoriasis is a non contagious skin condition that can affect anybody and that people with psoriasis are really no different inside from anyone else. The World Psoriasis Day project should also aim to dispel myths about the condition.
2. Encourage healthcare decision makers to give psoriasis suffers better access to the most appropriate therapies for their condition: World Psoriasis Day should aim to encourage healthcare decision makers for example governments, physicians, carers and all those responsible for psoriasis care/ medicines to allow psoriasis sufferers access to all the most appropriate therapies. For too long psoriasis has not been seen as a priority with patients not always getting access to the most appropriate therapies for their condition.
3. Deliver relevant information and knowledge to interested parties: World Psoriasis Day should aim to provide information and knowledge to those who are affected by psoriasis/ psoriatic arthritis as well as the general public, in order that people can be better informed about the condition, develop a better understanding, enabling them to be more confident to speak about it.
4. Provide a patient voice platform: World Psoriasis Day should provide a platform from which the 'patient voice' can be heard and from which people with psoriasis can be encouraged to speak out about their needs and wants.www.worldpsoriasisday.com
The aims for WPD were defined by the Steering Committee as follows:
1. Raise awareness about psoriasis: World Psoriasis Day communication and activities should for example explain that psoriasis is a non contagious skin condition that can affect anybody and that people with psoriasis are really no different inside from anyone else. The World Psoriasis Day project should also aim to dispel myths about the condition.
2. Encourage healthcare decision makers to give psoriasis suffers better access to the most appropriate therapies for their condition: World Psoriasis Day should aim to encourage healthcare decision makers for example governments, physicians, carers and all those responsible for psoriasis care/ medicines to allow psoriasis sufferers access to all the most appropriate therapies. For too long psoriasis has not been seen as a priority with patients not always getting access to the most appropriate therapies for their condition.
3. Deliver relevant information and knowledge to interested parties: World Psoriasis Day should aim to provide information and knowledge to those who are affected by psoriasis/ psoriatic arthritis as well as the general public, in order that people can be better informed about the condition, develop a better understanding, enabling them to be more confident to speak about it.
4. Provide a patient voice platform: World Psoriasis Day should provide a platform from which the 'patient voice' can be heard and from which people with psoriasis can be encouraged to speak out about their needs and wants.www.worldpsoriasisday.com
Friday, September 15, 2006
Humira Exceeds Expectations In Treating Psoriasis
Recently revealed data show a study of Abbott Laboratories (ABT) drug Humira and its ability to treat the skin disease psoriasis exceeded expectations and topped results in an earlier trial, an Abbott official said Tuesday.
Results from the Phase 3 trial have not yet been publicly released and will be presented at a conference early next month. But data in the trial were recently "unblinded," and Humira showed "significantly better efficacy than approved biologics" in psoriasis treatment, said Thomas Freyman, Abbott's chief financial officer.
Freyman spoke at a Bear Stearns conference that was broadcast on the Internet.
The recent trial looked at Humira, a placebo and methotrexate - a standard drug used for years to treat psoriasis - to see which treatment scored best after 16 weeks on a standard scale of psoriasis treatment. The recently revealed data showed that the trial was better than expected and better than a Phase 2 trial, Freyman said.
An Abbott spokeswoman confirmed that the latest trial met its primary endpoint, or goal. Safety information from the trial will be released, along with more specific trial data, at October's European Academy of Dermatology and Venereology conference in Rhodes, Greece.
Humira, which posted $1.4 billion in global sales last year, is currently approved to treat rheumatoid arthritis, arthritis of the spine and psoriatic arthritis - but not psoriasis itself. Abbott plans to file with the U.S. Food and Drug Administration for psoriasis-treatment approval in the first half of 2007.
The skin disease is one of multiple indications that could significantly expand Humira's reach and revenue-generating potential if the treatment is approved.
Abbott announced last week that it has filed with U.S. and European regulators seeking approval to market Humira for the treatment of moderate to severe Crohn's disease, a serious and chronic intestinal inflammatory disorder.
Abbott also plans to file with the FDA next year, seeking approval to use Humira to treat juvenile rheumatoid arthritis and ulcerative colitis, another intestinal inflammatory disease.
Freyman said Abbott continues to target Humira sales of more than $1.9 billion this year, and noted that his company has said that the new indications alone represent a multibillion-dollar opportunity.
"Humira continues to meet or exceed our expectations," he said at the Bear Stearns conference.
"This is a product that's got legs," he added.
Humira is part of a class of treatments called tumor necrosis factor antagonists, or anti-TNF. TNF is a substance believed to play a role in inflammatory conditions.
article by Jon Kamp
Results from the Phase 3 trial have not yet been publicly released and will be presented at a conference early next month. But data in the trial were recently "unblinded," and Humira showed "significantly better efficacy than approved biologics" in psoriasis treatment, said Thomas Freyman, Abbott's chief financial officer.
Freyman spoke at a Bear Stearns conference that was broadcast on the Internet.
The recent trial looked at Humira, a placebo and methotrexate - a standard drug used for years to treat psoriasis - to see which treatment scored best after 16 weeks on a standard scale of psoriasis treatment. The recently revealed data showed that the trial was better than expected and better than a Phase 2 trial, Freyman said.
An Abbott spokeswoman confirmed that the latest trial met its primary endpoint, or goal. Safety information from the trial will be released, along with more specific trial data, at October's European Academy of Dermatology and Venereology conference in Rhodes, Greece.
Humira, which posted $1.4 billion in global sales last year, is currently approved to treat rheumatoid arthritis, arthritis of the spine and psoriatic arthritis - but not psoriasis itself. Abbott plans to file with the U.S. Food and Drug Administration for psoriasis-treatment approval in the first half of 2007.
The skin disease is one of multiple indications that could significantly expand Humira's reach and revenue-generating potential if the treatment is approved.
Abbott announced last week that it has filed with U.S. and European regulators seeking approval to market Humira for the treatment of moderate to severe Crohn's disease, a serious and chronic intestinal inflammatory disorder.
Abbott also plans to file with the FDA next year, seeking approval to use Humira to treat juvenile rheumatoid arthritis and ulcerative colitis, another intestinal inflammatory disease.
Freyman said Abbott continues to target Humira sales of more than $1.9 billion this year, and noted that his company has said that the new indications alone represent a multibillion-dollar opportunity.
"Humira continues to meet or exceed our expectations," he said at the Bear Stearns conference.
"This is a product that's got legs," he added.
Humira is part of a class of treatments called tumor necrosis factor antagonists, or anti-TNF. TNF is a substance believed to play a role in inflammatory conditions.
article by Jon Kamp
Thursday, September 07, 2006
Improving Your Psoriasis
Dermatitis-Ltd is a blend of soothing, beneficial minerals specially formulated to work synergistically with your skin to improve the appearance of psoriasis and psoriasis-related conditions.
Individuals with psoriasis experience skin conditions such as itching, cracking, stinging, burning, or bleeding (ICN Pharmaceuticals, Inc.). These symptoms are usually worse in the winter months due to the lack of sunlight and low indoor humidity (Hall 132). The skin is most likely to crack at the joints where the body bends or in areas where the individual fails to refrain from scratching. Scratching can also lead to bleeding and infection, which is why it should be avoided at all costs. This skin condition has also been known to affect fingernails and toenails by causing pits or dents in them. There is also the possibility that the soft tissue inside the mouth and genitalia can be affected. In some cases, individuals experience joint inflammation, which can lead to the development of arthritis symptoms. This condition is known as psoriatic arthritis.
Individuals with psoriasis experience skin conditions such as itching, cracking, stinging, burning, or bleeding (ICN Pharmaceuticals, Inc.). These symptoms are usually worse in the winter months due to the lack of sunlight and low indoor humidity (Hall 132). The skin is most likely to crack at the joints where the body bends or in areas where the individual fails to refrain from scratching. Scratching can also lead to bleeding and infection, which is why it should be avoided at all costs. This skin condition has also been known to affect fingernails and toenails by causing pits or dents in them. There is also the possibility that the soft tissue inside the mouth and genitalia can be affected. In some cases, individuals experience joint inflammation, which can lead to the development of arthritis symptoms. This condition is known as psoriatic arthritis.
Tuesday, August 29, 2006
Defining Psoriasis
Psoriasis is a chronic scaling skin. It may range from just a few spots anywhere on the body to large areas of involvement. It is not contagious or spread able from one part of the body to another or from one person to another. There is no blood test to diagnose psoriasis. The diagnosis is made by observation and examination of the skin. Sometimes microscopic examination of the skin (biopsy) is helpful where the changes are not typical or characteristic. The exact cause of psoriasis is unknown, but hereditary and genetic factors are important. Psoriasis runs in families. This does not mean, however, that every child of a parent with psoriasis will develop psoriasis, but it is common that somewhere down the line psoriasis will appear in families. Psoriasis is not caused by allergies, infections, dietary deficiencies or excesses, or nervous tension.
Monday, July 10, 2006
Types Of Psoriasis
There are five different types of psoriasis. The most common form of psoriasis is called "plaque psoriasis," which is characterized by well-defined patches of red, raised skin. About 80 percent of people with psoriasis have this type. Plaque psoriasis can appear on any skin surface, although the knees, elbows, scalp, trunk and nails are the most common locations. The other types of psoriasis are: Guttate described as small, red, individual drops on the skin. Inverse psoriasis is smooth, dry areas of skin, often in folds or creases, that are red and inflamed but do not have scaling Erythrodermic psoriasis is characterized as periodic, widespread, fiery redness of the skin. Pustular psoriasis which involves either generalized, widespread areas of reddened skin, or localized areas, particularly the hands and feet (palmo-plantar pustular psoriasis).Typically, people have only one form of psoriasis at a time. Sometimes two different types can occur together, one type may change to another type, or one type may become more severe. For example, a trigger may convert plaque psoriasis to pustular.
The Chronic Psoriasis Picture
Psoriasis is a chronic scaling skin. It may range from just a few spots anywhere on the body to large areas of involvement. It is not contagious or spread able from one part of the body to another or from one person to another. There is no blood test to diagnose psoriasis. The diagnosis is made by observation and examination of the skin. Sometimes microscopic examination of the skin (biopsy) is helpful where the changes are not typical or characteristic. The exact cause of psoriasis is unknown, but hereditary and genetic factors are important. Psoriasis runs in families. This does not mean, however, that every child of a parent with psoriasis will develop psoriasis, but it is common that somewhere down the line psoriasis will appear in families. Psoriasis is not caused by allergies, infections, dietary deficiencies or excesses, or nervous tension.
Understanding Psoriasis
Psoriasis is a common immune-mediated chronic skin disease that comes in different forms and varying levels of severity. Most researchers now conclude that it is related to the immune system (psoriasis is often called an "immune-mediated" disorder).It is not contagious. In general, it is a condition that is frequently found on the knees, elbows, scalp, hands, feet or lower back. Many treatments are available to help manage its symptoms. More than 4.5 million adults in the United States have it. Between 10 percent and 30 percent of people with psoriasis also develop a related form of arthritis, called psoriatic arthritis.
Tuesday, June 27, 2006
Google Asked To Stop Running Ads Promoting 'Miracle Cures"
Contact: Michael Paranzino of Psoriasis Cure Now, 202-253-4863 or michael@psorcurenow.org Web: http://www.psorcurenow.org
KENSINGTON, Md., June 20 /U.S. Newswire/ -- "Psoriasis Cure Now," a nonprofit patient advocacy group, today asked internet search giant Google to enforce its own corporate policy against accepting advertisements that promote phony cures for incurable diseases. Google is currently running numerous paid ads designed to deceive people with psoriasis, a painful, incurable and often debilitating immune system disease that affects as many as 7.5 million Americans.
"The Google brand stands for integrity and credibility," said Michael Paranzino, president of Psoriasis Cure Now, "which is why we have asked Google to enforce its own sensible policy prohibiting ads for phony medical 'cures.' People with painful, incurable diseases are particularly vulnerable to scam artists seeking to prey on their misfortune. We hope Google will enforce its policy to protect its users from false and potentially unhealthy advertising."
Google's content policy clearly states: "Advertising is not permitted for the promotion of miracle cures, such as 'Cure cancer overnight!'" ( https://adwords.google.com/select/contentpolicy.html ) Yet as of yesterday, nine different paid ads alongside search results for the word "psoriasis" made just that kind of bogus claim, including: "Psoriasis Can Be Cured"; "New Psoriasis Cure"; "eradicate your psoriasis in 2-3 days"; and "treatment guaranteed to end Psoriasis."
Unfortunately, there is no cure for psoriasis. In fact, scientists believe a dozen or more different genes may play a role in this complex disease, along with environmental triggers that make psoriasis even more difficult to treat.
Google competitor Yahoo! is not running any psoriasis advertisements that make obviously false claims. "We applaud Yahoo! for its practice and look forward to Google enforcing its policy to protect both its users and its corporate image," Paranzino added.
KENSINGTON, Md., June 20 /U.S. Newswire/ -- "Psoriasis Cure Now," a nonprofit patient advocacy group, today asked internet search giant Google to enforce its own corporate policy against accepting advertisements that promote phony cures for incurable diseases. Google is currently running numerous paid ads designed to deceive people with psoriasis, a painful, incurable and often debilitating immune system disease that affects as many as 7.5 million Americans.
"The Google brand stands for integrity and credibility," said Michael Paranzino, president of Psoriasis Cure Now, "which is why we have asked Google to enforce its own sensible policy prohibiting ads for phony medical 'cures.' People with painful, incurable diseases are particularly vulnerable to scam artists seeking to prey on their misfortune. We hope Google will enforce its policy to protect its users from false and potentially unhealthy advertising."
Google's content policy clearly states: "Advertising is not permitted for the promotion of miracle cures, such as 'Cure cancer overnight!'" ( https://adwords.google.com/select/contentpolicy.html ) Yet as of yesterday, nine different paid ads alongside search results for the word "psoriasis" made just that kind of bogus claim, including: "Psoriasis Can Be Cured"; "New Psoriasis Cure"; "eradicate your psoriasis in 2-3 days"; and "treatment guaranteed to end Psoriasis."
Unfortunately, there is no cure for psoriasis. In fact, scientists believe a dozen or more different genes may play a role in this complex disease, along with environmental triggers that make psoriasis even more difficult to treat.
Google competitor Yahoo! is not running any psoriasis advertisements that make obviously false claims. "We applaud Yahoo! for its practice and look forward to Google enforcing its policy to protect both its users and its corporate image," Paranzino added.
Friday, June 16, 2006
The Genetics Of Psoriasis
A new gene associated with a variant of psoriasis and seborrheic dermatitis has been identified by a research group led by Dr. Ohad Birk at the Morris Kahn Laboratory of Human Genetics at Ben Gurion University and Soroka Medical Center. The gene discovered by the Israeli researchers is of much interest as it allows the first major molecular insight into why the specific skin cells proliferate excessively, causing these two common skin diseases. Psoriasis and seborrheic dermatitis affect 2-3% of the population worldwide and 85% of AIDS patients. Both skin diseases are caused by excessive proliferation of specific cells (keratinocytes) in the skin. To date, there is only very limited understanding as to the molecular mechanisms causing these two common disorders. The two-and-a-half-year study examined an Israeli Moroccan Jewish family with 44 members over five generations who showed signs characteristic of psoriasis and seborrheic dermatitis. By using advanced techniques to analyze DNA samples of the affected members of the family and comparing them to normal, unmutated DNA, Ramon Birnbaum, a doctoral student at Birk's laboratory, has succeeded in pinning the beginning of the molecular pathway on a mutation in a gene that is normally expressed, or "turned on" in the keratinocytes. The gene is believed to suppress or regulate cell proliferation and is thought to be a transcription factor, meaning that it switches on other genes, which may also play a role in the disease. When mutated, this regulation malfunctions, enabling excessive proliferation of skin cells and calling in cells of the immune system. The findings, to be reported in this month's issue of Nature Genetics, allow new insights into the mechanism of disease in psoriasis and seborrheic dermatitis. In turn, these insights are likely to assist pharmaceutical companies in developing "smart drugs" for these two common skin diseases.
Tuesday, June 06, 2006
Types Of Psoriasis
Plaque-type psoriasis is the most common form of the disease and is commonly referred to as psoriasis vulgaris (Camisa 56). It is characterized by inflamed skin lesions topped with silvery white scales. It can assume many different appearances based on where it is located, the activity of the disease, and the treatment being administered. It is most commonly found on the elbows, knees, scalp, sacrum, umbilicus, intergluteal cleft, and genitalia (Camisa 56).
Guttate psoriasis is characterized by small dot-like lesions. It is most common in children and young adults who have a prior history of upper respiratory infection, pharyngitis, or tonsillitis (Camisa 64). The lesions are not as scaly as plaque-type psoriasis and are likely to be found on the trunk and involve the face (Camisa 64).
Pustular psoriasis is characterized by pustules, which are blister-like lesions of non-infectious fluid, and intense scaling. Individuals with pustular psoriasis are often among the most seriously ill and may have to be hospitalized (Camisa 67).
Erythrodermic psoriasis is the most uncommon form of psoriasis and is characterized by intense redness and swelling, exfoliation of dead skin, and pain. Erythrodermic psoriasis usually develops during the course of chronic psoriasis, however in some cases it may be the initial type of psoriasis even in children (Camisa 74). Individuals with this type of psoriasis may experience chills, low grade fever, and may be rather uncomfortable (Camisa 75).
Inverse psoriasis is characterized by smooth inflamed lesions in the body folds -- armpits, under the breast, skin folds of the groin, buttocks, and genitals.
Koebner's Phenomenon psoriasis are psoriatic lesions which appear at the site of injury, infection or other skin psoriasis, or may be a new lesion in an existing case.
The degree of psoriasis can also vary from individual to individual. It ranges in severity from mild (affects less than 2% of body) to moderate (affects 2-10% of body) to severe (affects greater than 10% of the body). Skin injury and irritation, sun exposure, diet, stress and anxiety, medications, and infections have been known to make psoriasis worse.
Guttate psoriasis is characterized by small dot-like lesions. It is most common in children and young adults who have a prior history of upper respiratory infection, pharyngitis, or tonsillitis (Camisa 64). The lesions are not as scaly as plaque-type psoriasis and are likely to be found on the trunk and involve the face (Camisa 64).
Pustular psoriasis is characterized by pustules, which are blister-like lesions of non-infectious fluid, and intense scaling. Individuals with pustular psoriasis are often among the most seriously ill and may have to be hospitalized (Camisa 67).
Erythrodermic psoriasis is the most uncommon form of psoriasis and is characterized by intense redness and swelling, exfoliation of dead skin, and pain. Erythrodermic psoriasis usually develops during the course of chronic psoriasis, however in some cases it may be the initial type of psoriasis even in children (Camisa 74). Individuals with this type of psoriasis may experience chills, low grade fever, and may be rather uncomfortable (Camisa 75).
Inverse psoriasis is characterized by smooth inflamed lesions in the body folds -- armpits, under the breast, skin folds of the groin, buttocks, and genitals.
Koebner's Phenomenon psoriasis are psoriatic lesions which appear at the site of injury, infection or other skin psoriasis, or may be a new lesion in an existing case.
The degree of psoriasis can also vary from individual to individual. It ranges in severity from mild (affects less than 2% of body) to moderate (affects 2-10% of body) to severe (affects greater than 10% of the body). Skin injury and irritation, sun exposure, diet, stress and anxiety, medications, and infections have been known to make psoriasis worse.
Wednesday, May 31, 2006
Folk Remedies Have A Place In The Treatment Of Psoriasis
Psoriasis is a difficult disorder to treat. But researchers report in the American Journal of Therapeutics that they have identified a natural preparation from a plant that effectively treats mild to moderate psoriasis. The plant, Mahonia aquifolium, grows wild in North America and was used in folk medicine to treat skin diseases.
Psoriasis is a difficult disorder to treat because the severity and distribution of psoriatic plaques varies immensely, and because current medications can have undesirable side effects. This common skin disorder affects more than 4.5 million people in North America.
But according to an article in the American Journal of Therapeutics (March/April 2006, Volume 13, No. 2, p. 121-126), a natural preparation from a plant holds promise for psoriasis sufferers.
Steve Bernstein and other researchers from the Dermatology and Cosmetic Center in Rochester, New York conducted a randomized, double-blind, placebo-controlled study using a proprietary topical cream prepared with Mahonia aquifolium.
This plant, also known as the barberry, Oregon grape, or berberis, grows wild in North and South American and Europe. It was initially used in American folk medicine as an oral medication for inflammatory skin diesases including psoriasis and syphilis.
Of the 200 psoriasis patients enrolled in the trial, 97 completed the 12-week course and 74 completed the same regimen using a placebo cream.
Bernstein and his colleagues traced a statistically significant improvement of the signs and symptoms of moderate plaque psoriasis compared with patients receiving placebo. The medication was well tolerated when applied to the affected area twice a day for twelve weeks. No significant side effects were reported by either the active or control group.
The researchers concluded that the cream containing Mahonia aquifolium extract is a safe and effective treatment for mild to moderate psoriasis.
Psoriasis is a difficult disorder to treat because the severity and distribution of psoriatic plaques varies immensely, and because current medications can have undesirable side effects. This common skin disorder affects more than 4.5 million people in North America.
But according to an article in the American Journal of Therapeutics (March/April 2006, Volume 13, No. 2, p. 121-126), a natural preparation from a plant holds promise for psoriasis sufferers.
Steve Bernstein and other researchers from the Dermatology and Cosmetic Center in Rochester, New York conducted a randomized, double-blind, placebo-controlled study using a proprietary topical cream prepared with Mahonia aquifolium.
This plant, also known as the barberry, Oregon grape, or berberis, grows wild in North and South American and Europe. It was initially used in American folk medicine as an oral medication for inflammatory skin diesases including psoriasis and syphilis.
Of the 200 psoriasis patients enrolled in the trial, 97 completed the 12-week course and 74 completed the same regimen using a placebo cream.
Bernstein and his colleagues traced a statistically significant improvement of the signs and symptoms of moderate plaque psoriasis compared with patients receiving placebo. The medication was well tolerated when applied to the affected area twice a day for twelve weeks. No significant side effects were reported by either the active or control group.
The researchers concluded that the cream containing Mahonia aquifolium extract is a safe and effective treatment for mild to moderate psoriasis.
Monday, May 22, 2006
The Historical Picture Of Psoriasis
Psoriasis has been around since the days of Greek mythology, more than 2,500 years ago. It was considered a curse from the gods.The Bible refers to psoriasis but mistakenly calls it leprosy. For hundreds of years, people with the disease were ostracized and forced to wander as homeless beggars. Some had to wear warning bells so others could avoid their paths. Some suffered the same fate as lepers, who were burned at the stake in the 14th century."Amazingly, psoriasis was a disease that had been misunderstood for more than 2,000 years before it was clearly defined (in the early 1800s) and named what we know it as today."
Tuesday, May 16, 2006
Living With Nail Psoriasis
Erosion of the nail plate and tenderness of the fingertip may have several causes, the most common being onycholysis, a spontaneous separation of the nail plate from the underlying skin. It classically occurs at the distal end of the nail and can be quite painful. It is a common condition, primarily occurring in females and in the elderly. Treatment consists of avoiding trauma to the nail, avoiding irritants and keeping the nail dry.
Another common condition is fungal infections of the nail (medical term: onychomycosis), and this should be considered especially if the condition is spreading to other nails, as is the case with this reader. Note that dermatologists often see patients with obvious clinical evidence of fungal even though the lab tests are negative, so a course of oral anti-fungal therapy might still be indicated. There are also a whole host of other conditions that your dermatologist could consider, including bacterial infections, eczema, psoriasis and even warts beneath the nail. These are far too numerous to list here, but your dermatologist should be familiar with the most common ones.
You should also realize that many nail disorders are extremely difficult to treat since the nail plate is not "living" tissue. Many nail disorders are incurable, but pain or tenderness should be relieved with appropriate therapy.
comment by Dr. Julian Schamroth, a veteran Jerusalem dermatologist
Another common condition is fungal infections of the nail (medical term: onychomycosis), and this should be considered especially if the condition is spreading to other nails, as is the case with this reader. Note that dermatologists often see patients with obvious clinical evidence of fungal even though the lab tests are negative, so a course of oral anti-fungal therapy might still be indicated. There are also a whole host of other conditions that your dermatologist could consider, including bacterial infections, eczema, psoriasis and even warts beneath the nail. These are far too numerous to list here, but your dermatologist should be familiar with the most common ones.
You should also realize that many nail disorders are extremely difficult to treat since the nail plate is not "living" tissue. Many nail disorders are incurable, but pain or tenderness should be relieved with appropriate therapy.
comment by Dr. Julian Schamroth, a veteran Jerusalem dermatologist
Wednesday, May 10, 2006
A Factual Picture Of Psoriasis
Psoriasis facts and figures.
Psoriasis is a chronic skin condition affecting approximately 4.5 million people in the United States.
New skin cells grow too rapidly, resulting in inflamed, swollen, scaly patches of skin in areas where the old skin has not shed quickly enough.
Psoriasis can be limited to a few spots or can involve more extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.
Psoriasis is not a contagious disease. The cause of psoriasis is unknown, and there currently is no cure.
Psoriasis can strike people at any age, but the average age of onset is approximately 28 years. Likewise, it affects both men and women, with a slightly higher prevalence in women than in men.
Approximately 30 percent of people with psoriasis are estimated to have moderate-to-severe forms of the disease.Psoriasis can be a physically and emotionally painful condition. It often results in physical limitations, disfiguration and a significant burden in managing the daily care of the disease.
Psoriasis sufferers may feel embarrassed, angry, frustrated, fearful, depressed and, in some cases, even suicidal.
Psoriasis is a chronic skin condition affecting approximately 4.5 million people in the United States.
New skin cells grow too rapidly, resulting in inflamed, swollen, scaly patches of skin in areas where the old skin has not shed quickly enough.
Psoriasis can be limited to a few spots or can involve more extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.
Psoriasis is not a contagious disease. The cause of psoriasis is unknown, and there currently is no cure.
Psoriasis can strike people at any age, but the average age of onset is approximately 28 years. Likewise, it affects both men and women, with a slightly higher prevalence in women than in men.
Approximately 30 percent of people with psoriasis are estimated to have moderate-to-severe forms of the disease.Psoriasis can be a physically and emotionally painful condition. It often results in physical limitations, disfiguration and a significant burden in managing the daily care of the disease.
Psoriasis sufferers may feel embarrassed, angry, frustrated, fearful, depressed and, in some cases, even suicidal.
Monday, May 01, 2006
Signs And Symptoms Of Scalp Psoriasis
Psoriasis that affects the scalp is also called seborrheic psoriasis. The scalp may be the first site to be affected by psoriasis. The condition may resemble severe dandruff. Patches of thick, flaky skin may extend to the forehead below the hairline. Scales may build up in the outer ear. Other than the forehead and the ears, the face is usually spared. However, some people may have patches of inflamed skin that resemble seborrheic dermatitis a type of dandruff eczema that affects the scalp and face.Psoriasis on the scalp is common and, in many cases, it is the only area affected. It usually consists of red, scaly patches that are sometimes lumpy. The edge of the patch tends to be well defined. This type of psoriasis can extend beyond the hairline, onto the forehead. Psoriasis of the scalp does not damage the hair follicle and is not associated with alopecia (hair loss), but if the scale is thick and forms hard lumps, it can lead to temporary hair thinning. However, this is not permanent and will grow back again after the psoriasis clears.This form of psoriasis can be extremely uncomfortable. It is often very itchy, and the psoriatic patches that are inflamed and sore can start to bleed if they are scratched or picked. The condition is not caused by poor hygiene or hair care. Scalp psoriasis can be demoralizing, as the look of dead skin cells on clothing can be embarrassing, and it is not always easy to brush them off inconspicuously. Itchiness is another big problem, not only because of the social implication but also because it inflames the condition and makes it worse. Forehead along the hairline is a common site as is the temples, nape of the neck, around the ears, as well as the hair parting. Massaging a little warm baby/olive/coconut oil gently into the scalp, preferably before going to bed to allow plenty of time to soak (bind up the head in an old towel) will help. Wash out with cream shampoo (i.e. Dry Hair Products), add a little lemon juice to the final rinse to get rid of excess grease. Only shampoo three times a week, more than this and the natural oils may be washed out. Always treat the head as gently as possible, do not comb or brush harshly. Perms and colorants can be used as long as the skin is not broken. Shampoo the hair and scalp with a tar-based shampoo that can be purchased over-the-counter or by prescription. Shampoos, scalp steroid lotions, vitamin D analogues and some tar preparations such as tar pomade may be used on the scalp.
Wednesday, April 26, 2006
Signs And Symptoms Of Psoriatic Arthirtis
Although psoriatic arthritis normally affects only people with psoriasis, skin and joint problems usually don't develop simultaneously. Many people have psoriasis long before they develop arthritic symptoms, and a few have joint pain for decades before skin symptoms appear. But to receive a diagnosis of psoriatic arthritis, you must have signs and symptoms of both conditions:
Patches of thick, red skin covered with silvery scales, especially on your elbows, knees, scalp or the lower end of your spine. These patches (plaques often itch or burn, and the skin at your joints may crack.
Pain, redness, swelling and reduced motion in your joints — especially the small joints at the ends of your fingers and toes. The joints in your spine and your sacroiliac joints — the two large joints that connect your pelvis and the triangular bone at the end of your spine (sacrum) — also may be affected.
Stiffness and fatigue in the morning.
Pitted, discolored nails that may separate from the nail beds.
Eye inflammations such as conjunctivitis or iritis.
In addition to general arthritic symptoms, there are five distinct types of psoriatic arthritis, each with its own characteristics:
Asymmetric arthritis. The mildest form of psoriatic arthritis, asymmetric arthritis usually affects joints on only one side of your body or different joints on each side — including those in your hip, knee, ankle or wrist. One to three joints are generally involved, and they're often tender and red. When asymmetric arthritis occurs in your hands and feet, swelling and inflammation in the tendons can cause your fingers and toes to resemble small sausages (dactylitis).
Symmetric arthritis. Unlike asymmetric arthritis, symmetric arthritis usually affects four or more of the same joints on both sides of your body. It's similar to rheumatoid arthritis, one of the most common and debilitating of the many arthritic conditions. Although symmetric arthritis is generally milder than rheumatoid arthritis, it can cause progressively disabling joint damage. More women than men have symmetric arthritis, and psoriasis associated with this condition tends to be severe.
Distal interphalangeal joint predominant (DIP). A small percentage of people with psoriatic arthritis — most of them men — have DIP, which affects the small joints closest to the nails (distal joints) in the fingers and toes. DIP is sometimes misdiagnosed as osteoarthritis, a type of arthritis that results from the destruction of cartilage on the ends of the bones. But psoriatic arthritis usually causes nail problems that don't occur with osteoarthritis.
Spondylitis. This form of psoriatic arthritis can cause inflammation in your spine as well as stiffness and inflammation in your neck, lower back or sacroiliac joints. Inflammation can also occur where ligaments and tendons attach to your spine. As the disease progresses, movement tends to become increasingly painful and difficult. Psoriatic spondylitis isn't the same as ankylosing spondylitis, another arthritic condition. Ankylosing spondylitis doesn't occur with psoriasis and usually affects the entire spine, whereas psoriatic spondylitis may affect only your neck or low back.
Arthritis mutilans. A small percentage of people with psoriatic arthritis have arthritis mutilans — a severe, painful and crippling form of the disease. Over time, arthritis mutilans destroys the small bones in the hands, especially the fingers, leading to permanent deformity and disability.
The symptoms of psoriatic arthritis are likely to be better at some times and worse at others. But because skin and joint problems frequently flare up and go into remission at different times, you may have severe psoriasis when your joints are relatively pain-free and aching joints when your skin clears.
Juvenile psoriatic arthritisChildren with psoriatic arthritis usually develop signs and symptoms of the disease around age 9 or 10. Symptoms are often mild, although some children may have severe and debilitating problems that last into adulthood.
In general, children have many of the same signs and symptoms that adults do, but they're more likely to develop skin and joint problems simultaneously. And because children's bones are still forming, abnormal bone development can affect growth.
Patches of thick, red skin covered with silvery scales, especially on your elbows, knees, scalp or the lower end of your spine. These patches (plaques often itch or burn, and the skin at your joints may crack.
Pain, redness, swelling and reduced motion in your joints — especially the small joints at the ends of your fingers and toes. The joints in your spine and your sacroiliac joints — the two large joints that connect your pelvis and the triangular bone at the end of your spine (sacrum) — also may be affected.
Stiffness and fatigue in the morning.
Pitted, discolored nails that may separate from the nail beds.
Eye inflammations such as conjunctivitis or iritis.
In addition to general arthritic symptoms, there are five distinct types of psoriatic arthritis, each with its own characteristics:
Asymmetric arthritis. The mildest form of psoriatic arthritis, asymmetric arthritis usually affects joints on only one side of your body or different joints on each side — including those in your hip, knee, ankle or wrist. One to three joints are generally involved, and they're often tender and red. When asymmetric arthritis occurs in your hands and feet, swelling and inflammation in the tendons can cause your fingers and toes to resemble small sausages (dactylitis).
Symmetric arthritis. Unlike asymmetric arthritis, symmetric arthritis usually affects four or more of the same joints on both sides of your body. It's similar to rheumatoid arthritis, one of the most common and debilitating of the many arthritic conditions. Although symmetric arthritis is generally milder than rheumatoid arthritis, it can cause progressively disabling joint damage. More women than men have symmetric arthritis, and psoriasis associated with this condition tends to be severe.
Distal interphalangeal joint predominant (DIP). A small percentage of people with psoriatic arthritis — most of them men — have DIP, which affects the small joints closest to the nails (distal joints) in the fingers and toes. DIP is sometimes misdiagnosed as osteoarthritis, a type of arthritis that results from the destruction of cartilage on the ends of the bones. But psoriatic arthritis usually causes nail problems that don't occur with osteoarthritis.
Spondylitis. This form of psoriatic arthritis can cause inflammation in your spine as well as stiffness and inflammation in your neck, lower back or sacroiliac joints. Inflammation can also occur where ligaments and tendons attach to your spine. As the disease progresses, movement tends to become increasingly painful and difficult. Psoriatic spondylitis isn't the same as ankylosing spondylitis, another arthritic condition. Ankylosing spondylitis doesn't occur with psoriasis and usually affects the entire spine, whereas psoriatic spondylitis may affect only your neck or low back.
Arthritis mutilans. A small percentage of people with psoriatic arthritis have arthritis mutilans — a severe, painful and crippling form of the disease. Over time, arthritis mutilans destroys the small bones in the hands, especially the fingers, leading to permanent deformity and disability.
The symptoms of psoriatic arthritis are likely to be better at some times and worse at others. But because skin and joint problems frequently flare up and go into remission at different times, you may have severe psoriasis when your joints are relatively pain-free and aching joints when your skin clears.
Juvenile psoriatic arthritisChildren with psoriatic arthritis usually develop signs and symptoms of the disease around age 9 or 10. Symptoms are often mild, although some children may have severe and debilitating problems that last into adulthood.
In general, children have many of the same signs and symptoms that adults do, but they're more likely to develop skin and joint problems simultaneously. And because children's bones are still forming, abnormal bone development can affect growth.
Psoriatic Arthritis
Tens of millions of Americans experience the pain and physical limitations of arthritis. Yet arthritis isn't a single medical problem but a group of more than 100 conditions that can cause inflammation in your joints, muscles, tendons, ligaments and bones.
One of these conditions is psoriatic arthritis, which may affect as many as 1 million of the approximately 6 million Americans who have psoriasis. Most are adults in their 30s, 40s and 50s, but children also can develop a form of the disease.
In addition to the inflamed, scaly skin that's typical of psoriasis, people with psoriatic arthritis have swollen, painful joints — especially in their fingers and toes — and pitted, discolored nails. They may also develop inflammatory eye conditions such as conjunctivitis.
There are several types of psoriatic arthritis, with symptoms that range from mild to severe. In general, the disease isn't as crippling as other forms of arthritis, but if left untreated it can cause discomfort, disability and deformity. Although no cure exists for psoriatic arthritis, medication, physical therapy and lifestyle changes often can relieve pain and slow the progression of joint damage.
One of these conditions is psoriatic arthritis, which may affect as many as 1 million of the approximately 6 million Americans who have psoriasis. Most are adults in their 30s, 40s and 50s, but children also can develop a form of the disease.
In addition to the inflamed, scaly skin that's typical of psoriasis, people with psoriatic arthritis have swollen, painful joints — especially in their fingers and toes — and pitted, discolored nails. They may also develop inflammatory eye conditions such as conjunctivitis.
There are several types of psoriatic arthritis, with symptoms that range from mild to severe. In general, the disease isn't as crippling as other forms of arthritis, but if left untreated it can cause discomfort, disability and deformity. Although no cure exists for psoriatic arthritis, medication, physical therapy and lifestyle changes often can relieve pain and slow the progression of joint damage.
Tuesday, April 18, 2006
Treating Psoriasis With Immune Suppressants, Steroids, Lotions And Tar
Topical lotions, ointments, creams, gels, and shampoos for the skin and scalp are prescribed for mild-to-moderate cases of psoriasis or in combination with other treatments for more severe cases. FDA-approved prescription topicals to treat psoriasis include corticosteroids, retinoids, calcipotriene, and coal tar products. These drugs slow down skin cell production and reduce inflammation.
Corticosteroids are synthetic drugs that resemble naturally occurring hormones. Side effects may include thinning of the skin and stretch marks at the area where the topical is applied. Corticosteroids may also suppress the adrenal glands' production of natural steroids, which could leave the body susceptible to disease.
Retinoids are derivatives of vitamin A and calcipotriene is a synthetic form of vitamin D. Retinoids and calcipotriene are not the same as over-the-counter vitamin A and D supplements, which have no value for treating psoriasis, says Wilkin. "These topical creams on the skin deliver the vitamin-like chemicals right to where you want them," he says. Skin irritation where the topical is applied may be a side effect. Retinoids are also available by prescription as oral systemic drugs.
Coal tar products can help with scaling, itching, and inflammation but are not used as commonly as some other topicals, says Lindstrom. They are messy, can stain, and have a strong odor.
Carol Bentson of Washington, D.C., has had plaque psoriasis for more than 30 years, causing "major itching" all over and pain along the scalp line. She has treated it with topical corticosteroids, ultraviolet light, and cortisone injected into her scalp, elbows, toes, and legs. At times, "ointment wouldn't penetrate the areas of heavy plaque buildup, no matter how much I put on," she says.
Bentson has accumulated "sacks of lotions" to treat psoriasis. She would find a topical treatment that worked for a while but then quit working, forcing her to switch to another one.
"With a potent topical steroid, there is a phenomenon called tachyphylaxis," says Craig Leonardi, M.D., associate clinical professor of dermatology at the Saint Louis University Medical School. "Prolonged use can cause down-regulation [decrease] of steroid receptors in cells. The net effect is that the skin becomes less responsive to steroids over time."
Wilkin adds that this unresponsiveness may be a temporary effect. "A patient may need to be off the steroid for a few days or a week and when put back on it, the responsiveness could come back."
Exposing the skin to ultraviolet (UV) light--either from the sun or an artificial source--sets off a biological process that kills T cells, which slows the buildup of skin cells and reduces inflammation.
Light boxes that emit UV light to treat moderate-to-severe psoriasis and other skin diseases are medical devices that require licensing by the FDA. A person steps into the light box, which is about the size of a telephone booth, while lamps direct the light onto the body.
"Treatment with these devices is complex," says Richard Felten, an FDA chemist and senior medical device reviewer. The physician must determine an individual's sensitivity to UV and adjust the light emissions for the most effective treatment with the least risk of side effects, he says. Side effects may include burning, darkened skin, premature aging, and skin cancer. Three to five treatments per week for several weeks or months may be needed to get the psoriasis under control, followed by weekly maintenance treatments.
Light therapy, or phototherapy, is usually done in the physician's office or a medical facility that has the devices, says Felten. "The FDA has cleared some devices for home use under certain conditions and with a doctor's prescription," he says. Home devices include handheld devices for scalp psoriasis and stand-alone light boxes for other areas of the body.
Light therapy usually involves a short wavelength of ultraviolet light, called UVB. For people with resistant moderate-to-severe psoriasis, a combination of an oral or topical drug called psoralen and a longer wavelength ultraviolet A (UVA) light is used. This treatment is called "psoralen plus UVA" (PUVA).
"Psoralen makes the patient more sensitive to the UVA," says Lindstrom, "so once they've taken a dose of psoralen, a smaller dose of UVA is needed to treat them." Patients must be very careful to protect both skin and eyes for 24 hours after psoralen use to prevent damage, she says.
The FDA has also approved a special type of laser, an excimer laser, as a phototherapy device to treat mild-to-moderate psoriasis. "These lasers can deliver a much more controlled beam of light to small areas of the affected skin," says Felten.
The FDA has approved oral and injected drugs that circulate throughout the body to treat psoriasis that is moderate, severe, or disabling. These systemic drugs are very powerful, and while some may be used continuously, others can only be used for a limited time because of their severe side effects. Once a drug is discontinued, the psoriasis may reactivate. The risk of birth defects prevents many systemics from being taken by pregnant women or women planning to become pregnant.
Systemic drugs that may be prescribed for psoriasis include acitretin, methotrexate, cyclosporine, and biologics, which are drugs made from proteins of living cells. Methotrexate, cyclosporine, and the biologic drugs are immunosuppressants, meaning they lower the body's normal immune response. "These drugs suppress the immune cells that cause psoriasis, but they don't distinguish these cells from the immune cells that protect our body from infections," says Elektra Papadopoulos, M.D., an FDA dermatologist.
Acitretin, a retinoid that is given orally for severe psoriasis, helps normalize the growth of skin cells. One of the side effects is raised fat (lipid) levels in the blood, and people taking this drug must get regular blood tests to monitor their cholesterol and triglyceride levels.
Methotrexate and cyclosporine slow the growth of skin cells. Methotrexate, taken orally or by injection, is also a chemotherapy drug for cancer patients. Cyclosporine, taken orally, was first approved to prevent organ rejection in transplant recipients. People using either of these drugs must be closely monitored and should use them only for short periods of time because of serious, potentially fatal, side effects.
Biologics are the newest systemic psoriasis treatments. Since 2003, the FDA has licensed three biologics to treat moderate-to-severe plaque psoriasis: Amevive (alefacept), manufactured by Biogen Inc.; Raptiva (efalizumab), made by Genentech Inc.; and Enbrel (etanercept), marketed by Amgen Inc. and Wyeth Pharmaceuticals. Enbrel was first licensed in 2002 to treat the arthritis associated with psoriasis, and in 2004 to treat psoriasis itself.
"All are immunosuppressive and have different proposed mechanisms," says Papadopoulos. Amevive simultaneously reduces the number of immune cells, including T cells, and inhibits T-cell activation. Raptiva inhibits the activation of T cells and the migration of those cells across blood vessels and into tissues, including the skin.
Enbrel inhibits the action of an inflammatory chemical messenger in the immune system called tumor necrosis factor-alpha (TNF-alpha), which is believed to play a role in both the skin and the joint symptoms of psoriasis.
All three biologics are injected. The FDA has licensed Amevive to be given in a physician's office, either injected into the muscle or into a vein (intravenously). It's a once-a-week treatment for 12 weeks; further treatments may be given after a waiting period.
The FDA has licensed Raptiva and Enbrel for home treatment. People can inject themselves with Raptiva under the skin once a week or with Enbrel once or twice a week. Both drugs are recommended for continuous use to maintain results.
Since biologic drugs are immunosuppressants, they may carry an increased risk of infection and cancer. Rare but serious effects have also included blood abnormalities and autoimmune diseases such as lupus. Other side effects are flu-like symptoms and pain and inflammation at the injection site.
Some dermatologists prescribe biologics alone for psoriasis or in combination with topical treatments. Leonardi says when he prescribes biologics, "I don't have to resort to adding other systemic therapies such as methotrexate, cyclosporine, acitretin, or phototherapy."
"Biologics are an alternative treatment to some of the traditional therapies," says Papadopoulos.
"Now we need to get the expense down," says Leonardi, who has patients who pay $30,000 per year on drugs to treat psoriasis.
Bird feels fortunate that her insurance company covers most of the expense of Enbrel, which is prescribed for both her psoriasis and psoriatic arthritis. Because of the arthritis pain, she has used a cane to help her walk and has had surgery on her wrist to correct some of the arthritis damage. Although Enbrel has been less effective over time for the psoriasis, she says, it's reduced her arthritic pain by about 95 percent. "I can jog down to the corner to chase after the dog," she says. "And last summer, I went hiking with my children in Colorado."
Reducing Treatment Risks
Biologics, other systemic drugs, and phototherapy are powerful treatments with increased risks, says Lindstrom.
Biologics may raise the risk for developing cancer and serious bacterial or fungal infections that spread throughout the body (sepsis).
Cyclosporine can damage the kidneys, methotrexate puts the liver and lungs at risk, and phototherapy can cause skin cancer. To reduce these risks, doctors often put patients on "rotational therapy." "The thought is by moving from one therapy to another therapy over time, the risk to any individual organ is reduced," says Lindstrom.
"We also try to choose a drug with an appropriate benefit-risk ratio," she says. For mild psoriasis, a topical steroid may be appropriate. For more severe disease, where it becomes impractical to apply topicals over a large surface area several times a day, a patient may need a systemic treatment.
Most of the highly effective treatments for psoriasis affect the immune system in some way. For steroid drugs, which have been around for more than 50 years, the risks are well known. But less is known about the long-term side effects of newer drugs, such as the biologics. The safety and side effects of biologics and other immune-suppressing drugs to treat psoriasis continue to be monitored by drug manufacturers and the FDA.
For many people, dealing with the emotional impact of psoriasis can be as challenging as treating the disease.
Bird says that mothers have pulled their children away from her on the subway, and some people, horrified by her skin lesions, have asked her if she has AIDS. As her disease has evolved over 30 years, so has Bird's way of dealing with these reactions. In her teens, she'd tell people she had leprosy just for the shock value, she says. Today, Bird is open about the disease but still relies on her defiant attitude to "steel myself for the experience" of going to the beach. "I love to swim," she says. But Bird knows that without covering herself up in a public place, she "runs the risk of people just rubbernecking."
"When I'm feeling forgiving, I try to ignore them," she says, "but when I'm angry, I think 'didn't your mother teach you not to stare?'"
Bird advises others with psoriasis to find out what works best for them to cope with the emotional effects of the disease. Going to therapy has helped her, she says. So has leading a support group for psoriasis sufferers. "It's important for people to work on their emotional well-being," says Bird, "however they choose--whether it's meditation, yoga, or putting on long pants and going out dancing."
Researchers continue to look for reasons why immune cells overreact and what genes may be responsible for psoriasis, hoping to find better treatments, and eventually a cure. Psoriasis research is aided by the visibility of the symptoms on the skin.
"You can see the disease," says Leonardi. "You don't have to do invasive testing to see the effects of therapy." Psoriasis research has a "tremendous spillover into other fields besides dermatology," he adds. "There is a huge need for drugs to suppress the immune system without the side effects."
Multiple sclerosis, Crohn's disease, rheumatoid arthritis, and type 1 diabetes are just a few of the diseases that may also benefit from psoriasis research.
Corticosteroids are synthetic drugs that resemble naturally occurring hormones. Side effects may include thinning of the skin and stretch marks at the area where the topical is applied. Corticosteroids may also suppress the adrenal glands' production of natural steroids, which could leave the body susceptible to disease.
Retinoids are derivatives of vitamin A and calcipotriene is a synthetic form of vitamin D. Retinoids and calcipotriene are not the same as over-the-counter vitamin A and D supplements, which have no value for treating psoriasis, says Wilkin. "These topical creams on the skin deliver the vitamin-like chemicals right to where you want them," he says. Skin irritation where the topical is applied may be a side effect. Retinoids are also available by prescription as oral systemic drugs.
Coal tar products can help with scaling, itching, and inflammation but are not used as commonly as some other topicals, says Lindstrom. They are messy, can stain, and have a strong odor.
Carol Bentson of Washington, D.C., has had plaque psoriasis for more than 30 years, causing "major itching" all over and pain along the scalp line. She has treated it with topical corticosteroids, ultraviolet light, and cortisone injected into her scalp, elbows, toes, and legs. At times, "ointment wouldn't penetrate the areas of heavy plaque buildup, no matter how much I put on," she says.
Bentson has accumulated "sacks of lotions" to treat psoriasis. She would find a topical treatment that worked for a while but then quit working, forcing her to switch to another one.
"With a potent topical steroid, there is a phenomenon called tachyphylaxis," says Craig Leonardi, M.D., associate clinical professor of dermatology at the Saint Louis University Medical School. "Prolonged use can cause down-regulation [decrease] of steroid receptors in cells. The net effect is that the skin becomes less responsive to steroids over time."
Wilkin adds that this unresponsiveness may be a temporary effect. "A patient may need to be off the steroid for a few days or a week and when put back on it, the responsiveness could come back."
Exposing the skin to ultraviolet (UV) light--either from the sun or an artificial source--sets off a biological process that kills T cells, which slows the buildup of skin cells and reduces inflammation.
Light boxes that emit UV light to treat moderate-to-severe psoriasis and other skin diseases are medical devices that require licensing by the FDA. A person steps into the light box, which is about the size of a telephone booth, while lamps direct the light onto the body.
"Treatment with these devices is complex," says Richard Felten, an FDA chemist and senior medical device reviewer. The physician must determine an individual's sensitivity to UV and adjust the light emissions for the most effective treatment with the least risk of side effects, he says. Side effects may include burning, darkened skin, premature aging, and skin cancer. Three to five treatments per week for several weeks or months may be needed to get the psoriasis under control, followed by weekly maintenance treatments.
Light therapy, or phototherapy, is usually done in the physician's office or a medical facility that has the devices, says Felten. "The FDA has cleared some devices for home use under certain conditions and with a doctor's prescription," he says. Home devices include handheld devices for scalp psoriasis and stand-alone light boxes for other areas of the body.
Light therapy usually involves a short wavelength of ultraviolet light, called UVB. For people with resistant moderate-to-severe psoriasis, a combination of an oral or topical drug called psoralen and a longer wavelength ultraviolet A (UVA) light is used. This treatment is called "psoralen plus UVA" (PUVA).
"Psoralen makes the patient more sensitive to the UVA," says Lindstrom, "so once they've taken a dose of psoralen, a smaller dose of UVA is needed to treat them." Patients must be very careful to protect both skin and eyes for 24 hours after psoralen use to prevent damage, she says.
The FDA has also approved a special type of laser, an excimer laser, as a phototherapy device to treat mild-to-moderate psoriasis. "These lasers can deliver a much more controlled beam of light to small areas of the affected skin," says Felten.
The FDA has approved oral and injected drugs that circulate throughout the body to treat psoriasis that is moderate, severe, or disabling. These systemic drugs are very powerful, and while some may be used continuously, others can only be used for a limited time because of their severe side effects. Once a drug is discontinued, the psoriasis may reactivate. The risk of birth defects prevents many systemics from being taken by pregnant women or women planning to become pregnant.
Systemic drugs that may be prescribed for psoriasis include acitretin, methotrexate, cyclosporine, and biologics, which are drugs made from proteins of living cells. Methotrexate, cyclosporine, and the biologic drugs are immunosuppressants, meaning they lower the body's normal immune response. "These drugs suppress the immune cells that cause psoriasis, but they don't distinguish these cells from the immune cells that protect our body from infections," says Elektra Papadopoulos, M.D., an FDA dermatologist.
Acitretin, a retinoid that is given orally for severe psoriasis, helps normalize the growth of skin cells. One of the side effects is raised fat (lipid) levels in the blood, and people taking this drug must get regular blood tests to monitor their cholesterol and triglyceride levels.
Methotrexate and cyclosporine slow the growth of skin cells. Methotrexate, taken orally or by injection, is also a chemotherapy drug for cancer patients. Cyclosporine, taken orally, was first approved to prevent organ rejection in transplant recipients. People using either of these drugs must be closely monitored and should use them only for short periods of time because of serious, potentially fatal, side effects.
Biologics are the newest systemic psoriasis treatments. Since 2003, the FDA has licensed three biologics to treat moderate-to-severe plaque psoriasis: Amevive (alefacept), manufactured by Biogen Inc.; Raptiva (efalizumab), made by Genentech Inc.; and Enbrel (etanercept), marketed by Amgen Inc. and Wyeth Pharmaceuticals. Enbrel was first licensed in 2002 to treat the arthritis associated with psoriasis, and in 2004 to treat psoriasis itself.
"All are immunosuppressive and have different proposed mechanisms," says Papadopoulos. Amevive simultaneously reduces the number of immune cells, including T cells, and inhibits T-cell activation. Raptiva inhibits the activation of T cells and the migration of those cells across blood vessels and into tissues, including the skin.
Enbrel inhibits the action of an inflammatory chemical messenger in the immune system called tumor necrosis factor-alpha (TNF-alpha), which is believed to play a role in both the skin and the joint symptoms of psoriasis.
All three biologics are injected. The FDA has licensed Amevive to be given in a physician's office, either injected into the muscle or into a vein (intravenously). It's a once-a-week treatment for 12 weeks; further treatments may be given after a waiting period.
The FDA has licensed Raptiva and Enbrel for home treatment. People can inject themselves with Raptiva under the skin once a week or with Enbrel once or twice a week. Both drugs are recommended for continuous use to maintain results.
Since biologic drugs are immunosuppressants, they may carry an increased risk of infection and cancer. Rare but serious effects have also included blood abnormalities and autoimmune diseases such as lupus. Other side effects are flu-like symptoms and pain and inflammation at the injection site.
Some dermatologists prescribe biologics alone for psoriasis or in combination with topical treatments. Leonardi says when he prescribes biologics, "I don't have to resort to adding other systemic therapies such as methotrexate, cyclosporine, acitretin, or phototherapy."
"Biologics are an alternative treatment to some of the traditional therapies," says Papadopoulos.
"Now we need to get the expense down," says Leonardi, who has patients who pay $30,000 per year on drugs to treat psoriasis.
Bird feels fortunate that her insurance company covers most of the expense of Enbrel, which is prescribed for both her psoriasis and psoriatic arthritis. Because of the arthritis pain, she has used a cane to help her walk and has had surgery on her wrist to correct some of the arthritis damage. Although Enbrel has been less effective over time for the psoriasis, she says, it's reduced her arthritic pain by about 95 percent. "I can jog down to the corner to chase after the dog," she says. "And last summer, I went hiking with my children in Colorado."
Reducing Treatment Risks
Biologics, other systemic drugs, and phototherapy are powerful treatments with increased risks, says Lindstrom.
Biologics may raise the risk for developing cancer and serious bacterial or fungal infections that spread throughout the body (sepsis).
Cyclosporine can damage the kidneys, methotrexate puts the liver and lungs at risk, and phototherapy can cause skin cancer. To reduce these risks, doctors often put patients on "rotational therapy." "The thought is by moving from one therapy to another therapy over time, the risk to any individual organ is reduced," says Lindstrom.
"We also try to choose a drug with an appropriate benefit-risk ratio," she says. For mild psoriasis, a topical steroid may be appropriate. For more severe disease, where it becomes impractical to apply topicals over a large surface area several times a day, a patient may need a systemic treatment.
Most of the highly effective treatments for psoriasis affect the immune system in some way. For steroid drugs, which have been around for more than 50 years, the risks are well known. But less is known about the long-term side effects of newer drugs, such as the biologics. The safety and side effects of biologics and other immune-suppressing drugs to treat psoriasis continue to be monitored by drug manufacturers and the FDA.
For many people, dealing with the emotional impact of psoriasis can be as challenging as treating the disease.
Bird says that mothers have pulled their children away from her on the subway, and some people, horrified by her skin lesions, have asked her if she has AIDS. As her disease has evolved over 30 years, so has Bird's way of dealing with these reactions. In her teens, she'd tell people she had leprosy just for the shock value, she says. Today, Bird is open about the disease but still relies on her defiant attitude to "steel myself for the experience" of going to the beach. "I love to swim," she says. But Bird knows that without covering herself up in a public place, she "runs the risk of people just rubbernecking."
"When I'm feeling forgiving, I try to ignore them," she says, "but when I'm angry, I think 'didn't your mother teach you not to stare?'"
Bird advises others with psoriasis to find out what works best for them to cope with the emotional effects of the disease. Going to therapy has helped her, she says. So has leading a support group for psoriasis sufferers. "It's important for people to work on their emotional well-being," says Bird, "however they choose--whether it's meditation, yoga, or putting on long pants and going out dancing."
Researchers continue to look for reasons why immune cells overreact and what genes may be responsible for psoriasis, hoping to find better treatments, and eventually a cure. Psoriasis research is aided by the visibility of the symptoms on the skin.
"You can see the disease," says Leonardi. "You don't have to do invasive testing to see the effects of therapy." Psoriasis research has a "tremendous spillover into other fields besides dermatology," he adds. "There is a huge need for drugs to suppress the immune system without the side effects."
Multiple sclerosis, Crohn's disease, rheumatoid arthritis, and type 1 diabetes are just a few of the diseases that may also benefit from psoriasis research.
Monday, April 10, 2006
The Guttate Psoriasis Picture
Guttate psoriasis is characterized by small red dots (or drops) of psoriasis. Guttate is derived from the Latin word gutta meaning "drop." It often appears on the trunk, arms and legs. The lesions may have some scale. Guttate psoriasis frequently appears suddenly following a streptococcal infection or viral upper respiratory infections. There are also other events that can precipitate an attack of guttate psoriasis: tonsillitis, a cold, chicken pox, immunizations, physical trauma, psychological stress, illness, and the administration of anti-malarial drugs. Guttate psoriasis is many small patches of psoriasis, all over the body, and often happens after a throat infection. Guttate Psoriasis most often affects children and young adults. It appears as small, red bumps-the size of drops of water-on the skin. It usually appears suddenly, often several weeks after an infection such as strep throat.
Tuesday, April 04, 2006
Biotech Sells Psoriasis Treatment Amevive To Japanese Drug Maker
Biotech company Biogen Idec Inc. said Monday it agreed to sell the worldwide rights of Amevive, a psoriasis treatment, to the U.S. arm of Japanese drug maker Astellas Pharma Inc., for $60 million.
A Biogen spokesman said the deal also includes undisclosed royalty payments.
Biogen said it will continue to manufacture Amevive, a biologic anti-inflammatory compound, and supply it to Astellas. Biogen added it expects the transaction to close as early as mid-April.
A Biogen spokesman said the deal also includes undisclosed royalty payments.
Biogen said it will continue to manufacture Amevive, a biologic anti-inflammatory compound, and supply it to Astellas. Biogen added it expects the transaction to close as early as mid-April.
Wednesday, March 29, 2006
Smoking Is A Risk Factor In Psoriasis
Although dry skin has long been associated with smoking, not until recently has it also been linked to psoriasis. Thousands of doctors are now advising patients to use a good shielding lotion as treatment for psoriasis, but will no doubt soon be adding cessation of smoking to their recommendations.Psoriasis is considered a chronic skin condition and presents as elevated, dry, scaly, itchy patches on the skin. The most common sites are the elbows, knees and other parts of the legs, the scalp, lower back, face, palms, and the soles of the feet. About one third of the diagnosed cases are genetic, although the first outbreak is frequently triggered by stress or physical injury. The condition is driven by the immune system – T cells, the white blood cells that help protect the body from infection and are responsible for creating scabs over wounds, become overactive and trigger other immune responses. These lead to inflammation and rapid turnover of skin cells. The immature skin cells then rise to the surface and form the scaly patches.A recent study, published in the December issue of Archives of Dermatology, found that those who smoke more than a pack of cigarettes per day were at twice the risk of having more severe psoriasis than those who smoke 10 cigarettes or less, and that patients who smoke are more likely to have psoriasis.Although no causal relationship was established, lead researcher Dr. Gerald G. Krueger, a professor of dermatology at the University of Utah School of Medicine stated that if one is not genetically predisposed to psoriasis, "one of the things that you can do to make sure that you get psoriasis is smoke."
Tuesday, March 21, 2006
Psoriasis Susceptibility Gene Identified
University of Michigan scientists have found a common genetic variation in an immune system gene that makes people much more likely to develop psoriasis – a disfiguring inflammatory skin disease. Named PSORS1 (SORE-ESS-1), for psoriasis susceptibility 1, the gene is the first genetic determinant of psoriasis to be definitively identified in a large clinical study. Its discovery could lead to new, more effective treatments for psoriasis without the risks and side-effects of current therapies. The gene's causative role in psoriasis was demonstrated in a University of Michigan Medical School study of 2,723 people from 678 families in which at least one family member had the disease. Results of the U-M study – the most comprehensive analysis of a psoriasis gene to date – will be published in the May 2006 issue of the American Journal of Human Genetics. Psoriasis is a chronic disease that affects about 2 percent of the U.S. population. People with psoriasis develop thick, flaky white patches on their skin and scalp. The disease is disfiguring and can have a negative effect on quality of life. About 25 percent of people with psoriasis eventually develop psoriatic arthritis, which can be severe. Unlike diseases caused by a mutation in just one gene, psoriasis is what scientists call a multi-factorial disease. This means that people must inherit several disease-related genes, plus be exposed to one or more environmental triggers, in order to get psoriasis. "For every individual with psoriasis who carries the PSORS1 gene, there are 10 other people with the gene who don't get psoriasis," says study director James T. Elder, M.D., Ph.D., a professor of dermatology and of radiation oncology in the U-M Medical School and the Ann Arbor VA Healthcare System. "It's as if you are pushing a shopping cart down the aisle at the grocery store and putting genes in your cart," Elder adds. "There are several different brands of each gene on the shelf and one of them is bad for you. If you pull down enough bad ones, then you can get sick. "But even if you get all the bad genes, you still need a trigger from the environment to develop the disease," explains Elder. "In psoriasis, strep throat is a very common initial trigger. It activates the immune system to attack the strep bacteria. But once the strep infection is cleared, the immune system starts attacking the patient's own skin cells. About half the time, strep-induced psoriasis goes away and never comes back. But for the other 50 percent of young people who get it, psoriasis progresses to become a chronic life-long disease." The PSORS1 gene is actually one of over 20 different varieties (scientists call them alleles) of a gene called HLA-C. "In terms of our grocery store analogy, think of PSORS1 as one of 20 'brands' of HLA-C on the shelf," Elder says. Located on human chromosome 6, HLA-C is one of several genes in the major histocompatibility complex (MHC) that regulate how the immune system fights off infection. MHC genes carry DNA-coded instructions for proteins whose job it is to distinguish between what belongs in the body and what doesn't. "There is a great deal of genetic variation in the MHC, because it's on the front lines of dealing with pathogens and cancer," Elder explains. "It's an area where it's good to be different. If everybody were the same, we'd be like hybrid corn. A plague could come along and wipe us all out." Scientists have been searching for genes associated with psoriasis for more than 30 years, but until now studies have been inconclusive, according to Rajan P. Nair, Ph.D., the study's first author and a U-M assistant research professor in dermatology. "Researchers have identified 19 candidate loci, or areas on chromosomes, that may be genetically linked to psoriasis," Nair says. "Many studies confirmed a strong association with the MHC, but no one could determine which gene in the MHC was involved in psoriasis." In a previous study, Nair and his U-M colleagues narrowed the search for the PSORS1 gene down to a 300,000-base-pair segment of chromosome 6 that included HLA-C and at least 10 other genes. To determine which of the 11 genes was linked to psoriasis, U-M scientists used a technique called haplotype mapping. Haplotypes are clusters of alleles that tend to be inherited together as a group, because they are located close to each other on the same chromosome. This means that small individual variations in DNA, which originated in a distant ancestor, are often passed intact from generation to generation. If a haplotype contains genetic changes that make people more susceptible to a disease, scientists can find it by comparing DNA sequences in haplotypes from people with the disease to those of people who don't have the disease. U-M researchers first sequenced and compared all DNA within the 300,000 base-pair target segment from 10 MHC chromosomes carried by five people enrolled in the study. Detailed analysis of these 10 DNA sequences revealed differences that were only present on psoriasis chromosomes, but never on normal chromosomes. Further analysis by U-M scientists narrowed the search down to one gene, HLA-C, and one specific disease-causing allele, HLA-Cw6. Drugs used to treat psoriasis are also used for other autoimmune diseases, such as lupus and rheumatoid arthritis. These drugs turn off the immune response, which leaves the body vulnerable to infection. Now that U-M scientists have identified HLA-Cw6 as being the PSORS1 gene, Elder says scientists can concentrate on finding ways to block its ability to bind to cell surface antigens, which could lead to the development of safer treatments for psoriasis. "What we're all shooting for is trying to find out which branches of the immune system are triggering psoriasis, so you don't have to shut down the whole immune system – only the parts that are important," Elder says. While Elder believes that PSORS1 is the major gene involved in susceptibility to psoriasis, he cautions that it's not the only one. He says much additional research will be required to find the other genes involved and to understand all the secrets of this complex and puzzling disease. "Access to a large, diverse pool of study subjects is vital to the success of this type of clinical research," Elder says. "We are grateful to the 5,000 people who have participated in our psoriasis study so far. It has been a collaborative effort involving physicians, scientists and patients from dermatology departments at many institutions – including the U-M, the University of Kiel in Germany, Detroit's Henry Ford Hospital, and the Ann Arbor VA Healthcare System."
Friday, March 17, 2006
Treating Psoriasis With Dermatitis-Ltd
Dermatitis-Ltd will improve the skin beauty and provide improve the appearance of the various forms of psoriasis.
The ingredients of Dermatitis-Ltd III are: zinc oxide, sodium chloride, magnesium stearate, polyethylene glycol, iron oxide, copper oxide, and sulfur (sulfur is used externally only and is not to be confused with sulfa which is taken internally only). Dermatitis-Ltd does not contain any potentially irritating preservatives, such as methylparaben, propylparaben, and Quaternium-15, and contains no irritating fragrances. Dermatitis-Ltd has a pH of 7.0 which is the perfect pH balance to allow the skin to normalize itself and heal itself
The ingredients of Dermatitis-Ltd III are: zinc oxide, sodium chloride, magnesium stearate, polyethylene glycol, iron oxide, copper oxide, and sulfur (sulfur is used externally only and is not to be confused with sulfa which is taken internally only). Dermatitis-Ltd does not contain any potentially irritating preservatives, such as methylparaben, propylparaben, and Quaternium-15, and contains no irritating fragrances. Dermatitis-Ltd has a pH of 7.0 which is the perfect pH balance to allow the skin to normalize itself and heal itself
Tuesday, March 14, 2006
Psoriasis Treatment Beats Expectations In Phase II Trials
Celgene Corporation has reported better than expected phase II data evaluating CC-10004 as a potential oral therapy for patients with severe plaque-type psoriasis.
CC-10004 is a novel, orally available small molecule with anti-inflammatory activities that inhibits the production of multiple proinflammatory mediators including PDE-4, TNF-alpha, interleukin-2 (IL-2), interferon-gamma, leukotrienes, and nitric oxide synthase. CC-10004 is the lead investigational drug in this class of anti-inflammatory compounds, and is being studied in phase II proof of principle clinical trials for the treatment of psoriasis and other chronic inflammatory diseases.
At the 64th American Academy of Dermatology meeting, Dr Alice Bendix Gottlieb, professor of medicine at Tufts-New England Medical Center, presented data from a phase II trial evaluating the clinical response in patients with severe plaque psoriasis treated for 29 days with CC-10004.
Dr Gottlieb reported that that 73.7% of enrolled patients demonstrated improvement in their psoriasis symptoms with 15.8% of these patients showing a greater than 50% reduction in their psoriasis area and severity index (PASI) score.
In addition, 53.3% of the evaluable 15 patients demonstrated greater than 20% reduction in epidermal skin thickness, the protocol-defined definition of pharmacodynamic response. The mean reduction of epidermal thickness among the evaluable patients was 20.5%.
Furthermore, 52.9% of enrolled patients showed an improvement in their physician's global assessment scores and 58.8% showed a reduction in their psoriasis body surface area scores.
"We are very encouraged with the results of the psoriasis trials as they exceeded the predetermined guidelines we had established," said Dr Jerome Zeldis, Celgene's chief medical officer. "Based on these results, we are accelerating our clinical program and are moving forward with an adequate and well-controlled multi-center study."
CC-10004 is a novel, orally available small molecule with anti-inflammatory activities that inhibits the production of multiple proinflammatory mediators including PDE-4, TNF-alpha, interleukin-2 (IL-2), interferon-gamma, leukotrienes, and nitric oxide synthase. CC-10004 is the lead investigational drug in this class of anti-inflammatory compounds, and is being studied in phase II proof of principle clinical trials for the treatment of psoriasis and other chronic inflammatory diseases.
At the 64th American Academy of Dermatology meeting, Dr Alice Bendix Gottlieb, professor of medicine at Tufts-New England Medical Center, presented data from a phase II trial evaluating the clinical response in patients with severe plaque psoriasis treated for 29 days with CC-10004.
Dr Gottlieb reported that that 73.7% of enrolled patients demonstrated improvement in their psoriasis symptoms with 15.8% of these patients showing a greater than 50% reduction in their psoriasis area and severity index (PASI) score.
In addition, 53.3% of the evaluable 15 patients demonstrated greater than 20% reduction in epidermal skin thickness, the protocol-defined definition of pharmacodynamic response. The mean reduction of epidermal thickness among the evaluable patients was 20.5%.
Furthermore, 52.9% of enrolled patients showed an improvement in their physician's global assessment scores and 58.8% showed a reduction in their psoriasis body surface area scores.
"We are very encouraged with the results of the psoriasis trials as they exceeded the predetermined guidelines we had established," said Dr Jerome Zeldis, Celgene's chief medical officer. "Based on these results, we are accelerating our clinical program and are moving forward with an adequate and well-controlled multi-center study."
Friday, March 10, 2006
How Severe Is My Psoriasis
People with psoriasis on less than 2 percent of their body are considered to have a mild case. Generally, isolated patches of psoriasis are found on the knees, elbows, scalp and hands and feet. Topical treatments—including moisturizers and over-the-counter and prescription creams, ointments and shampoos—are usually sufficient to keep the psoriasis in check.
Moderate psoriasis is defined as affecting between 2 percent and 10 percent of the body's surface. Psoriasis may appear on the arms, legs, torso, scalp and other areas. Appropriate therapies include topical treatments, phototherapy and oral medications, depending on the location and extent of the psoriasis and other individual factors.
Psoriasis covering more than 10 percent of the body is considered severe. Extensive areas of skin may be covered with psoriasis plaques or pustules, or widespread erythrodermic psoriasis can cause severe peeling of the skin. People with severe psoriasis are more likely to develop psoriatic arthritis. Powerful treatments, including phototherapy, oral medications or a combination of these, are usually necessary to manage severe psoriasis.
Moderate psoriasis is defined as affecting between 2 percent and 10 percent of the body's surface. Psoriasis may appear on the arms, legs, torso, scalp and other areas. Appropriate therapies include topical treatments, phototherapy and oral medications, depending on the location and extent of the psoriasis and other individual factors.
Psoriasis covering more than 10 percent of the body is considered severe. Extensive areas of skin may be covered with psoriasis plaques or pustules, or widespread erythrodermic psoriasis can cause severe peeling of the skin. People with severe psoriasis are more likely to develop psoriatic arthritis. Powerful treatments, including phototherapy, oral medications or a combination of these, are usually necessary to manage severe psoriasis.
Tuesday, March 07, 2006
Determining The Best Treatment For Psoriasis
Treatment of psoriasis is determined by the location, severity and history of psoriasis in each individual. There is no one method of treatment, for each person with psoriasis may respond differently. One main objective of treatment is to slow down the more rapid than usual growth rate of the skin cells. The rapid growth rate of skin cells causes the red, scaly psoriasis patches. The underlying cause of this increased skin growth is not yet known. For patients with minimal psoriasis, therapy is limited to topical medications that are drugs applied to the skin. For patients with moderate to widespread psoriasis, topical treatments are often combined with ultraviolet light therapy. Either sunlight or artificial ultraviolet light therapy can be used. If topical and ultraviolet light therapy are not effective, or are not practical, systemic or oral medications can be used. These may be combined with ultraviolet light therapy, the so-called photo-chemotherapy or PUVA therapy. In severe cases and unresponsive cases of psoriasis, there are oral medications that slow down the growth rate of skin which are helpful. These drugs can have significant side effects and have to be used with the proper safeguard and caution. Even these strong drugs do not cure psoriasis but only help to control the disease.
Friday, March 03, 2006
Medicis Psoriasis Drug Gets Wider Use FDA Approval
Dermatology product maker Medicis Pharmaceutical Corp. on Thursday said the Food and Drug Administration has approved a wider use for the company's Vanos skin medication.
The wider use allows Medicis to market the steroid as a primary treatment for skin inflammation and itching for patients 12 and older. Such condition include eczema and exposure to poison ivy.
The drug was approved last year, and launched in April, as a treatment for plaque-type psoriasis, a chronic condition of red, scaly inflamed skin
The wider use allows Medicis to market the steroid as a primary treatment for skin inflammation and itching for patients 12 and older. Such condition include eczema and exposure to poison ivy.
The drug was approved last year, and launched in April, as a treatment for plaque-type psoriasis, a chronic condition of red, scaly inflamed skin
Remicade Recieves Posts Phase III Trial Results
Centocor Inc. reported positive study results of tests using its drug Remicade in patients suffering from psoriasis.
The results of the phase-III study were presented by the Horsham, Pa., biotechnology company Friday at the annual American Academy of Dermatology meeting in San Francisco.
The study showed patients taking Remicade for 10 weeks achieved at least 75 percent improvement in their psoriasis, a chronic inflammatory disease. Nearly 2 million Americans suffer from the skin disorder.
Remicade is already approved as a treatment for rheumatoid arthritis and Crohn's disease.
The Food and Drug Administration is reviewing Centocor's application, filed in November, to expand the use of the drug to include treating moderate to severe psoriasis
The results of the phase-III study were presented by the Horsham, Pa., biotechnology company Friday at the annual American Academy of Dermatology meeting in San Francisco.
The study showed patients taking Remicade for 10 weeks achieved at least 75 percent improvement in their psoriasis, a chronic inflammatory disease. Nearly 2 million Americans suffer from the skin disorder.
Remicade is already approved as a treatment for rheumatoid arthritis and Crohn's disease.
The Food and Drug Administration is reviewing Centocor's application, filed in November, to expand the use of the drug to include treating moderate to severe psoriasis
Tuesday, February 28, 2006
Trial Failure Halts Testing On Psoriasis Drug
CombinatoRx has decided to discontinue development of CRx-140, its oral product candidate for the treatment of psoriasis, after the compound failed to reach its primary and secondary endpoints in a phase II trial.
The trial, which enrolled 103 patients in the US and Canada, studied the effect of a 12 week treatment of CRx-140 compared to low-dose cyclosporine. However, the drug failed to show a statistically significant greater reduction in symptoms of severe psoriasis than cyclosporine.
In the trial, psoriasis symptoms were measured as scores on the physician global assessment (PGA) and psoriasis area severity index (PASI) scales.
"The preliminary results from this first phase IIa trial of CRx-140 are clearly disappointing," said Dr Jan Lessem, chief medical officer of CombinatoRx. "Both CRx-140 and low dose cyclosporine decreased PGA and PASI, but the results of the two arms were not statistically different, nor was the magnitude of the effects sufficient to warrant further development."
The trial, which enrolled 103 patients in the US and Canada, studied the effect of a 12 week treatment of CRx-140 compared to low-dose cyclosporine. However, the drug failed to show a statistically significant greater reduction in symptoms of severe psoriasis than cyclosporine.
In the trial, psoriasis symptoms were measured as scores on the physician global assessment (PGA) and psoriasis area severity index (PASI) scales.
"The preliminary results from this first phase IIa trial of CRx-140 are clearly disappointing," said Dr Jan Lessem, chief medical officer of CombinatoRx. "Both CRx-140 and low dose cyclosporine decreased PGA and PASI, but the results of the two arms were not statistically different, nor was the magnitude of the effects sufficient to warrant further development."
Friday, February 24, 2006
Treating Psoriasis With Lasers
Doctors have begun introducing an instrument known as the XTRAC laser to treat psoriasis.
Statistically, about four and a half million Americans suffer from psoriasis.
Psoriasis is a skin condition that is difficult to diagnose and has no cure. The skin troubles associated with psoriasis are caused by abnormal white blood cells. The cells settle into the skin, causing it to become irritated and inflamed.
Experts said the XTRAC laser targets those cells.
Bethesda Dermatologist Dr. Ronald Prussick said the laser works best on people with relatively small, isolated patches that don't respond to other treatments.
"The way it works is it helps get those abnormal white blood cells that are in the skin, back out of the skin back into the blood stream," said Prussick. "It works very well for the scalp, and I also use it for people who have the psoriasis on the hands and the feet, because traditionally, those areas are difficult to treat."
Each laser treatment lasts just a few minutes. But doctors said it usually takes several sessions over a period of weeks to see a difference.
Elizabeth Thornton has been suffering with psoriasis on her hands and feet for two years. She said that at times, it's been so severe she could barely walk and trying to find a treatment that works has been a struggle.
"I've had 10 million creams. I have any cream you can name, I've had so many of them," said Thornton.
The laser has been able to do for Elizabeth what the creams and medications couldn't.
"It cleared up my feet, completely cleared, my hands cleared," said Thornton.
Doctors stress that the laser is not a cure for psoriasis and it only provides temporary relief. They also said the laser won't work for everyone and should be used by people who haven't responded to other treatments.
The cost of the laser treatments is usually covered by health insurance.
Statistically, about four and a half million Americans suffer from psoriasis.
Psoriasis is a skin condition that is difficult to diagnose and has no cure. The skin troubles associated with psoriasis are caused by abnormal white blood cells. The cells settle into the skin, causing it to become irritated and inflamed.
Experts said the XTRAC laser targets those cells.
Bethesda Dermatologist Dr. Ronald Prussick said the laser works best on people with relatively small, isolated patches that don't respond to other treatments.
"The way it works is it helps get those abnormal white blood cells that are in the skin, back out of the skin back into the blood stream," said Prussick. "It works very well for the scalp, and I also use it for people who have the psoriasis on the hands and the feet, because traditionally, those areas are difficult to treat."
Each laser treatment lasts just a few minutes. But doctors said it usually takes several sessions over a period of weeks to see a difference.
Elizabeth Thornton has been suffering with psoriasis on her hands and feet for two years. She said that at times, it's been so severe she could barely walk and trying to find a treatment that works has been a struggle.
"I've had 10 million creams. I have any cream you can name, I've had so many of them," said Thornton.
The laser has been able to do for Elizabeth what the creams and medications couldn't.
"It cleared up my feet, completely cleared, my hands cleared," said Thornton.
Doctors stress that the laser is not a cure for psoriasis and it only provides temporary relief. They also said the laser won't work for everyone and should be used by people who haven't responded to other treatments.
The cost of the laser treatments is usually covered by health insurance.
Wednesday, February 22, 2006
New Options In Treating Psoriasis May Not Help Everyone
It’s a new era for patients covered in the itchy, scaly skin disease psoriasis. After years with few good treatments, doctors finally have a handful of therapies that promise to help control the incurable condition with fewer bad side effects.
What changed? Scientists learned that psoriasis isn’t just a skin-deep disorder but a dysfunction of the immune system, so the new therapies target the real culprit.
“Five to six years ago, I was telling my patients it was the wasteland,” says Dr. Craig Leonardi of St. Louis University Medical School, who participated in studies of the new treatments. “Now there’s this huge explosion of amazing drugs coming forward.
The new options don’t help everyone, cautions Dr. Michael Tharp, dermatology chief at Chicago’s Rush University Medical Center. And they’re very expensive, costing $10,000 a year or more.
But, “it’s a great first step,” Tharp says. “Now we’ve got very directed molecules and know where they work and how they work. ... I hope it is just the beginning.”
Two unique psoriasis shots, Amevive and Raptiva, recently won Food and Drug Administration approval. Two drugs already sold to treat other conditions — Enbrel and Remicade — are used against psoriasis, too. A list of other potential treatments is under study.
What changed? Scientists learned that psoriasis isn’t just a skin-deep disorder but a dysfunction of the immune system, so the new therapies target the real culprit.
“Five to six years ago, I was telling my patients it was the wasteland,” says Dr. Craig Leonardi of St. Louis University Medical School, who participated in studies of the new treatments. “Now there’s this huge explosion of amazing drugs coming forward.
The new options don’t help everyone, cautions Dr. Michael Tharp, dermatology chief at Chicago’s Rush University Medical Center. And they’re very expensive, costing $10,000 a year or more.
But, “it’s a great first step,” Tharp says. “Now we’ve got very directed molecules and know where they work and how they work. ... I hope it is just the beginning.”
Two unique psoriasis shots, Amevive and Raptiva, recently won Food and Drug Administration approval. Two drugs already sold to treat other conditions — Enbrel and Remicade — are used against psoriasis, too. A list of other potential treatments is under study.
Tuesday, February 14, 2006
TolerRx Gets Orphan Drug Designation
TolerRx, Inc. today announcedthat its lead product, TRX4, has received orphan drug designation by the U.S.Food and Drug Administration (FDA) for the treatment of new-onset Type 1diabetes mellitus. TolerRx is currently conducting a clinical study of TRX4 inthe U.S. in subjects with Type 1 diabetes. Orphan drug designation would entitle TolerRx to exclusive TRX4 marketingrights in the United States for seven years should TolerRx be the firstcompany to receive marketing approval for this type of therapeutic drugproduct. In addition, the designation would allow TolerRx to apply forresearch funding, tax credits for certain research expenses, and a waiver fromthe FDA application user fee required by the Prescription Drug User Fee Act(PDUFA). "We are pleased to have received this orphan drug designation for TRX4 inthe treatment of new-onset Type 1 diabetes," said Douglas J. Ringler, ChiefExecutive Officer of TolerRx. "This designation is one in a number of plannedstrategic initiatives that will provide us with financial and regulatorybenefits and market exclusivity." In a study of subjects with new-onset Type 1 diabetes published in theJune 23, 2005 edition of the New England Journal of Medicine, TRX4 (ChAglyCD3)was shown to preserve the function of insulin-producing beta cells in thepancreas and reduce the amount of administered insulin needed to control bloodglucose levels for at least 18 months after a single six day course of TRX4.At the doses used in this study, TRX4 administration was associated withtransient symptoms of flu-like syndrome and transient EBV reactivation.TolerRx recently initiated a clinical trial in the U.S. in subjects with Type1 diabetes designed to optimize and select a TRX4 dosing regimen to be used inlater phase trials. About Type 1 Diabetes Diabetes (medically known as diabetes mellitus) is the name given todisorders in which the body has difficulty regulating its blood glucose, orblood sugar, levels. There are two major types of diabetes: Type 1 and Type 2.Type 1, also called juvenile diabetes or insulin-dependent diabetes, is adisorder of the body's immune system. In Type 1 diabetes, the pancreasproduces little or no insulin as a result of the immune system attacking anddestroying the insulin-producing beta cells in the pancreas. Therefore, Type 1diabetes patients require frequent administration of insulin therapy each dayto control their blood sugar levels. In the United States, approximately 1.3 million people have Type 1diabetes, and each year approximately 30,000 new patients are diagnosed withthe disease, including 13,000 children. About TRX4 TRX4 is a monoclonal antibody that binds to a receptor found on all Tcells called CD3, which is involved in normal T cell signaling. TRX4 isdesigned to block the function of autoreactive T-effector cells that attackthe body's tissues and cause autoimmune disease. Because T-effector cells andT-regulatory cells utilize different signaling pathways for activation, TRX4is expected to suppress autoreactive T cells while promoting T-regulatory cellactivity, resulting in a state of immunological tolerance. In addition to Type1 diabetes, TolerRx is also developing TRX4 for the treatment of psoriasis andis currently enrolling subjects in a U.S. Phase Ib study of subjects withmoderate-to-severe psoriasis.
Tuesday, February 07, 2006
Treating Psoriasis With Retinoids
These drugs are related to Vitamin A. They normalize the growth of skin cells in psoriasis. A new retinoid, acitretin (Soriatane) was introduced in 1998, replacing etretinate (Tegison). This drug is useful in treating severe forms of psoriasis, such as Erythrodermic and pustular psoriasis that do not respond to other therapies. Retinoids are almost certain to cause birth defects. They cannot be used by pregnant women, women planning to become pregnant, or their male partners. Women who take acitretin must avoid pregnancy for up to 3 years after they stop taking the drug. Women also must not drink alcohol while they are taking acitretin and for 2 months after they stop taking it. Alcohol can cause the drug to change to its chemical cousin, etretinate, in the blood. Etretinate can cause severe birth defects for many years after its use. Other possible side effects of retinoids are dry skin, chapped lips, dryness of the eyes and nasal passages, hair thinning, sun sensitivity, and bone spurs of the long bones or spine. The drugs may also increase blood levels of liver enzymes and triglycerides, a type of fat found in the blood. Reducing the dose of the drug usually reduces these side effects. Another retinoid, isotretinoin (Accutane) is sometimes used to treat psoriasis. It may be helpful for some people, especially if combined with ultraviolet light treatment, but it is generally less effective than acitretin. Isotretinoin is approved by the U.S. Food and Drug Administration to treat severe acne but not to treat psoriasis.
Friday, February 03, 2006
Progress Noted In Psoriasis treatment
Pharmaceutical products developer York Pharma said it has progressed in the development of a new topical treatment for psoriasis. The group said it has selected Carbenoxolone as its lead compound for a new class of drugs termed Vitamin A Metabolic Pathway inhibitors. "To date, in vitro and in vivo study results supporting the use of carbenoxolone in psoriasis have all been positive," said the group. It added that Phase II results further supported carbenoxolone as a new treatment for psoriasis. "York is pleased that these preliminary Phase II data indicate the potential of carbenoxolone for the treatment of this condition, and that the company's dermatology pipeline is continuing to make significant progress," said chief executive Terry Sadler.
Wednesday, February 01, 2006
Aloe Vera For Psoriasis
Long used to speed the healing of mild burns, it's now study proved to improve symptoms of psoriasis when used three times a day for eight months. Break the leaf of an aloe plant to get the soothing gel or use a lotion that's at least 20% pure aloe vera.
Monday, January 30, 2006
Psoriasis
Psoriasis is a condition whose main symptom is gray or silvery flaky patches on the skin which are red and inflamed underneath. In the United States, it affects 2 to 2.6 percent of the population, or between 5.8 and 7.5 million people. Commonly affected areas include the scalp, elbows, knees, arms, stomach and back. Psoriasis is autoimmune in origin, and is not contagious. Around a quarter of people with psoriasis also suffer from psoriatic arthritis, which is similar to rheumatoid arthritis in its effects. Psoriasis was first given that name in complete differentiation from other skin conditions by the Austrian dermatologist Ferdinand von Hebra in 1841, although there are what are believed to be descriptions of the disease in sources going back to ancient Roman and possibly even biblical times.
Wednesday, January 25, 2006
Smoking May Worsen Psoriasis
Need another reason to quit smoking? It might be making your psoriasis worse.
Researchers have found a link between smoking and the severity of psoriasis. According to a December 2005 study in Archives of Dermatology, people who smoke more than one pack a day have double the risk of severe psoriasis compared to people who smoke half a pack or less a day.
For some time, researchers have known that cigarettes may trigger psoriasis in people who are susceptible to the disease, especially pustular psoriasis. In one study, cigarette smoking more than doubled the risk of developing psoriasis in women and almost the same in men.
It is unclear exactly how smoking might exacerbate psoriasis, but cigarettes are known to alter the function of white blood cells. Smoking may also cause the body to overproduce proteins that contribute to skin inflammation in psoriasis.
Although there's no direct evidence that quitting smoking can improve your condition, it's possible you could boost your odds. According to a 2000 study in Cutis, three-quarters of those whose psoriasis had gone into remission were nonsmokers, while two-thirds of those whose disease remained largely the same were smokers.
In any case, kicking the habit is a proven way to improve your overall health and reduce your risk of lung cancer, heart disease and stroke. So, if you're a smoker, it's important to take steps to quit. Quitting can be difficult, but support can be found through smoking cessation programs at hospitals and health centers or through individual, group or telephone counseling.
Another popular choice for helping to kick the habit is nicotine replacement therapy, which is available in gum, inhaler, nasal spray and patch form. These products are designed to be tapered slowly as you wean yourself off nicotine. Other choices are bupropion (Wellbutrin) and nortriptyline (Pamelor, Aventyl). These products don't contain nicotine, but they can help reduce cravings and withdrawal symptoms.
Researchers have found a link between smoking and the severity of psoriasis. According to a December 2005 study in Archives of Dermatology, people who smoke more than one pack a day have double the risk of severe psoriasis compared to people who smoke half a pack or less a day.
For some time, researchers have known that cigarettes may trigger psoriasis in people who are susceptible to the disease, especially pustular psoriasis. In one study, cigarette smoking more than doubled the risk of developing psoriasis in women and almost the same in men.
It is unclear exactly how smoking might exacerbate psoriasis, but cigarettes are known to alter the function of white blood cells. Smoking may also cause the body to overproduce proteins that contribute to skin inflammation in psoriasis.
Although there's no direct evidence that quitting smoking can improve your condition, it's possible you could boost your odds. According to a 2000 study in Cutis, three-quarters of those whose psoriasis had gone into remission were nonsmokers, while two-thirds of those whose disease remained largely the same were smokers.
In any case, kicking the habit is a proven way to improve your overall health and reduce your risk of lung cancer, heart disease and stroke. So, if you're a smoker, it's important to take steps to quit. Quitting can be difficult, but support can be found through smoking cessation programs at hospitals and health centers or through individual, group or telephone counseling.
Another popular choice for helping to kick the habit is nicotine replacement therapy, which is available in gum, inhaler, nasal spray and patch form. These products are designed to be tapered slowly as you wean yourself off nicotine. Other choices are bupropion (Wellbutrin) and nortriptyline (Pamelor, Aventyl). These products don't contain nicotine, but they can help reduce cravings and withdrawal symptoms.
Thursday, January 19, 2006
Lapto Psoriasis Infects Village
Bellary, Karnataka:
The mystery disease that has affected 258 people, including 156 women, at Siddammanahalli village in this district, has been diagnosed as Lapto Psoriasis.Informing this to newspersons here today, National Institute for Communicable Diseases Deputy Director and Microbiologist Dr Sohan Lal said unclean and unhygienic environment, lack of proper drainage system and drinking contaminated water led to the outbreak of the disease.
Animals and rodents were the main carriers of the Lapto Spiral bacteria which caused the disease.
He said the disease was also prevalent at Yadgiri in Gulbarga district, some villages in Bidar district, Madanapalle in Andhra Pradesh, besides some villages in Maharashtra.
Dr Lal and Lab Assistant Shivakumar went round the village yesterday to zero in on the cause for the spread of the disease. Expressing satisfaction over the supply of medicines by the District Health Department to contain the disease, Dr Lal said the Veterinary Department had been asked to initiate steps to study cattle diseases.
The mystery disease that has affected 258 people, including 156 women, at Siddammanahalli village in this district, has been diagnosed as Lapto Psoriasis.Informing this to newspersons here today, National Institute for Communicable Diseases Deputy Director and Microbiologist Dr Sohan Lal said unclean and unhygienic environment, lack of proper drainage system and drinking contaminated water led to the outbreak of the disease.
Animals and rodents were the main carriers of the Lapto Spiral bacteria which caused the disease.
He said the disease was also prevalent at Yadgiri in Gulbarga district, some villages in Bidar district, Madanapalle in Andhra Pradesh, besides some villages in Maharashtra.
Dr Lal and Lab Assistant Shivakumar went round the village yesterday to zero in on the cause for the spread of the disease. Expressing satisfaction over the supply of medicines by the District Health Department to contain the disease, Dr Lal said the Veterinary Department had been asked to initiate steps to study cattle diseases.
Friday, January 13, 2006
Join The National Psoriasis Foundation To Speak Out On Capitol Hill
The National Psoriasis Foundation is urging people who care about psoriasis to make their voice heard by joining the Foundation at its third annual Capitol Hill Day, Feb. 26-27, 2006. Foundation staff and volunteers from around the country will personally deliver a message to Congress on the seriousness of psoriasis and psoriatic arthritis, the importance of access to medications and the need for more federal research funding toward a cure. Deadline for registration is Jan. 26. "Constituent voices on Capitol Hill make all the difference," says Gail M.Zimmerman, president and CEO of the National Psoriasis Foundation. "People affected by these diseases need to stand up and be heard." Zimmerman encourages people to join the effort. "This is a powerful opportunity to increase our impact in Washington, D.C.," she says. Capitol Hill Day 2005 brought tangible results for the psoriasis community: More than two dozen U.S. representatives signed a joint letter in support of increased psoriasis research funding at the National Institutes ofHealth (NIH); related Senate appropriations report language was adopted; and the Senate passed a resolution recognizing August 2005 as Psoriasis Awareness Month. The 2005 event served as a spring board for further action, as psoriasis advocates sent nearly 10,000 messages to Congress through the PsoriasisFoundation Web site on behalf of psoriasis since last April. No experience is necessary to attend Capitol Hill Day. The Psoriasis Foundation provides training and information, and will pair volunteers together when they visit congressional offices. Limited scholarship money for expenses is available for people who qualify, on a first-come, first-served basis. For more information, to register, or to inquire about a scholarship, go to http://www.psoriasis.org or call1-800-723-9166.
Tuesday, January 10, 2006
Identifying A Important Trigger In Psoriasis
An immune molecule that normally assists in cell “suicide” may be an important trigger in the development of the common skin disease psoriasis, according to scientists from the Technion-Israel Institute of Technology and State University of New York, Stony Brook.
The culprit, a molecule called Fas, acts as a middleman between activated immune cells and a handful of inflammatory hormones involved in psoriasis flare-ups, say Technion researcher Dr. Amos Gilhar and colleagues. The study appears in the January, 10 2006 American Journal of Pathology.
Psoriasis is a non-contagious, lifelong skin disease that usually appears as scaly and inflamed patches of skin, although it can take several different forms. In patients with psoriasis, the white blood cells that make up the body’s immune defense system go into overdrive, triggering other immune responses that pile up skin cells at an abnormal rate.
Current treatments for psoriasis such as the drug Enbrel focus on these inflammatory hormones, but the researchers were able to stop the development of psoriasis in mice long before these hormones came into play by injecting an Fas-blocking antibody.
“The finding that antibodies to Fas can prevent psoriasis further demonstrates the complexity of the disease and its numerous molecular pathways,” Gilhar says.
Dr. Alice Gottlieb, chair of the Clinical Research Center at the Robert Wood Johnson Medical School in New Jersey agrees. “This research shows that activation of the Fas pathway is important in starting the ball rolling in psoriasis,” comments Gottlieb (who was not involved with this study). “These findings could have implications for other immune diseases such as rheumatoid arthritis and Crohn's disease,”
The researchers suspected that the Fas molecule was in the middle of this process, since it is found at high levels in psoriatic skin and leads an intriguing dual life. Most of the time, Fas guides the normal process of cell suicide called apoptosis. But in cells where apoptosis is blocked by other molecules, as it is in psoriatic cells, Fas switches roles and encourages the production of common inflammatory hormones instead.
To figure out exactly where Fas stood in the development of psoriasis, Gilhar and colleagues transferred grafts of clear, non-involved skin from human psoriasis patients to mice. They injected the mice with white blood cells bearing the Fas molecule on their surfaces to jump-start the formation of psoriatic skin lesions.
By blocking Fas action with a special antibody, the researchers were able to show that Fas actually is the key middleman in psoriasis formation. Without Fas, the natural killer cells were unable to trigger the production of the inflammatory hormones that lead to the characteristic skin thickening and other signs of psoriasis.
There is some evidence that Fas is involved in other skin conditions such as eczema, so future treatments targeting the Fas pathway may prove useful for a variety of diseases, suggests Dr. Richard Kalish, Gilhar’s collaborator from SUNY Stony Brook. However, researchers need to develop a human antibody to Fas before the technique could be tested in people.
“The current study is one of the many wonderful papers that have come out of this very productive collaboration across many miles between Dr. Gilhar and Dr. Kalish,” says Gottlieb.
According to the National Psoriasis Foundation in the United States, 1-3 percent of the world’s population suffers from psoriasis. About 30 percent of people with psoriasis have severe cases, where the affected skin covers more than 3 percent of their body. In some people, the disease is associated with a form of arthritis.
The Technion-Israel Institute of Technology is Israel's leading science and technology university. Home to the country’s winners of the Nobel Prize in science, it commands a worldwide reputation for its pioneering work in nanotechnology, computer science, biotechnology, water-resource management, materials engineering, aerospace and medicine. The majority of the founders and managers of Israel's high-tech companies are alumni. Based in New York City, the American Technion Society is the leading American organization supporting higher education in Israel, with 17 offices around the country.
The culprit, a molecule called Fas, acts as a middleman between activated immune cells and a handful of inflammatory hormones involved in psoriasis flare-ups, say Technion researcher Dr. Amos Gilhar and colleagues. The study appears in the January, 10 2006 American Journal of Pathology.
Psoriasis is a non-contagious, lifelong skin disease that usually appears as scaly and inflamed patches of skin, although it can take several different forms. In patients with psoriasis, the white blood cells that make up the body’s immune defense system go into overdrive, triggering other immune responses that pile up skin cells at an abnormal rate.
Current treatments for psoriasis such as the drug Enbrel focus on these inflammatory hormones, but the researchers were able to stop the development of psoriasis in mice long before these hormones came into play by injecting an Fas-blocking antibody.
“The finding that antibodies to Fas can prevent psoriasis further demonstrates the complexity of the disease and its numerous molecular pathways,” Gilhar says.
Dr. Alice Gottlieb, chair of the Clinical Research Center at the Robert Wood Johnson Medical School in New Jersey agrees. “This research shows that activation of the Fas pathway is important in starting the ball rolling in psoriasis,” comments Gottlieb (who was not involved with this study). “These findings could have implications for other immune diseases such as rheumatoid arthritis and Crohn's disease,”
The researchers suspected that the Fas molecule was in the middle of this process, since it is found at high levels in psoriatic skin and leads an intriguing dual life. Most of the time, Fas guides the normal process of cell suicide called apoptosis. But in cells where apoptosis is blocked by other molecules, as it is in psoriatic cells, Fas switches roles and encourages the production of common inflammatory hormones instead.
To figure out exactly where Fas stood in the development of psoriasis, Gilhar and colleagues transferred grafts of clear, non-involved skin from human psoriasis patients to mice. They injected the mice with white blood cells bearing the Fas molecule on their surfaces to jump-start the formation of psoriatic skin lesions.
By blocking Fas action with a special antibody, the researchers were able to show that Fas actually is the key middleman in psoriasis formation. Without Fas, the natural killer cells were unable to trigger the production of the inflammatory hormones that lead to the characteristic skin thickening and other signs of psoriasis.
There is some evidence that Fas is involved in other skin conditions such as eczema, so future treatments targeting the Fas pathway may prove useful for a variety of diseases, suggests Dr. Richard Kalish, Gilhar’s collaborator from SUNY Stony Brook. However, researchers need to develop a human antibody to Fas before the technique could be tested in people.
“The current study is one of the many wonderful papers that have come out of this very productive collaboration across many miles between Dr. Gilhar and Dr. Kalish,” says Gottlieb.
According to the National Psoriasis Foundation in the United States, 1-3 percent of the world’s population suffers from psoriasis. About 30 percent of people with psoriasis have severe cases, where the affected skin covers more than 3 percent of their body. In some people, the disease is associated with a form of arthritis.
The Technion-Israel Institute of Technology is Israel's leading science and technology university. Home to the country’s winners of the Nobel Prize in science, it commands a worldwide reputation for its pioneering work in nanotechnology, computer science, biotechnology, water-resource management, materials engineering, aerospace and medicine. The majority of the founders and managers of Israel's high-tech companies are alumni. Based in New York City, the American Technion Society is the leading American organization supporting higher education in Israel, with 17 offices around the country.
Wednesday, January 04, 2006
Another Option In Psoriasis Treatment
Abbott Laboratories announced that the U.S. Food and Drug Administration (FDA) approved the biologic drug Humira (generic name adalimumab) for reducing signs and symptoms of active arthritis in patients with psoriatic arthritis. Humira is also approved to treat rheumatoid arthritis. The National Psoriasis Foundation welcomes the news as another treatment option for psoriasis and psoriatic arthritis patients.
How will people use it?Patients take Humira at home by giving themselves an injection of 40 milligrams (mg) every other week, similar to diabetes patients who give themselves insulin injections. Humira is designed to be taken continuously to maintain improvement. The medication can be used alone or in combination with methotrexate or other DMARDs (disease-modifying antirheumatic drugs) under a doctor's supervision.
How effective is it?In a double-blind, placebo-controlled study of 313 patients with active psoriatic arthritis, researchers monitored joint symptoms and the skin.
Improvements in both skin and joint symptoms were seen as early as two weeks and continued to improve over time.
Determining arthritis measurement scores in those using 40 mg of Humira every other week:
At week 12, nearly 60 percent achieved 20 percent improvement
At week 24, nearly one quarter achieved 70 percent improvement
Nearly 70 patients in the trial had skin lesions involving greater than 3 percent body surface area and were treated with Humira. In measurements of psoriasis severity by week 24:
75 percent achieved 50 percent improvement
Nearly 60 percent achieved 75 percent improvement
More than 40 percent achieved 90 percent improvement Humira is not approved by the FDA for the treatment of psoriasis, but studies of its effectiveness in treating this disease are being conducted.
How does it work?Humira blocks tumor necrosis factor-alpha (TNF-alpha), a chemical "messenger" in the immune system that signals other cells to cause inflammation. There is too much TNF-alpha in the skin of people with psoriasis and the joints of people with certain types of arthritis.
Humira helps lower the amount of TNF-alpha, thus interrupting the inflammatory cycle of psoriasis and psoriatic arthritis and leading to improvement in symptoms for many people who take it.
What are the side effects?Common side effects in psoriatic arthritis patients included upper respiratory tract infections, injection site reactions and high blood pressure.
According to the product label information, in studies of rheumatoid arthritis patients, the most common side effects included:
upper respiratory infections
abdominal pain
headache
rash
injection site reactions
urinary tract infection
These side effects were generally mild and did not cause most patients to stop taking Humira. These events happened most often after the first dose of Humira and may decrease after additional doses.
Humira treatment should not be started in someone with an active infection, and it may not be recommended for someone with a history of recurring infections. People taking Humira should be monitored for signs of infection, and if a serious infection develops, the medication should be stopped.
Tuberculosis, invasive fungal infections and other serious infections have been reported in Humira patients; some of the infections have been fatal. The infections often occurred in patients who were also using other medications that affect the immune system, such as methotrexate.
People should be evaluated for latent TB infections by getting a TB skin test prior to treatment with Humira. Patients with evidence of TB exposure might require additional testing and treatment before starting Humira.
There have been rare reports of central nervous system disorders in association with the use of Humira. Doctors are advised to use caution in considering the use of Humira in patients with pre-existing or the recent onset of central nervous system disorders, including multiple sclerosis. About 12 percent of patients develop antibodies to the medication, and these people are more likely to have an allergic-type reaction to the treatment.
The FDA has reviewed the association between TNF-alpha medications such as Humira and an increased risk of developing lymphoma, a type of cancer. The FDA concluded there is not enough data to know if these medications contributed to higher risk. Humira's safety and side effects continue to be monitored by Abbott Laboratories and the FDA.
How will people use it?Patients take Humira at home by giving themselves an injection of 40 milligrams (mg) every other week, similar to diabetes patients who give themselves insulin injections. Humira is designed to be taken continuously to maintain improvement. The medication can be used alone or in combination with methotrexate or other DMARDs (disease-modifying antirheumatic drugs) under a doctor's supervision.
How effective is it?In a double-blind, placebo-controlled study of 313 patients with active psoriatic arthritis, researchers monitored joint symptoms and the skin.
Improvements in both skin and joint symptoms were seen as early as two weeks and continued to improve over time.
Determining arthritis measurement scores in those using 40 mg of Humira every other week:
At week 12, nearly 60 percent achieved 20 percent improvement
At week 24, nearly one quarter achieved 70 percent improvement
Nearly 70 patients in the trial had skin lesions involving greater than 3 percent body surface area and were treated with Humira. In measurements of psoriasis severity by week 24:
75 percent achieved 50 percent improvement
Nearly 60 percent achieved 75 percent improvement
More than 40 percent achieved 90 percent improvement Humira is not approved by the FDA for the treatment of psoriasis, but studies of its effectiveness in treating this disease are being conducted.
How does it work?Humira blocks tumor necrosis factor-alpha (TNF-alpha), a chemical "messenger" in the immune system that signals other cells to cause inflammation. There is too much TNF-alpha in the skin of people with psoriasis and the joints of people with certain types of arthritis.
Humira helps lower the amount of TNF-alpha, thus interrupting the inflammatory cycle of psoriasis and psoriatic arthritis and leading to improvement in symptoms for many people who take it.
What are the side effects?Common side effects in psoriatic arthritis patients included upper respiratory tract infections, injection site reactions and high blood pressure.
According to the product label information, in studies of rheumatoid arthritis patients, the most common side effects included:
upper respiratory infections
abdominal pain
headache
rash
injection site reactions
urinary tract infection
These side effects were generally mild and did not cause most patients to stop taking Humira. These events happened most often after the first dose of Humira and may decrease after additional doses.
Humira treatment should not be started in someone with an active infection, and it may not be recommended for someone with a history of recurring infections. People taking Humira should be monitored for signs of infection, and if a serious infection develops, the medication should be stopped.
Tuberculosis, invasive fungal infections and other serious infections have been reported in Humira patients; some of the infections have been fatal. The infections often occurred in patients who were also using other medications that affect the immune system, such as methotrexate.
People should be evaluated for latent TB infections by getting a TB skin test prior to treatment with Humira. Patients with evidence of TB exposure might require additional testing and treatment before starting Humira.
There have been rare reports of central nervous system disorders in association with the use of Humira. Doctors are advised to use caution in considering the use of Humira in patients with pre-existing or the recent onset of central nervous system disorders, including multiple sclerosis. About 12 percent of patients develop antibodies to the medication, and these people are more likely to have an allergic-type reaction to the treatment.
The FDA has reviewed the association between TNF-alpha medications such as Humira and an increased risk of developing lymphoma, a type of cancer. The FDA concluded there is not enough data to know if these medications contributed to higher risk. Humira's safety and side effects continue to be monitored by Abbott Laboratories and the FDA.
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