The combination of apremilast with biologics is safe and associated with reductions in the mean Psoriasis Area and Severity Index (PASI) score in patients with psoriasis who have recently shown biologic fatigue, according to study results published in the Journal of Dermatology.

The study was a retrospective analysis of efficacy and safety results of a combination psoriasis treatment regimen consisting of apremilast and biologics (n=14). Patients included in the analysis were initially treated with 1 biologic, but after the efficacy of the biologic(s) declined, apremilast was added to the existing treatment program. Biologics included infliximab, adalimumab, secukinumab, ixekizumab, and ustekinumab.

Changes in the PASI score, as well as achievement of 75% and 50% reductions in PASI Score (PASI-75 and PASI-50, respectively), were assessed at weeks 0, 12, and 24 after the apremilast addition.

A total of 11 patients achieved a 90% improvement in PASI score after biologic therapy, with the lowest PASI scores ranging from 0 to 3.8 (mean, 1.30.3). Prior to biologic treatment, PASI scores in the overall cohort ranged from 5.9 to 39.0 (mean, 19.52.7). The mean PASI score before the addition of apremilast to biologic therapy was 3.20.4. The addition of apremilast to the existing biologic treatment protocol decreased the mean PASI score to 1.60.3 at 24-week follow-up. Approximately 50% of patients had achieved PASI-50, whereas only 29% achieved PASI-75 at 24 weeks.

There were 4 patients who developed diarrhea during the 24 weeks and 1 patient reported both diarrhea and nausea. In 2 patients, weight loss >5% of body weight occurred. Adverse events were not severe enough to cause any patient to discontinue the combination treatment.

Study limitations were the small number of patients, the inclusion of only patients with biologic fatigue, and its retrospective nature.

Based on their findings, the investigators concluded that apremilast could be safely combined with a biologic in psoriatic patients who are not responding adequately to a biologic alone.

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Reference

Takamura S, Sugai S, Taguchi R, Teraki Y. Combination therapy of apremilast and biologics in patients with psoriasis showing biologic fatigue [published online December 22, 2019]. J Dermatol. doi:10.1111/1346-8138.15193

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Addition of Apremilast to Biologic Therapy Is Successful for Treating Psoriasis in Biologic Fatigue - Dermatology Advisor

Image: Joshua Coppola, scientist, engineering, lab automation, works alongside his robotic lab partner, Venus. Source: AbbVie.

By Manas Mishra

(Reuters) - AbbVie Inc on Friday forecast 2020 earnings above Wall Street estimates as the drugmaker expects growth to be powered by its new treatments for psoriasis and rheumatoid arthritis at a time when sales of its blockbuster drug Humira slow.

Shares of Illinois-based AbbVie are up 4.7% to $91.30 in late morning trading.

The drugmaker expects the two treatments, Skyrizi and Rinvoq, to bring in a combined revenue of about $1.70 billion in 2020.

The profit forecast excludes any impact from its $63 billion deal for Botox-maker Allergan Plc, which it expects to close in the first quarter.

The launches of Skyrizi and Rinvoq are going extremely well, Chief Executive Officer Richard Gonzalez said in a statement.

In the fourth quarter, Skyrizi brought in sales of $216 million, topping estimates of $142 million, according to five analysts polled by Refinitiv. Rinvoq, which was approved in August, brought in sales of $33 million.

AbbVie is betting on new treatments and the addition of Botox to its portfolio as it braces for a revenue hit when it loses patent protection for Humira, the worlds best-selling medicine, in its biggest market, the United States, in 2023.

While AbbVie is seeking to shine light on its early stage pipeline, we anticipate the performance of the stock will be heavily tied to ongoing Skyrizi and Rinvoq rollouts, said Citi analyst Andrew Baum.

He expects investors to focus on the delivery of promised savings from the Allergan deal.

Humira has been boosting the companys revenue ever since it was approved to treat psoriasis and rheumatoid arthritis. However, the drugs sales have suffered since new competition entered Europe.

Quarterly sales of the blockbuster drug were largely unchanged compared with a year earlier at $4.92 billion. But it beat expectations of $4.85 billion.

The company forecast 2020 adjusted earnings of between $9.61 and $9.71 per share, ahead of the average analysts estimate of $9.48.

AbbVie reported net profit of $2.80 billion, or $1.88 per share, in the quarter ended Dec. 31, compared with a loss of $1.83 billion, or $1.23 per share, a year earlier when it recorded $4.12 billion in impairment charges.

Excluding items, the drugmaker earned $2.21 per share in the fourth quarter and beat expectations of $2.19.

Net revenue rose 4.8% to $8.70 billion, marginally higher than average analysts estimate of $8.69 billion.

Reporting by Manas Mishra and Tamara Mathias in Bengaluru; Editing by Arun Koyyur.

_____

Source: Reuters

DISCLOSURE:The views and opinions expressed in this article are those of the authors, and do not represent the views of equities.com. Readers should not consider statements made by the author as formal recommendations and should consult their financial advisor before making any investment decisions. To read our full disclosure, please go to: http://www.equities.com/disclaimer. The author of this article, or a firm that employs the author, is a holder of the following securities mentioned in this article : None

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AbbVie Forecasts Higher 2020 Profit on New Psoriasis and Arthritis Therapies - Equities.com

(MENAFN - GetNews) Psoriasis Drugs Market Analysis By Key Players, Trends, Insights, Dynamics, Future Outlook, Applications and Segmentation, Forecast to 2025

Psoriasis Drugs Market Size, Growth and Share Analysis By Drug Class [Tumour Necrosis Factor Inhibitors (Adalimumab, Infliximab and Etanercept), Interleukin-Inhibitors (Ustekinumab, Secukinumab, Ixekizumab and Brodalumab), Vitamin D Analogues (Calcitriol, Calcipotriol and Tacalcitol)], Treatment Type {Topicals [Over-the-counter (OTC) Topicals, Topical Non-Steroids and Topical Steroids], Systemic (Retinoid, Cyclosporine and Methotrexate), Biologics [Tumour Necrosis Factor Alpha (TNF-) Inhibitors, InterleU.K.in 12 and 23 (IL-12/23) Inhibitors, Interleukin 17 (IL-17) Inhibitor, T cell Inhibitor]}, Region (Americas, Europe, Asia-Pacific and Middle East & Africa) - Forecast till 2025

Psoriasis Drugs Market Analysis

The Psoriasis Drugs Market is predicted to touch USD 13.1 billion at a 7.3% CAGR between 2019-2025, states the latest Market Research Future (MRFR) report. Psoriasis, simply put, is an autoimmune condition that causes rapid development of cells on the skin. The overgrowth can result in scaly, thick plaques that may itch and cause discomfort. Scales generally develop on joints, especially the knees and elbows, but it may appear in any part of the body including the face, scalp, neck, feet, and hands.

Various factors are propelling the global Psoriasis Drugs Market growth. Such factors, according to the latest Market Research Future report, include vulnerability towards psoriatic arthritis, favorable reimbursement policies, growing awareness about psoriasis, increasing availability of biosimilars and biologics, aging population and changing lifestyle. Additional factors propelling the growth of the Psoriasis Drugs Market include rising prevalence of autoimmune diseases, increasing incidence of psoriasis, increasing R & D activities for psoriasis treatment, and technological advancements.

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On the contrary, lack of knowledge regarding the exact cause of psoriasis and its etiology, the high price of medications with their low efficacy and efficiency, side effects associated with symptomatic treatments, and lack of permanent and effective treatment are factors that may hamper the Psoriasis Drugs Market growth during the forecast period.

Psoriasis Drugs Market Segmentation

The Market Research Future report offers a complete segmental analysis of the Psoriasis Drugs Market based on treatment type and drug class.

By drug class, thePsoriasis treatment Marketis segmented into vitamin D analogues, InterleU.K.in-inhibitors, and tumor necrosis factor inhibitors. The tumor necrosis factor inhibitors segment is again segmented into etanercept, infliximab, and adalimumab. The InterleU.K.in-inhibitors segment is again segmented into brodalumab, ixekizumab, SecU.K.inumab, and ustekinumab. The vitamin D analogues segment is again segmented into tacalcitol, calcipotriol, and calcitriol.

By treatment, the Psoriasis Drugs Market is segmented into biologics, systematic, and topicals. The topicals segment is again segmented into topical steroids, topical non-steroids, and over the counter topicals. The systematic segment is again segmented into methotrexate, cyclosporine, and retinoid. The biologics segment is again segmented into T cell inhibitor, InterleU.K.in 17 (IL-17) inhibitor, InterleU.K.in 12 and 23 (IL-12/23) inhibitors, and tumor necrosis factor-alpha (TNF-a) inhibitors.

Psoriasis Drugs Market Regional Analysis

By region, the Psoriasis Drugs Market report covers the latest trends and growth opportunities across the Americas, Europe, the Asia Pacific, the Middle East and Africa, and Latin America. Of these, North America will spearhead the market during the forecast period. Various factors are propelling the growth of the Psoriasis Drugs Market in the region, such as the growing awareness about psoriasis treatment, rising prevalence of psoriasis, presence of key manufacturers, and increasing health infrastructure.

The Psoriasis Drugs Market in Europe will have the second-largest share during the forecast period. Various factors are propelling the growth of the Psoriasis Drugs Market in the region such as growing awareness about psoriasis, the launch of biosimilars (amzevita, elerzi), and increasing prevalence of psoriasis.

The Psoriasis Drugs Market in the APAC region will grow at the fastest pace during the forecast period. Various factors are propelling the growth of the Psoriasis Drugs Market in the region such as growing geriatric population, large patient pool, improving medical facilities and healthcare infrastructure, increasing participation of key market players, increasing investments to develop new therapeutics to treat psoriasis, and increasing awareness.

The Psoriasis Drugs Market in the MEA will have a small share during the forecast period for the low economic development in Africa.

The Psoriasis Drugs Market in Latin America will have a favorable growth during the forecast period owing to the focus of manufacturers to create novel therapeutics and rise in the psoriasis patient pool.

Psoriasis Drugs Market Key Players

Notable players profiled in the Psoriasis Drugs Market report include Eli Lilly and Company (US), Amgen (US), AbbVie (US), Merck and Co. Inc (US), Pfizer Inc (US), Johnson & Johnson (US), Celgene Corporation (US), AstraZeneca (UK), UCB (Belgium), and Novartis International AG (Switzerland).

Psoriasis Drugs Industry News

Daavlin, a renowned US-based phototherapy units' manufacturer that utilizes therapeutic UV light to effectively and safely treat patients with eczema, vitiligo, and psoriasis have joined hands with HealthLens to give patients better access to receive a dermatology consultation as well as treatment right from their home. The patient just needs to book a consultation online, followed by uploading some pictures of the skin condition and brief health history, after which the information will get electronically encrypted and sent securely to the physician who will respond within 1-2 days.

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At Market Research Future (MRFR), we enable our customers to unravel the complexity of various industries through our Cooked Research Report (CRR), Half-Cooked Research Reports (HCRR), & Consulting Services. MRFR team have supreme objective to provide the optimum quality market research and intelligence services to our clients.

Media Contact Company Name: Market Research Future Contact Person: Abhishek Sawant Email: Send Email Phone: +1 646 845 9312 Address: Market Research Future Office No. 528, Amanora Chambers Magarpatta Road, Hadapsar City: Pune State: Maharashtra Country: India Website: https://www.marketresearchfuture.com/reports/psoriasis-treatment-market-2769

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Psoriasis Drugs Market Size Is Projected to Reach USD 13.1 Billion at a CAGR of 7.3% By 2025 - MENAFN.COM

Excess body weight places a great strain on nearly all domains of the bodys functions. As the trend of obesity remains unchecked, clinicians will continue to see issues associated with obesity often the result of superficial physiologic reactions to the presence of excess fatty tissue as well as underlying pathophysiologic changes associated with increased adipose fat.1-3

Obesity has many cutaneous manifestations, including striae, intertrigo, plantar hyperkeratosis, lymphedema, acanthosis nigricans, and a greater risk for skin infections and melanoma.1,3 It also contributes to inflammatory dermatologic conditions such as psoriasis and poor wound healing.1

General skin features of people with obesity (defined as a body mass index [BMI] of 30 or higher) are often altered1,3 due to multiple obesity-related factors. A 2017 study3 of American women found that skin barrier and moisturizing functions were significantly impaired by obesity, resulting in considerable dryness and roughness, compared with nonobese women. Skin coloration changes such as facial redness believed to be due to dilation of the local blood vessels in response to inflammation were noted, as was reduced yellow coloration. Conversely, scaliness and roughness were products of systemic inflammation combined with insulin resistance, demonstrated by altered levels of interleukin (IL)-6, leptin, adipokines, and insulin.

Other localized skin manifestations linked to obesity include the following:

The chronic inflammatory skin condition hidradenitis suppurativa is often aggravated by the number and depth of skin folds, which increase with greater weight gain.2,5 This condition generally occurs in the armpit and groin and in skin folds, areas on the body given to friction (skin-to-skin and skin-to-clothing contact) as an individual moves. Hidradenitis suppurativa often begins with follicular plugging, which triggers inflammation and abscess formation.5 Further development into sinus tracts often promotes secondary infection of the area.

Patients with obesity are at higher risk for skin infections such as folliculitis, candidiasis, furunculosis, erythrasma, and tinea cruris as a result of obesity and comorbid conditions such as diabetes and impaired circulation.1,2 These infections most often occur in and around skin folds of the lower genital region and around the breasts, where increased moisture, body heat, and sweating contribute to the colonization of yeast and other bacteria.1,2

Other, more serious conditions may also develop, including the following:

Obesity is associated with a worsened prognosis of psoriasis and is considered an independent risk factor for the development of this chronic inflammatory skin disorder through the production of macrophages from adipose fat.1,6,7 Because visceral adipose fat is increased with obesity, the production of proinflammatory cytokines (including tumor necrosis factor-, IL-6, IL-8, IL-17, IL-18, and monocyte chemoattractant protein-1) and adipokines (such as chemerin, visfatin, leptin, and adiponectin) also increases, stimulating autonomic inflammatory responses.6,7 Reduction of body weight has shown a direct correlation to reduced severity of psoriasis symptoms.1,6,7 Obesity also interferes with the pharmacodynamics of drugs used to treat psoriasis and can increase the risks for adverse events.7

All specialists will continue to see a rise in obesity-related complications, and dermatologists will be called on to treat a wide-ranging conditions related to weight issues. Many of the autonomic characteristics of skin are altered and, in some cases, impaired by obesity. Weight management may soon come under the dermatologists purview as a component of intervention for cutaneous manifestations of obesity, in addition to other treatments.1,2

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References

1. Shipman AR, Millington GWM. Obesity and the skin.Br J Dermatol. 2011;165:743-750.

2. Scheinfeld NS. Obesity and dermatology. Clin Dermatol. 2004;22:303-309.

3. Mori S, Shiraishi A, Epplen K, et al. Characterization of skin function associated with obesity and specific correlation to local/systemic parameters in American women. Lipids Health Dis. 2017;16(1):214.

4. Hahler B. An overview of dermatological conditions commonly associated with the obese patient. Ostomy Wound Manage. 2006;52(6):34-47.

5. Lee EY, Alhusayen R, Lansang P, et al. What is hidradenitis suppurativa? Can Fam Physician. 2017;63:114-120.

6. Chiricozzi A, Raimondo A, Lembo S, et al. Crosstalk between skin inflammation and adipose tissue-derived products: pathogenic evidence linking psoriasis to increased adiposity [abstract].Expert Rev Clin Immunol. 2016;12:1299-1308.

7. Owczarczyk-Saczonek A, Placek W. Compounds of psoriasis with obesity and overweight [abstract].Postepy Hig Med Dosw (Online). 2017;71:761-772.

This article originally appeared on Dermatology Advisor

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Effects of Obesity on Skin - Endocrinology Advisor

Patients with psoriasis who are treated with biologics have a higher risk for hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivations, especially if they are young, hepatitis B surface antigen (HBsAg) seropositive, hepatitis B e-antigen (HBeAg) seropositive, and receiving tumor necrosis factor (TNF)- inhibitor therapy, study data published in the Journal of the American Academy of Dermatology suggest.

University researchers from Taiwan reviewed the medical records of patients with psoriasis who had been treated with TNF- inhibitors, interleukin (IL)-12/23 inhibitors, or IL-17 inhibitors. The investigators used baseline serology to categorize 561 patients with HBV infection into chronic HBV infection, resolved HBV infection, and occult HV infection categories. In addition, a total of 112 patients with HCV infection were included.

Overall, the cohort included 2060 patients with psoriasis treated with biologics between 2009 and 2018. A total of 3562 treatment episodes in the cohort were recorded. At baseline, every 3 months during a treatment episode, and at the end of treatment or follow-up, researchers measured HBV DNA/HCV RNA levels and serum alanine transaminase and aspartate transaminase levels. Reactivations of HBV and HCV viral loads were assessed to examine variables associated with reactivation and biologic-treated psoriasis.

A total of 14 treatment episodes for HCV involved reactivation of the virus during 1522 person-months follow-up (incidence, 110.4/1000 person-years). Univariate and multivariate analyses did not find significant predictors for HCV reactivation. Conversely, reactivation of HBV was observed in 72 treatment episodes for chronic HBV during 3012 person-months follow-up, compared with 3 treatment episodes for occult HBV and 13 for resolved HBV.

Independent risk factors of HBV reactivation in the multivariable model included an absence of antiviral drug prophylaxis, HBsAg positivity, HBeAg positivity, and young age. In HBsAg-positive patients without antiviral prophylaxis, HBeAg positivity was an independent risk factor for HBV reactivation in the adjusted analysis (adjusted hazard ratio [aHR], 3.35; 95% CI, 1.30-8.67; P =.0126). Reactivation of HBV was more common in patients treated with TNF inhibitors vs IL-17 inhibitors (aHR, 2.67; 95% CI, 1.08-6.58; P =.033).

Limitations of the study include its observational design and lack of a comparison group, which the researchers suggest could have consisted of patients with psoriasis but without HCV or HBV infections and who were not treated with biologics.

Although the risk for HCV reactivation seems low in patients with chronic yet stable HCV, the researchers suggest that monitoring of the HCV viral load is still recommended for psoriasis patients with chronic active HCV disease.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors disclosures.

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Reference

Chiu HY, Chiu YM, Chang Liao NF, et al. Predictors of hepatitis B and C virus reactivation in patients with psoriasis treated with biological agent: a nine-year multicenter cohort study [published online December 7, 2019]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2019.12.001

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Biologic-Treated Patients With Psoriasis Have Higher Risk for HBV and HCV Reactivations - Dermatology Advisor

The research report presents a detailed competitive analysis of the Psoriasis treatment Global Market 2019 market Share, Size, and Future scope 2026. This research report classifies the market by manufacturers, region, type, and applications.

The data presented in the graphical format gives a thorough understanding of the major players of Psoriasis treatment . The restraints and growth, industry plans, innovations, mergers, and acquisitions are covered in this report. The market is segmented based on key industry verticals like the product type, applications, and geographical regions.

Get a Sample Copy of the Report @ https://www.reportspedia.com/report/life-sciences/global-psoriasis-treatment-market-research-report-2020-2026-of-major-types,-applications-and-competitive-vendors-in-top-regions-and-countries/54139 #request_sample

Key Players of Psoriasis treatment Report are:

Novartis International AGJohnson & JohnsonPfizer Inc.Merck and Co. Inc.AbbVie and AmgenEli Lilly

Short Description of Psoriasis treatment Market 2019-2026:

The Psoriasis treatment market was valued t XX Million US$ in 2019 and is projected to reach XX Million US$ by 2026, at a CAGR of XX% during 2019-2026. The research report gives historic report from 2013-2018.

The market is segmented into below points:

Market by Type/Products:

TNF InhibitorsPhosphodiesterase InhibitorsInterleukin BlockersOthers

Market by Application/End-Use:

OralTropicalInjectable

Enquire or share your questions if any before the purchasing this report @ https://www.reportspedia.com/report/life-sciences/global-psoriasis-treatment-market-research-report-2020-2026-of-major-types,-applications-and-competitive-vendors-in-top-regions-and-countries/54139 #inquiry_before_buying

Outline of the data covered in this study:

The market study covers the forecast Psoriasis treatment information from 2019-2026 and key questions answered by this report include:

In this study, the years considered to estimate the market size of Psoriasis treatment are as follows:

Historic Period: 2015-2019.

Base Year: 2019.

Estimated Year: 2020.

Forecast Year 2020 to 2026.

Significant Features that are under Offering and Key Highlights of the Reports:

Table of contents:

For More TOC Content Continued,

Get A Sample Pdf Copy Of Table Of Content Describing Current Value And Volume Of The Market With All Other Essential Information @ https://www.reportspedia.com/report/life-sciences/global-psoriasis-treatment-market-research-report-2020-2026-of-major-types,-applications-and-competitive-vendors-in-top-regions-and-countries/54139 #table_of_contents

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Global Psoriasis treatment Market Is Estimated To Expand At a Healthy CAGR in Upcoming year 2020-2026 - News Times

TORONTO, Feb. 11, 2020 (GLOBE NEWSWIRE) -- Eli Lilly Canada announced today that Health Canada approved TALTZ (ixekizumab) on February 4, 2020, for the treatment of adult patients with active ankylosing spondylitis (AS), which is also known as radiographic axial spondyloarthritis (r-axSpA), who have responded inadequately to, or are intolerant to, conventional therapy. This is the third indication for TALTZ, which was first approved by Health Canada for moderate- to severe plaque psoriasis and psoriatic arthritis in 2016 and 2018, respectively.

People living with ankylosing spondylitis deal with a considerable amount of pain and anxiety. If left untreated, it can severely affect their mobility and mental wellbeing, says Dr. Doron Sagman, Vice President, R&D and Medical Affairs, Eli Lilly Canada. We are very pleased that TALTZ is now approved for the treatment of AS in Canada.

AS is a chronic inflammatory disease that often starts at the base of the spine in the sacroiliac joints around the pelvis, and can spread upwards to other parts of the spine; it is estimated to affect 300,000 Canadians.1

We are pleased to learn that a new medication to treat ankylosing spondylitis has been approved by Health Canada. Timely and equitable access to diverse treatment options are essential for patients living with this painful and debilitating condition, says Graeme Reed, interim President, Canadian Spondylitis Association.

The efficacy and safety of TALTZ in AS was demonstrated in two randomized, double-blind, placebo-controlled Phase 3 studies that included 657 adult patients with active AS: COAST-V in patients who are biologic disease-modifying antirheumatic drug (bDMARD)-nave, and COAST-W in patients who previously had an inadequate response or were intolerant to tumor necrosis factor (TNF) inhibitors.

In both studies2, the primary efficacy endpoint was the proportion of patients at 16 weeks achieving Assessment of Spondyloarthritis International Society 40 (ASAS40) response compared to placebo. ASAS40 measures disease signs and symptoms such as pain, inflammation and function. The COAST clinical trial program includes the first and only registration trials in AS to achieve ASAS40 response at 16 weeks as a primary endpoint.

Results from both studies demonstrated that patients treated with TALTZ achieved statistically significant and clinically meaningful improvements in signs and symptoms, as defined by ASAS40 response, compared to placebo. At 16 weeks, patients achieved ASAS40 at the following response rates:

Additionally, patients treated with TALTZ demonstrated statistically significant improvements in key secondary endpoints in both studies, including the proportion of patients at 16 weeks achieving ASAS20 at the following response rates:

TALTZ achieved a significant improvement over placebo in ASAS40 at Week 16, which is a more stringent endpoint than the commonly used ASAS20, says Dr. Proton Rahman, MD, FRCPC, Rheumatologist, St. Johns NL and COAST-W study investigator. Health Canadas approval is helpful for physicians who are looking for alternative treatment options and significant for our patients with AS.

Overall, the safety profile observed in patients with AS who were treated with TALTZ is consistent with the safety profile in patients with psoriasis.

About TALTZTALTZ (ixekizumab) is a monoclonal antibody that selectively binds with interleukin 17A (IL-17A) cytokine and inhibits its interaction with the IL-17 receptor. IL-17A is a naturally occurring cytokine that is involved in normal inflammatory and immune responses. TALTZ inhibits the release of pro-inflammatory cytokines and chemokines.

About Lilly in RheumatologyLilly in rheumatology aims to create a brighter future for people with debilitating rheumatologic diseases through innovative discoveries and patient-centered solutions.

About Eli Lilly CanadaEli Lilly and Company is a global healthcare leader that unites caring with discovery to make life better for people around the world. We were founded more than a century ago by Colonel Eli Lilly, who was committed to creating high quality medicines that meet peoples needs, and today we remain true to that mission in all our work. Lilly employees work to discover and bring life-changing medicines to people who need them, improve the understanding and management of disease, and contribute to our communities through philanthropy and volunteerism.

Story continues

Eli Lilly Canada was established in 1938, the result of a research collaboration with scientists at the University of Toronto, which eventually produced the worlds first commercially-available insulin. Our work focuses on oncology, diabetes, autoimmunity, neurodegeneration, and pain. To learn more about Lilly Canada, please visit us at http://www.lilly.ca.

For our perspective on issues in healthcare and innovation, follow us on twitter @LillyPadCA

Media Contact: Samira RehmanRehman_Samira@lilly.com 647-617-1994

REFERENCES1 Arthritis Society. https://arthritis.ca/about-arthritis/arthritis-types-(a-z)/types/ankylosing-spondylitis2 TALTZ Product Monograph.

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Health Canada has approved TALTZ (ixekizumab) for the Treatment of Active Ankylosing Spondylitis (Radiographic Axial Spondyloarthritis) - Yahoo...

Red, scaly patches on your skin can be embarrassing, and you might do your best to hide them when youre out in public.

If you are living with these signs of psoriasis, however, you are far from alone. In the United States, about 8 million people have a form of psoriasis.

Psoriasis can cause significant discomfort, both physically and emotionally. It is more than just dry skin, and treating it is important to improve quality of life.

Read on to learn more about this condition, who is at risk, the complications and how it is treated and prevented.

Psoriasis is a hereditary skin condition that causes areas of the skin to shed rapidly. It can cause patches of raised skin or blisters on the scalp, elbows, knees, trunk or lower back. It is a chronic condition that can return multiple times. There are many kinds of psoriasis, with plaque psoriasis being the most common form.

People with a family history of psoriasis have a higher risk of developing it themselves. It can be triggered by stress or emotional disorders, or even by certain types of medication. Infections or skin injuries can also cause a flare-up.

A common side effect of psoriasis is psoriatic arthritis, which affects between 10 and 30 percent of people with the condition. Psoriatic arthritis causes inflammation in the joints and may damage joints permanently. People with psoriasis also have a higher chance of developing diabetes, heart disease and other serious conditions.

Various treatments can improve psoriasis symptoms. Topical treatments include steroid creams, vitamin A or vitamin D3 creams, and moisturizers. Medications are also available, though some are reserved for severe cases due to serious potential side effects. Ultraviolet light treatments can also reduce inflammation.

Treatment for your psoriasis can vary as you age because your body may react differently to medications and your skin can change over time, says Dan Bushnell, administrator at Gramercy Court Assisted Living. If you begin to experience new side effects, or if treatments dont work as well as they did in the past, be sure to talk to your doctor about other options.

Psoriasis is hereditary, and there is no way to prevent a person from developing the condition at some point. However, avoiding triggers like stress, sunburns and infections can keep flare-ups at bay. Caring for your skin can keep the condition under control. Use creams, lotions and humidifiers to keep your skin moist. Watch out for medications that increase your risk for a flare-up.

Psoriasis can have a major impact on your quality of life, especially if you are dealing with a severe case. While this condition cant be cured, there are treatments to improve symptoms and reduce flare-ups. If you are experiencing psoriasis symptoms, work with your physician to find the right treatment to keep it from running your life.

Dr. Amy Osmond Cook is a health care technology consultant and VP of marketing at Simplus, a platinum Salesforce partner.

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Five things you should know about psoriasis - Daily Herald

Skyrizi, a key drug in AbbVies post-Humira future, has added another feather to its cap.

On Tuesday, the IL-23 inhibitor emerged superior in a head-to-head327-patient trial against Novartis dominant Cosentyx in patients with moderate-to-severe plaque psoriasis.

Data showed Skyrizi induced significantly higher rates of skin clearance compared to Cosentyx, meeting the primary goal of superiority with at least a 90% improvement from baseline in the Psoriasis Area and Severity Index (PASI 90) at week 52. Overall, 87% of Skyrizi-treated patients hit PASI 90, versus 57% of Cosentyx-treated patients at the one year mark.

The other main goal of non-inferiority at week 16 74% of Skyrizi patients achieved PASI 90 compared to 66% of Cosentyx patients was also met. Skyrizi also eclipsed Cosentyx on all secondary endpoints, including PASI 100, and PASI 75.

In the fall of 2017, Skyrizi was evaluated against J&Js Stelara and its own Humira in a psoriasis study and emerged victorious, handsomely outpacing the rival drugs in clearing psoriasis.

These head-to-head studies are key to establishing Skyrizis position in a crowded market, which includes Humira, Novartis anti-IL17 Cosentyx, J&Js anti-IL23 Tremfya, anti-IL12/23 Stelara, as well as Lillys anti-IL17 Taltz.

Skyrizi is not the first pure IL-23 inhibitor to be approved Tremfya was approved in 2017 and Ilumya in 2018. But the AbbVie drug has a dosing advantage over Tremfya it is administered every 12 weeks, versus once every two months for Tremfya, SVB Leerinks Geoffrey Porges said on Wednesday, noting that other psoriasis biologics in addition to the oral Otezla generated a combined $11.1 billion in 2018 sales.

This does not include sales of anti-TNFs in psoriasis, which should decrease as patients move to these new, more efficacious therapies. These products also all achieved $500 million $1 billion in the second year of launch, which is likely to also be achieved by Skyrizi, SVB Leerinks Geoffrey Porges wrote in a note last year.

Overall biologics are still used in only 30% of the moderate to severe psoriasis population, (per JNJ in 2017), and AbbVies Skyrizi should benefit from both best-in-category efficacy (i.e. market share gains) and the continued rapid market expansion.

Skyrizi was approved in April 2019. AbbVie paid Boehringer Ingelheim $595 million upfront to license rights to the drug, known chemically as risankizumab, in early 2016.Evaluate has pegged Skyrizi as the number 3 blockbuster on its list of heavyweight drugs launched in 2019, estimating the drug could earn more than $2 billion in 2024 a far cry from AbbVies homegrown estimate of $4 billion to $5 billion in peak sales. Porges has forecast adjusted peak annual sales of $3 billion.

Last August, Lillys Taltz beat J&Js Tremfya in a head-to-head psoriasis study. In 2018, J&J ran its own head-to-head psoriasis trial against Cosentyx and came out with data that showed Tremfya superseded Novartis dominant rival.

Social image: AbbVie

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AbbVie's Skyrizi hangs Novartis' Cosentyx out to dry in head-to-head psoriasis study - Endpoints News

A new study evaluated healthcare utilization among psoriatic arthritis (PsA) patients in the years leading up to their diagnosis. The researchers concluded here that PsA patients are significantly more likely to have medical visits than other patients during the time period leading up to their diagnosis, going back as far as five years.

PsA is a heterogeneous disease that can present in various clinical manifestations, such as synovitis, enthesitis, dactylitis and spondylitis, the study authors explained. Some of these features can present with only minimal findings on physical examination, and the differentiation from other conditions, such as osteoarthritis, can be challenging. Furthermore, unlike RA and lupus, PsA has no reliable diagnostic biomarkers. These factors, along with the lack of awareness of PsA among patients and primary care physicians, and limited access to specialty care contribute to delays in the diagnosis of PsA.

Better pre-diagnosis may be beneficial to disease treatment and outcomes, the researchers noted, so they explored the burden of musculoskeletal symptoms among patients who were eventually diagnosed with PsA.

The study was a population-based, matched cohort study that collected data from electronic medical records and administrative data in Ontario, Canada. PsA patients were age- and sex-matched to control patients from the same family physicians. Control patients were eligible for inclusion if they did not have a billing code indicating a diagnosis of spondyloarthritis, ankylosing spondylitis, or rheumatoid arthritis. Outcomes included healthcare utilization and costs pertaining to nonspecific musculoskeletal issues over the five-year period leading up to the index date.

Final analysis included 462 PsA patients and 2,310 controls (mean [SD] age, 54.2 [13.8] years; 55.6% were female). PsA patients were significantly more likely to visit a primary care physician for nonspecific musculoskeletal issues in the year leading up to the index date (odds ratio [OR]=2.14; 95% confidence interval [CI], 1.732.64); this trend was also observed in the five years leading up to the index date (OR=1.76; 95% CI, 1.432.18). PsA patients were also more likely than the controls to require musculoskeletal-related specialty care, diagnostic imaging and procedures prior to the index date. PsA patients were more likely to be assessed by nonrheumatologist musculoskeletal specialists (OR range, 1.592.03), visit an emergency department for musculoskeletal-related issues (OR range, 1.332.69), and have joint imaging (OR range, 3.206.26) and joint injections (OR range, 4.639.26).

Over the five years before index date, PsA patients were at least four times more likely than the controls to visit a rheumatologist. The most common diagnosis codes rheumatologists provided were for other disease of the musculoskeletal systems, psoriasis, osteoarthritis, and cramps, leg pain, muscle pain, joint pain, joint swelling.

The study appeared in Arthritis Care & Research.

The study authors concluded of the findings, his pattern reveals some of the underlying causes of diagnosis delays of PsA and highlights the need for diagnostic strategies and novel reliable biomarkers to aid in early diagnosis of PsA.

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PsA Patients Have More Medical Visits in Five Years Leading Up to Diagnosis - DocWire News

BACKGROUND:

Real-world studies evaluating patients with challenging-to-treat localizations of psoriasis (scalp, nail, and palmoplantar) are limited.

To characterize patients with versus without psoriasis in challenging-to-treat areas seen in routine US clinical practice.

This retrospective observational study included all adult patients with psoriasis enrolled in the Corrona Psoriasis Registry between April 2015 and May 2018 who initiated a biologic therapy at registry enrollment. Patients were stratified by the presence of scalp, nail, or palmoplantar psoriasis (nonmutually exclusive groups). Patient demographics, clinical char-acteristics, disease activity, and patient-reported outcome measures (pain, fatigue, itch, EuroQol visual analog scale [EQ VAS], Dermatology Life Quality Index [DLQI], and Work Productivity and Activity Impairment questionnaire [WPAI]) were assessed at registry enrollment and compared between patients with versus without each challenging-to-treat area using nonparametric Kruskal-Wallis tests for continuous variables and 2 or Fisher exact tests for categorical variables. Generalized linear regression models were used to estimate differences in disease activity and patient-reported outcomes between patients with versus without each challenging-to-treat area.

Among 2,042 patients with psoriasis (mean age [SD], 49.6 14.7 years; 51.5% male), 38.4% had psoriatic arthritis (PsA), 38.1% had scalp psoriasis, 16.0% had nail psoriasis, 10.9% had palmoplantar psoriasis, and 26.2% had a combination of 2 challenging-to-treat areas and PsA; only 34.2% had body plaque psoriasis without PsA or challenging-to-treat areas. Patients in all challenging-to-treat groups reported higher (mean [95% CI]) itch (scalp, 58.01 [57.62-58.40] vs. 54.35 [53.99-54.72]; nail, 56.42 [56.02-56.81] vs. 55.59 [55.20-55.97]; palmoplantar, 60.22 [59.86-60.59] vs. 55.15 [54.79-55.54]) and lower EQ VAS (scalp, 68.12 [67.78-68.48] vs. 69.46 [69.12-69.81]; nail, 66.21 [65.89-66.55] vs. 69.48 [69.14-69.83]; palmoplantar, 66.21 [66.07-66.75] vs. 69.29 [68.94-69.94]) scores than those without the respective challenging-to-treat localization. Patients with nail or palmoplantar psoriasis reported higher pain, fatigue, and DLQI scores than those without. Higher proportions of patients with scalp or palmoplantar psoriasis reported work impairment compared with those without.

Two-thirds of patients with psoriasis who initiated biologic therapy had PsA and/or 1 challenging-to-treat area. Patients with challenging-to-treat areas had worse patient-reported outcome scores than those without, indicating a significant burden of challenging-to-treat areas on patients quality of life.

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Characterization of Patients with Psoriasis in Challenging-to-Treat Body Areas in the Corrona Psoriasis Registry - DocWire News

Psoriasis is a skin infection that's caused due to multiple reasons. Read below to find out how you can treat psoriasis at home with these doable home remedies.

When it comes to taking care of our skin, we all make sure to apply creams and soaps that maintain the moisture and pH levels of our skin. However, some skin ailments are caused in spite of taking care of our skin. Lifestyle choices, stress and various other factors contribute to these ailments. And one such ailment is psoriasis.

Psoriasis is a skin condition which appears on various parts of the body like knees, elbows, scalp, and the torso. This ailment can be identified when you have thick, red skin with silver-white patches on your body, which are also known as scales. If not taken care of, these patches and scales can get itchy and painful with time. If you are suffering from this ailment, then here are some home remedies for it. However, if the condition worsens it's better to consult a dermatologist.

Here are some home remedies for psoriasis:

When it comes to treating this skin infection at home, plastic wraps can prove to be quite effective. If you are suffering from this skin condition, then you should wrap the affected area with plastic covers, mostly after applying their prescribed medication or ointment. It is done to help the body hold onto the vital natural oils and water.

Sea salt and Epsom salt again helps to deal with psoriasis. Sea salt will ensure removal of thick scales caused due to psoriasis, thus ensuring deeper penetration of the medication into the skin. They are known for their exfoliating properties and hence can provide relief from psoriasis.

Using apple cider vinegar in the affected areas can reduce the itching, pain and burning sensation to a great extent. It is a popular disinfectant and is popular for its properties and considerably benefits people suffering from this condition.

Drinking bitter gourd juice with lime on an empty stomach can again provide some relief from psoriasis. However, one needs to do this daily, since it takes about 5-6 months to show effective results.

You can also treat psoriasis by adding some additional dietary supplements to your routine diet. Vitamin D, aloe vera, fish oil are a few supplements which may help ease psoriasis symptoms.

Reduce fatty snacks and red meat. Add nuts, seeds and foods rich in Omega-3 fatty acids. With an ability to reduce inflammation, theyre the perfect foods for your psoriasis.

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Remedies for Psoriasis: THESE home treatments can help you deal with this skin infection - PINKVILLA

Medically reviewed by Drugs.com. Last updated on May 13, 2019.

Psoriasis is a chronic skin disorder that causes scaling and inflammation.

Psoriasis may develop as a result of an abnormality in the body's immune system. The immune system normally fights infection and allergic reactions.

Psoriasis probably has a genetic component. Nearly half of patients have family members with psoriasis.

Certain medications may trigger psoriasis. Other medications seem to make psoriasis worse in people who have the disease.

Psoriasis causes skin scaling and inflammation. It may or may not cause itching. There are several types of psoriasis:

Plaque psoriasis. In plaque psoriasis, there are rounded or oval patches (plaques) of affected skin. These are usually red and covered with a thick silvery scale. The plaques often occur on the elbows, knees, scalp or near the buttocks. They may also appear on the trunk, arms and legs.

Inverse psoriasis. Inverse psoriasis is a plaque type of psoriasis that tends to affect skin creases. Creases in the underarm, groin, buttocks, genital areas or under the breast are particularly affected. The red patches may be moist rather than scaling.

Pustular psoriasis. The skin patches are studded with pimples or pustules.

Guttate psoriasis. In guttate psoriasis, many small, red, scaly patches develop suddenly and simultaneously. Guttate psoriasis often occurs in a young person who has recently had strep throat or a viral upper respiratory infection.

About half of people with skin symptoms of psoriasis also have abnormal fingernails. Their nails are often thick and have small indentations, called pitting.

A type of arthritis called psoriatic arthritis affects some people with psoriasis. Psoriatic arthritis may occur before skin changes appear.

Your doctor will look for the typical skin and nail changes of this disorder. He or she can frequently diagnose psoriasis based on your physical examination.

When skin symptoms are not typical of the disorder, your doctor may recommend a skin biopsy. In a biopsy, a small sample of skin is removed and examined in a laboratory. The biopsy can confirm the diagnosis and rule out other possible skin disorders.

Psoriasis is a long-term disorder. However, symptoms may come and go.

There is no way to prevent psoriasis.

Treatment for psoriasis varies depending on the:

Treatments for psoriasis include:

Topical treatments. These are treatments applied directly to the skin.

Daily skin care with emollients for lubrication. These include petroleum jelly or unscented moisturizers.

Corticosteroid creams, lotions and ointments. These may be prescribed in medium and high-strength forms for stubborn plaques on the hands, feet, arms, legs and trunk. They may be prescribed in low-strength forms for areas of delicate skin such as the face.

Calcipotriol (Dovonex) slows production of skin scales.

Tazarotene (Tazorac) is a synthetic vitamin A derivative.

Coal tar

Salicylic acid to remove scales

Phototherapy. Extensive or widespread psoriasis may be treated with light. Phototherapy uses ultraviolet B or ultraviolet A, alone or in combination with coal tar.

A treatment called PUVA combines ultraviolet A light treatment with an oral medication that improves the effectiveness of the light treatment.

Laser treatment also can be used. It allows treatment to be more focused so that higher amounts of UV light can be used.

Vitamin A derivatives. These are used to treat moderate to severe psoriasis involving large areas of the body. These treatments are very powerful. Some have the potential to cause severe side effects. It's essential to understand the risks and be monitored closely.

Immunosuppressants. These drugs work by suppressing the immune system. They are used to treat moderate to severe psoriasis involving large areas of the body.

Antineoplastic agents. More rarely, these drugs (which are most often used to treat cancer cells) may be prescribed for severe psoriasis.

Biologic therapies. Biologics are newer agents used for psoriasis that has not responded to other treatments. Psoriasis is caused, in part, by substances made by the immune system that cause inflammation. Biologics act against these substances. Biologic treatments tend to be quite expensive.

If you are unsure whether you have psoriasis, contact your doctor. Also contact your doctor if you have psoriasis and are not doing well with over-the-counter treatment.

For most patients, psoriasis is a long-term condition.

There is no cure. But there are many effective treatments.

In some patients, doctors may switch treatments every 12 to 24 months. This prevents the treatments from losing their effectiveness and decreases the risk of side effects.

National Psoriasis Foundation6600 SW 92nd Ave.Suite 300Portland, OR 97223-7195Phone: 503-244-7404Toll-Free: 1-800-723-9166Fax: 503-245-0626http://www.psoriasis.org/

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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Psoriasis Guide: Causes, Symptoms and Treatment Options

*Certain restrictions apply. *Certain restrictions apply; eligibility not based on income.

Otezla (apremilast) is a prescription medicine approved for the treatment of patients with moderate to severe plaque psoriasis for whom phototherapy or systemic therapy is appropriate.

Otezla is a prescription medicine approved for the treatment of adult patients with active psoriatic arthritis.

Otezla is a prescription medicine approved for the treatment of adult patients with oral ulcers associated with Behets Disease.

You must not take Otezla if you are allergic to apremilast or to any of the ingredients in Otezla.

Otezla can cause severe diarrhea, nausea, and vomiting, especially within the first few weeks of treatment. Use in elderly patients and the use of certain medications with Otezla appears to increase the risk of having diarrhea, nausea, or vomiting. Tell your doctor if any of these conditions occur.

Otezla is associated with an increase in depression. In clinical studies, some patients reported depression, or suicidal behavior while taking Otezla. Some patients stopped taking Otezla due to depression. Before starting Otezla, tell your doctor if you have had feelings of depression, or suicidal thoughts or behavior. Be sure to tell your doctor if any of these symptoms or other mood changes develop or worsen during treatment with Otezla.

Some patients taking Otezla lost body weight. Your doctor should monitor your weight regularly. If unexplained or significant weight loss occurs, your doctor will decide if you should continue taking Otezla.

Some medicines may make Otezla less effective, and should not be taken with Otezla. Tell your doctor about all the medicines you take, including prescription and nonprescription medicines.

Side effects of Otezla include diarrhea, nausea, vomiting, upper respiratory tract infection, runny nose, sneezing, or congestion, abdominal pain, tension headache, and headache. These are not all the possible side effects with Otezla. Ask your doctor about other potential side effects. Tell your doctor about any side effect that bothers you or does not go away.

Tell your doctor if you are pregnant, planning to become pregnant or planning to breastfeed. Otezla has not been studied in pregnant women or in women who are breastfeeding.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-332-1088.

Please click here for Full Prescribing Information.

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What Is Plaque Psoriasis? Get the Facts - Otezla

Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales.

These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.

Most people are only affected with small patches. In some cases, the patches can be itchy or sore.

Psoriasis affects around 2% of people in the UK. It can start at any age, but most often develops in adults under 35 years old, and affects men and women equally.

The severity of psoriasis varies greatly from person to person. For some it's just a minor irritation, but for others it can majorly affect their quality of life.

Psoriasis is a long-lasting (chronic) disease that usually involves periods when you have no symptoms ormild symptoms, followed by periods when symptoms are more severe.

People with psoriasis have anincreased production of skin cells.

Skin cells are normallymade and replaced every 3 to 4 weeks, but in psoriasis this process only takes about 3 to 7 days.

The resulting build-up of skin cells is what creates the patches associated with psoriasis.

Although the process is not fully understood, it's thoughtto be related to a problem with the immune system.

The immune systemis your body's defence against disease and infection, but it attacks healthy skin cells by mistake in people with psoriasis.

Psoriasis can run in families,although the exact role genetics plays in causing psoriasis is unclear.

Many people's psoriasis symptoms start or become worse because of a certain event, known as a trigger.

Possible triggers of psoriasis includean injury to your skin, throat infections and using certain medicines.

The condition is not contagious, so it cannot be spread from person to person.

Find out more about the causes of psoriasis

A GP canoften diagnose psoriasis based on the appearance of your skin.

In rare cases, a small sample of skin called a biopsy will be sent to the laboratory for examination under a microscope.

This determines the exact type of psoriasis and rules out other skin disorders, such as seborrhoeic dermatitis, lichen planus, lichen simplex and pityriasis rosea.

You may be referred to a specialist in diagnosing and treating skin conditions (dermatologist) if your doctor is uncertain about your diagnosis, or if your condition is severe.

If your doctor suspects you have psoriatic arthritis, which is sometimes a complication of psoriasis, you may be referred to a doctor who specialises in arthritis (rheumatologist).

You may have blood tests to rule out other conditions, such as rheumatoid arthritis, and X-rays of the affected joints may be taken.

There's no cure for psoriasis, but a range of treatments can improve symptoms and the appearance of skin patches.

In most cases, the first treatment used will be a topical treatment, such as vitamin D analogues or topical corticosteroids. Topical treatments are creams and ointments applied to the skin.

If these are not effective, or your condition is more severe, a treatment called phototherapy may be used. Phototherapy involves exposing your skin to certain types of ultraviolet light.

In severe cases, where the above treatments are ineffective, systemic treatments may be used. These are oral or injected medicines that work throughout the whole body.

Although psoriasis is just a minor irritation for some people, it can have a significant impact on quality of life for those more severely affected.

For example,some people with psoriasis have low self-esteem because of the effect the condition has on their appearance.

It's also quitecommonto developtenderness, pain and swelling in the joints and connective tissue. This is known as psoriatic arthritis.

Speak to a GP or your healthcare team if you have psoriasis and youhave any concerns about your physical and mental wellbeing. Theycan offer advice and further treatment if necessary.

There are also support groups for people with psoriasis, such as The Psoriasis Association, where you can speak to other people with the condition.

Find out more about living with psoriasis

Media last reviewed: 5 November 2018Media review due: 5 November 2021

Page last reviewed: 9 May 2018Next review due: 9 May 2021

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Psoriasis - NHS

Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Revised and updated, August 2014.

Psoriasis is a chronic inflammatory skin condition characterised by clearly defined, red and scaly plaques (thickened skin). It is classified into several subtypes.

Psoriasis affects 24% of males and females. It can start at any age including childhood, with peaks of onset at 1525 years and 5060 years. It tends to persist lifelong, fluctuating in extent and severity. It is particularly common in Caucasians but may affect people of any race. About one-third of patients with psoriasis have family members with psoriasis.

Psoriasis is multifactorial. It is classified as an immune-mediated inflammatory disease (IMID).

Genetic factors are important. An individual's genetic profile influences their type of psoriasis and its response to treatment.

Genome-wide association studies report that the histocompatibility complex HLA-C*06:02 (previously known as HLA-Cw6) is associated with early-onset psoriasis and guttate psoriasis. This major histocompatibility complex is not associated with arthritis, nail dystrophy or late-onset psoriasis.

Theories about the causes of psoriasis need to explain why the skin is red, inflamed and thickened. It is clear that immune factors and inflammatory cytokines (messenger proteins) such as IL1 and TNF are responsible for the clinical features of psoriasis. Current theories are exploring the TH17 pathway and release of the cytokine IL17A.

Psoriasis usually presents with symmetrically distributed, red, scaly plaques with well-defined edges. The scale is typically silvery white, except in skin folds where the plaques often appear shiny and they may have a moist peeling surface. The most common sites are scalp, elbows and knees, but any part of the skin can be involved. The plaques are usually very persistent without treatment.

Itch is mostly mild but may be severe in some patients, leading to scratching and lichenification (thickened leathery skin with increased skin markings). Painful skin cracks or fissures may occur.

When psoriatic plaques clear up, they may leave brown or pale marks that can be expected to fade over several months.

Certain features of psoriasis can be categorised to help determine appropriate investigations and treatment pathways. Overlap may occur.

Typical patterns of psoriasis.

Post-streptococcal acute guttate psoriasis

Small plaque psoriasis

Chronic plaque psoriasis

Unstable plaque psoriasis

Flexural psoriasis

Scalp psoriasis

Sebopsoriasis

Palmoplantar psoriasis

Nail psoriasis

Erythrodermic psoriasis (rare)

Psoriasis

Generalised pustulosis and localised palmoplantar pustulosis are no longer classified within the psoriasis spectrum.

Patients with psoriasis are more likely than other people to have other health conditions listed here.

Psoriasis is diagnosed by its clinical features. If necessary, diagnosis is supported by typical skin biopsy findings.

Medical assessment entails a careful history, examination, questioning about the effect of psoriasis on daily life, and evaluation of comorbid factors.

Validated tools used to evaluate psoriasis include:

The severity of psoriasis is classified as mild in 60% of patients, moderate in 30% and severe in 10%.

Evaluation of comorbidities may include:

Patients with psoriasis should ensure they are well informed about their skin condition and its treatment. There are benefits from not smoking, avoiding excessive alcohol and maintaining optimal weight.

Mild psoriasis is generally treated with topical agents alone. Which treatment is selected may depend on body site, extent and severity of psoriasis.

Most psoriasis centres offer phototherapy with ultraviolet (UV) radiation, often in combination with topical or systemic agents. Types of phototherapy include

Moderate to severe psoriasis warrants treatment with a systemic agent and/or phototherapy. The most common treatments are:

Other medicines occasionally used for psoriasis include:

Systemic corticosteroids are best avoided due to a risk of severe withdrawal flare of psoriasis and adverse effects.

Biologics or targeted therapies are reserved for conventional treatment-resistant severe psoriasis, mainly because of expense, as side effects compare favourably with other systemic agents. These include:

Many other monoclonal antibodies are under investigation in the treatment of psoriasis.

Oral agents working through the protein kinase pathways are also under investigation. Several JAK (Janus kinase) inhibitors are under investigation for psoriasis, including tofacitinib and the TYK2 (tyrosine kinase 2) inhibitorBMS-986165; both are in Phase III trials for psoriasis.

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Psoriasis | DermNet NZ

Plaque Psoriasis

Plaque psoriasis is the most common type of psoriasis and it gets its name from the plaques that build up on the skin. There tend to be well-defined patches of red raised skin that can appear on any area of the skin, but the knees, elbows, scalp, trunk, and nails are the most common locations. There is also a flaky, white build up on top of the plaques, called scales. Possible plaque psoriasis symptoms include skin pain, itching, and cracking.

There are plenty of over-the-counter products that are effective in the treatment of plaque psoriasis. 1% hydrocortisone cream is a topical steroid that can suppress mild disease and preparations containing tar are effective in treating plaque psoriasis.

Scalp psoriasis is a common skin disorder that makes raised, reddish, often scaly patches. Scalp psoriasis can affect your whole scalp, or just pop up as one patch. This type of psoriasis can even spread to the forehead, the back of the neck, or behind the ears. Scalp psoriasis symptoms may include only slight, fine scaling. Moderate to severe scalp psoriasis symptoms may include dandruff-like flaking, dry scalp, and hair loss. Scalp psoriasis does not directly cause hair loss, but stress and excess scratching or picking of the scalp may result in hair loss.

Scalp psoriasis can be treated with medicated shampoos, creams, gels, oils, ointments, and soaps. Salicylic acid and coal tar are two medications in over-the-counter products that help treat scalp psoriasis. Steroid injections and phototherapy may help treat mild scalp psoriasis. Biologics are the latest class of medications that can also help treat severe scalp psoriasis.

Guttate psoriasis looks like small, pink dots or drops on the skin. The word guttate is from the Latin word gutta, meaning drop. There tends to be fine scales with guttate psoriasis that is finer than the scales in plaque psoriasis. Guttate psoriasis is typically triggered by streptococcal (strep throat) and the outbreak will usually occur two to three weeks after having strep throat.

Guttate psoriasis tends to go away after a few weeks without treatment. Moisturizers can be used to soften the skin. If there is a history of psoriasis, a doctor may take a throat culture to determine if strep throat is present. If the throat culture shows that streptococcal is present, a doctor may prescribe antibiotics.

Many patients with psoriasis have abnormal nails. Psoriatic nails often have a horizontal white or yellow margin at the tip of the nail called distal onycholysis because the nail is lifted away from the skin. There can often be small pits in the nail plate, and the nail is often yellow and crumbly.

The same treatment for skin psoriasis is beneficial for nail psoriasis. However, since nails grow slow, it may take a while for improvements to be evident. Nail psoriasis can be treated with phototherapy, systemic therapy (medications that spread throughout the body), and steroids (cream or injection). If medications do not improve the condition of nail psoriasis, a doctor may surgically remove the nail.

Read more from the original source:

Psoriasis Types, Images, Treatments

Published: January, 2015

Psoriasis begins when certain areas of skin produce new skin cells much more rapidly than normal, causing a thickening and scaling of the skin.

The scaly, red patches of skin caused by psoriasis affect men and women of all ages. They can erupt anywhere on the body, clear up for months at a time, and then reappear.

Although the exact causes of psoriasis are not known, the immune system is involved and heredity may play a role; at least 1 of 3 people with psoriasis has an immediate relative with the disease.

Psoriasis can be triggered by a strep throat infection, heavy alcohol consumption, stress, some medicines (such as beta blockers and lithium), injury to the skin, and infection with the human immunodeficiency virus (HIV).

Psoriasis appears as reddish patches of skin covered with silvery scales; they may or may not cause discomfort.

There are several types of psoriasis:

Among people with psoriasis, 1 in 7 develop psoriatic arthritis, an autoimmune disease that causes inflammation of the joints.

The typical skin and nail changes of this disorder are often all that are needed to make a diagnosis. When skin symptoms aren't typical, your doctor may recommend that you have a skin biopsy, in which a small sample of skin is removed and examined in a laboratory. The biopsy can confirm the diagnosis and rule out other possible skin disorders.

Psoriasis is a chronic condition for which there is no cure. However, there are many treatments available to help keep it from getting worse, or flaring up. Treatment depends on the type, its location, and how widespread it is.

These are treatments applied directly to the skin. They include:

Extensive or widespread psoriasis may be treated with light (phototherapy). A treatment called PUVA combines ultraviolet A light treatment with an oral medication that improves the effectiveness of the light treatment.

Laser treatment also can be used. It allows treatment to be more focused so higher amounts of UV light can be used.

These are used to treat moderate to severe psoriasis involving large areas of the body. These treatments are very powerful. Some have the potential to cause severe side effects, so it is essential to understand the risks and be monitored closely.

These drugs work by suppressing the immune system. They are used to treat moderate to severe psoriasis involving large areas of the body.

Anticancer drugs like methotrexate are sometimes used to treat severe psoriasis.

Biologic drugs, or biologics, target specific parts of the immune system. They block the action of a specific type of immune cell called a T cell, or block proteins in the immune system, such as tumor necrosis factor-alpha (TNF-alpha) or inflammatory proteins known as interleukin-12 and interleukin-23. These cells and proteins all play a major role in developing psoriasis and psoriatic arthritis.

Biologics are given by injection or intravenous infusion. They include

Disclaimer:As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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Psoriasis - Harvard Health

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Psoriasis: Practice Essentials, Background, Pathophysiology

NEW YORK Novartis AG, Merck & Co Inc and Allergan Plc were among companies that raised U.S. prices on more than 100 prescription medicines on Friday, bringing the tally to 445 drugs that will cost more in 2020, according to data analyzed by healthcare research firm 3 Axis Advisors.

That is above the average of 404 drug price increases in the first three days of January over the past five years. Nearly all of the price increases are below 10%, with the median price increase around 5%, according to 3 Axis.

Swiss drugmaker Novartis raised prices on nearly 30 drugs including psoriasis treatment Cosentyx and multiple sclerosis medicine Gilenya, 3 Axis said. Most of those increases were in the range of 5.5% to 7%.

Novartis said that while it is raising the list prices of about 7 percent of its U.S. medicines, after discounts and rebates to commercial and government payers it expects a net price decrease of 2.5% in 2020.

U.S. drugmaker Merck raised prices on about 15 drugs, including diabetes medicines Januvia and Janumet, mostly around 5%, 3 Axis said.

The list price of its top-selling cancer immunotherapy Keytruda, expected to tally more than $13 billion in 2019 sales, was pushed up 1.5%.

Merck in a statement said the increases are consistent with its commitment to not raise U.S. net prices by more than inflation annually.

Ireland-based Allergan, which is being acquired by rival AbbVie Inc for more than $60 billion, said it was raising prices on 25 drugs by 5% and on two more medicines by 2-3%. But with higher rebates and discounts, it said, net pricing would be flat to lower in 2020.

Reuters previously reported that Pfizer Inc, Bristol-Myers Squibb Co and AbbVie were among drugmakers that had raised prices on more than 330 drugs to start the year.

Soaring healthcare costs for U.S. consumers, and prescription drug prices in particular, are expected to again be a central issue in the 2020 presidential campaign for both parties. President Donald Trump, a Republican who made bringing them down a core pledge of his 2016 campaign, is running for re-election in 2020.

Under pressure from politicians and patients, many makers of branded drugs have pledged to keep annual U.S. price increases below 10% a year.

Prescription drug prices are higher in the United States than most developed countries where governments directly or indirectly control the costs, making it the world's most lucrative market for manufacturers.

Drugmakers often negotiate rebates or discounts on their list prices in exchange for favorable treatment from insurers and other healthcare payers. As a result, insurers and covered patients rarely pay the full list price of a drug.

(Reporting by Michael Erman; Editing by Bill Berkrot)

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Novartis, Merck and Allergan Join Those Raising U.S. Drug Prices for 2020 - The New York Times