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Daily Archives: November 27, 2019
Development of PsA Linked to Tenosynovitis in Patients With Arthralgia – AJMC.com Managed Markets Network
Posted: November 27, 2019 at 7:46 pm
Researchers used ultrasound to investigate the anatomical basis for arthralgia symptoms and found that tenosynovitis was the only significant difference in patients who went on to develop psoriatic arthritis (PsA).
Patients with psoriasis who experience nonspecific musculoskeletal symptoms and joint symptoms, or arthralgia, are more likely to develop PsA; in addition, a condition called enthesitis (when inflammation and pain occurs where tendons and ligaments meet bones) is more likely. Because joint damage can occur early in the course of PsA, early disease recognition and treatment is vital, the researchers noted.
In this study, researchers used ultrasound (US) to investigate the anatomical basis for joint symptoms in arthralgia and the link between these imaging findings and later development of PsA; a cross-sectional prevalence analysis of clinical and ultrasound abnormalities was performed in patients with psoriasis, PsA, and arthralgia. The multicenter study in Italy involved 61 patients with arthralgia, 57 patients with psoriasis, and 57 healthy controls.
Tenosynovitis was the only significant sonographic feature that differed between those with arthalgia and psoriasis (29.5% vs 5.3%;P <.001), although synovitis and enthesitis were numerically more frequent in arthalgia.
Five patients in the arthalgia group and 1 in the psoriasis group developed PsA, with an incidence rate of 109.2 per 1000 person-years in the arthralgia group versus 13.4 per 1000 person-years in the psoriasis group (P = .03).
In addition, a Visual Analogue Scale (VAS) score, a Health Assessment Questionnaire, joint tenderness, and US active enthesitis were baseline variables associated with PsA development.
Compared with patients with psoriasis alone (as well as healthy controls), patientswith both psoriasis and arthalgia had a higher mean (SD) VAS pain score of4(2.35) versus2(2.39) (P<.001) and tender joints count of 2.98 (4.7) vs 0.49 (0.98) (P<.001).
Looking at US results, 18 of the 61 (29.5%) patients with arthalgia showed tenosynovitis in at least 1 region as evaluated by grey scale synovitis (grade 1 in 17/18 patients and grade 2 in 1/18), compared with 3 of the 57 patients with psoriasis (5.3%) (P <.001) and 2/57 (3.5%) in healthy controls, all grade 1 for psoriasis and controls.
While sonographically determined synovitis, enthesitis, and tenosynovitis were numerically more frequent in the arthralgia group compared with the psoriasis group, only tenosynovitis was statistically significant in patients with arthralgia.
However, only enthesitis, as determined by US, was linked to the future evolution of PsA, but tenosynovitis was not.
These findings are relevant for enriching for subjects at risk of imminent PsA development, the authors said.
Zabotti A, McGonagle DG, Giovanni I, et al. Transition phase towards psoriatic arthritis: clinical and ultrasonographic characterisation of psoriatic arthralgia [published online October 23, 2019].RMD Open. doi: 10.1136/rmdopen-2019-001067.
Posted: at 7:46 pm
Singer-songwriter Cyndi Lauper first joined Novartis Cosentyx team as a spokesperson more than four years ago, and the two are still churning out initiatives.
The latest is an unbranded awareness campaign to open up frank discussions about psoriasis stigma in the workplace.The effort, called PsO at Work, was inspired by psoriasis patients who have talked to Novartis over the past five years about the challenges of having psoriasis at work. Those include feeling embarrassed about visible plaques and flaking skin and the stigma caused by the inaccurate perception that the condition is contagious, a Novartis spokesman said in an email interview.
RELATED: In Novartis' newest Cosentyx push, active, real-life patients take center stage
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PsO at Work aims to empower patients to feel comfortable speaking up about how psoriasis impacts them in the workplace and how they manage and deal with it, he said.
Lauper shares her own story online at PsOatWork.com and a social media effort encourages others to add their own experiences with the hashtag #PsOatWork.
Whether you are a performer, teacher or office manager, psoriasis can be a challenge at work and impact your ability to perform at your best," Lauper said in a press release. "Learning to figure out how to manage my psoriasis has allowed me to continue doing what I love while still standing out in the crowdbut not because of my psoriasis."
The unbrandedeffort comes on the heels of another round of Cosentyx branded TV ads, debuted recently, that include Lauper talking about her personal psoriasis journey over the past four years.
The new ads include several with Lauper and other real-life patients together and individually as they touttheir four or fiveyears of clear skin while using Cosentyx. The ads continue the "See Me" theme, begun three years ago.
The spokesman was clear that while Lauper appears in both campaigns, the two efforts are distinct and separate. Lauper has done other awareness work for Novartis previously,dating back to2015.
Although Cyndi does appear in branded advertisements, this (PoS at Work) initiative is about raising awareness of psoriasis and validating the experiences of people living with the condition, not drug. As the spokesperson for the campaign, Cyndi plays an important role as both an advocate and someone who has experienced the impact of psoriasis at work, he said.
RELATED:Lilly tees up another Novartis battle with ankylosing spondylitis OK for Taltz
Cosentyx was first approved in early 2015 to treat plaque psoriasis and added approved indications for ankylosing spondylitis and psoriatic arthritis in early 2016. Its chief competitor is Eli Lillys Taltz, another IL-17A inhibitor that now also compete in all three indications. With new phase 3 data in spondyloarthritis, Novartis is looking to make it four.
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Novartis, Cyndi Lauper shine a light on psoriasis challenges in the workplace - FiercePharma
Posted: at 7:46 pm
Patients with psoriasis who do not receive proper disease education may not adhere to treatment, which can lead to worse outcomes, The American Journal of Managed Care reported. According to the article, a recent study examined the effect of an educational program on knowledge and self-expertise about psoriasis for patients with the disease. Patients were asked to fill out 2 questionnaires about disease knowledge, therapy adherence, and therapy satisfaction before and after the educational program. Overall, the educated patients showed a significant increase in knowledge, self-expertise about their disease, and general health after the program, the article reported.
Officials with the FDA declined to approve Adamis Pharmaceuticals opioid overdose treatment Zimhi, the company announced in a press release. According to Adamis, Zimhi, which is a naloxone pre-filled single-dose syringe, is designed to deliver high doses of naloxone for the emergency treatment of known or suspected opioid overdose. In a Complete Response Letter sent to the manufacturer, the FDA questioned the treatments manufacturing process, but not its safety or effectiveness, the release said.
A recent study suggests that antibiotic exposure may be linked to the risk of developing Parkinson disease, MD Magazine reported. According to the article, the study included 13,976 patients, as well as 40,697 control patients. Overall, the authors found that exposure to antianaerobics and tetracyclines 10 to 15 years before the index data, as well as suflonamides and trimethoprim 1 to 5 years before the index date and antifungal medication 1 to 5 years before the index date were positively associated with Parkinson disease risk, the article reported.
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Trending News Today: Patients with Psoriasis Benefit from Disease Education - Pharmacy Times
Posted: at 7:46 pm
Novartis and thePsoriasis Association of Malaysia have launched the Be Pso Positive campaign in a bid to createreal world actions for enhancing the lives of those who take this medical condition in their stride and continue to pursue their individual aspirations and passion.
Done in collaboration with Edelman Malaysia and Malaysian singer and song writer Zee Avi, the latest spot is said to be the worlds first petition for Psoriasis heroes.Encouraged by the last years initiative of convincing Psoriasis patients to confidently face the limelight, this years collaboration pushes the envelope by kickstarting a petition to makePsoriasis treatment more accessible to all. Meanwhile, Edelman said the music video with Zee will roll out next week.Edelman Malaysias MD, Mazuin Zin, said music has the powerto both heal and make consumers feel for something that might not otherwise affect their lives.
A reason we decided to anchor our activism around scripting perhaps worlds first musical petition celebrating the lives of our Psoriasis heroes, their beliefs and aspirations. This truly is a demonstration how a brand walks the talk on its purpose in order to create an earned attention, she explained.
Mazuin added that the veryact of sitting down with those braving this medical condition and penning down their lifes aspirations with a professional lyricist brings out the key aspect that this medical condition is much deeper than a mere skin condition.
Through this musical journey we wish to educate both the sufferers and their care givers the aspect of how this condition can have much deeper manifestations in terms of psoriatic arthritis, cardiovascular diseases, diabetes and depression, among others, she added.
Posted: at 7:46 pm
It's an inflammatory, chronic skin condition that happens when your skin cells' natural turnover rate rapidly increasesresulting in dry, itchy, sometimes painful patches. It commonly appears on the elbows, knuckles, and scalp; it can, however, appear anywhere on the body.
The disease affects 8 million people in the United States and usually presents itself between 15 and 25, according to the National Psoriasis Foundation. We don't fully know what causes it, but it's related to the immune system, genetics, and environmental factors, Barr tells us.
"It's thought to be related to an immune system issue with T-cells, specifically T-regulator cells as well as other white blood cells, called neutrophils. While T-cells normally travel through the body to defend against foreign substances, such as viruses or bacteria, if you have psoriasis, the T-cells attack healthy skin cells as if to heal a wound or to fight an infection," Barr says. This triggers the increased production of healthy cells, resulting in the lesions. "Dilated blood vessels in psoriasis-affected areas also create warmth and redness," she says.
That's why it's vital to address inflammation in your treatment, as noted above.
Association Between Soluble Lectinlike Oxidized Low-Density Lipoprotein Receptor-1 and Coronary Artery Disease in Psoriasis – DocWire News
Posted: at 7:46 pm
Psoriasis, a chronic inflammatory skindiseaseassociated with accelerated noncalcifiedcoronaryburden (NCB) bycoronarycomputed tomography angiography (CCTA), accelerates lipoprotein oxidation in the form of oxidized modified lipoproteins. A transmembrane scavenger receptor for these oxidized modified lipoproteins is lectinlike oxidized low-density lipoprotein receptor-1 (LOX-1), which has been reported to be associated withcoronary artery disease. It is unknown whether this receptor is associated withcoronary artery diseasein psoriasis.
To assess the association between soluble LOX-1 (sLOX-1) and NCB in psoriasis over time.
In a cohort study at the National Institutes of Health, 175 consecutive patients with psoriasis were referred from outpatient dermatology practices between January 1, 2013, and October 1, 2017. A total of 138 consecutively recruited patients with psoriasis were followed up at 1 year.
Circulating soluble lectinlike oxidized low-density lipoprotein receptor-1 levels were measured blindly by field scientists running undiluted serum using an enzyme-linked immunosorbent assay.
Coronarycomputed tomography angiography scans were performed to quantify NCB in all 3 major epicardialcoronaryarteries by a reader blinded to patient demographics, visit, and treatment status.
Among the 175 patients with psoriasis, the mean (SD) age was 49.7 (12.6) years and 91 were men (55%). The cohort had relatively low median cardiovascular risk by Framingham risk score (median, 2.0 [interquartile range (IQR), 1.0-6.0]) and had a mean (SD) body mass index (calculated as weight in kilograms divided by height in meters squared) suggestive of overweight profiles (29.6 [6.0]). Elevated sLOX-1 levels were found in patients with psoriasis compared with age- and sex-matched controls (median, 210.3 [IQR, 110.9-336.2] vs 83.7 [IQR, 40.1-151.0]; P<.001), and were associated with Psoriasis Area Severity Index (PASI) score (=0.23; 95% CI, 0.082-0.374; P=.003). Moreover, sLOX-1 was associated with NCB independent of hyperlipidemia status (=0.11; 95% CI, 0.016-0.200; P=.023), an association which persisted after adjusting for traditional cardiovascular risk factors, statin use, and biologic psoriasis treatment (=0.10; 95% CI, 0.014-0.193; P=.03). At 1 year, in those who had clinical improvement in PASI (eg, >50% improvement), a reduction in sLOX-1 (median, 311.1 [IQR, 160.0-648.8] vs median, 224.2 [IQR, 149.1 427.4]; P=.01) was associated with a reduction in NCB (=0.14; 95% CI, 0.028-0.246; P=.02).
Soluble lectinlike oxidized low-density lipoprotein receptor-1 levels were elevated in patients with psoriasis and were associated with severity of skindisease. Moreover, sLOX-1 associated with NCB independent of hyperlipidemia status, suggesting that inflammatory sLOX-1 induction may modulate lipid-rich NCB in psoriasis. Improvement of skindiseasewas associated with a reduction of sLOX-1 at 1 year, demonstrating the potential role of sLOX-1 in inflammatory atherogenesis in psoriasis.
Posted: at 7:46 pm
While guidelines for psoriatic arthritis recommend a treatment target of remission or low disease activity, consensus is lacking on how to define either. Disease activity is most often measured by DAPSA (Disease Activity index for Psoriatic Arthritis) scorebased mainly on jointsor VLDA/MDA (very low disease activity/minimal disease activity) criteriabased on assessment of joints, skin, and entheses. Previous research indicates that remission/low disease activity rates are higher with the use of DAPSA than with VLDA/MDA, according to Laure Gossec, MD, PhD, but what measurements with either test mean to patients is not well known.
For a study published in Annals of the Rheumatic Diseases, Dr. Gossec and colleagues surveyed patients with psoriatic arthritis of more than 2 years and compared their perceptions of remissions with those of their physicians and VLDA, LDA, and DAPSA scores.
In these patients not selected for good disease control and with usually long disease duration, remission or low disease activity were attained by more than 50% of patients, says Dr. Gossec. Patient-perceived remission/low disease activity was frequent (65.4%). Patient-perceived remission was as frequent as remission based on DAPSA, whereas good status according to VLDA/MDA was reached less frequently. DAPSA-based status appeared to correctly reflect patient-perceived low disease activity, which is an argument to use this score to assess psoriatic arthritis.
As the first to compare treatment targets using composite scores and patient questions on assessment of status, the cross-sectional study used a patient questionnaire developed for this study with patient research partners, but not externally validated. Dr. Gossec also notes that whether the findings would be replicated in patients over time is unknown. She adds, though, that physicians now have more information on patient perceptions of remission, and comparison with composite scores to follow-up patients; DAPSA appeared to agree more with patients assessments, though both scores have strengths and weaknesses.
Comparing patient-perceived and physician-perceived remission and low disease activity in psoriatic arthritis: an analysis of 410 patients from 14 countrieshttps://ard.bmj.com/content/78/2/201
Posted: at 7:45 pm
EUGENE, Ore., Nov. 27, 2019 /PRNewswire/ -- Accidents happen: liquids plus mattresses equal disaster. Owning a waterproof mattress protector will extend the life of your mattress. You'll find the best of the best in RAVE Reviews' ranking of the best waterproof mattress protectors.
"Spilling liquid on your mattress can cause unsightly stains," said William Kennedy, Marketing and Creative Manager for RAVE Reviews, which can contribute to the growth of mold and bacteria, worsening allergies, skin conditions, and overall hygiene.
"Waterproof mattress protectors have improved a lot in recent years," he continued, no longer making that plasticky, crinkling sound they used to make. "The best products are now vinyl-free and made with materials that are waterproof, breathable, hypoallergenic, and natural," he said.
A total of 10 waterproof mattress protectors are featured in the ranking, emphasising products at a variety of price points.
Waterproof mattress protectors were reviewed on the following factors: waterproofing, value, what is it made of, does it sleep cool or hot, is it noisy, is it breathable, machine-washability, and is it a trusted brand.
Brands making the ranking are as follows:
1) Adoric Mattress Protector Brand: Adoric City: n/a
2) SafeRest Premium Hypoallergenic Waterproof Mattress Protector Brand: SafeRest City: Coral Springs, Florida
3) UltraPlush Premium Full Size Waterproof Mattress Protector Brand: UltraBlock City: Scotts Valley, California
4) Brooklyn Bedding Luxury Cooling Mattress Protector Brand: Brooklyn Bedding City: Phoenix, Arizona
5) One's Own Renewable Organic Mattress Protector with Tencel and Eucalyptus Brand: One's One City: Las Vegas, Nevada
6) Adaptive Shield Premium Performance Mattress Protector Brand: Adaptive Shield City: n/a
7) Utopia Bedding Waterproof Bamboo Mattress Protector Brand: Utopia Bedding City: Plainview, New York
8) LINENSPA Premium Smooth Fabric Mattress Protector Brand: LINENSPA City: Logan, Utah
9) Coop Home Goods Lulltra Waterproof Mattress Pad Protector Brand: Coop Home Goods City: Bell, California
10) MALOUF Sleep TITE PR1ME Smooth Waterproof Mattress Protector Brand: MALOUF City: Logan, Utah
Read the complete ranking here:
RAVE Reviews is like a product review site and a lifestyle magazine hooked up a fun and authoritative guide for consumer goods, entertainment, and travel.
SOURCE RAVE Reviews
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Posted: at 7:45 pm
To kick off the month of December, the city of Gastonia plans to pull out all the stops in transforming Main Avenue into a Christmastime utopia.
The annual event that has come to be known as Christmas in the City will take place over three hours downtown on Sunday, Dec. 1. It will aim to draw hundreds of festive residents to the historic business district, while helping them become immersed in the holiday spirit.
The celebration will kick off as usual with the popular Christmas parade that is being organized once again by the Gaston Jaycees. It will follow its established path heading east down Main Avenue, starting near Chester Street and proceeding roughly half a mile to Broad Street.
Christine Carlson, the citys event planner, said there will be a total of 80 entries in the parade this year, with traditional floats, marching bands, unique vehicles and everything in between. The featured finale, as always, will be Santa Claus on a fire engine.
At the same time that the parade gets underway, the Christmas marketplace will open around the Rotary Centennial Pavilion. It will feature about three dozen craft and business vendors, along with several food trucks selling meals and other seasonal treats. Free activities in the area will include face-painting, Sno-Globe photos and balloon twisting, as well as booths where children can make their own Christmas ornaments, color, and write letters to Santa.
Elevation Church Gaston will be giving out hot chocolate at no charge, and complimentary goody bags will be handed out at the event.
As the parade wraps up around 4:45 p.m., Keep Gastonia Beautiful will host the start of a holiday concert around the Rotary Pavilion. That will lead into Santa Claus himself flipping the switch to light the Christmas tree under the pavilion at 5:30 p.m. After that, children will be able to visit with Santa, telling him what presents theyd like to wake up to on Christmas morning.
Musical performances during the concert and tree lighting ceremony will be provided by the Gaston Symphonic Band, the W.A. Bess fifth-grade chorus, the York Chester Middle School Jazz Band, and the Roaring Panther Band of Pleasant Ridge Elementary School.
The event will conclude around 7 p.m. with a raffle drawing for three gift baskets.
You can reach Michael Barrett at 704-869-1826 or on Twitter @GazetteMike.
Posted: at 7:45 pm
"It's happening now."
The Feed starNina Toussaint-White's warning about the core message of the Amazon series shouldn't be taken too literally, of course. The world is not yet hooked up to a single network via neural implants (emphasis on "yet"), though the interplay between modern society and smartphone technology certainly emulates the high-stakes fears at play in Channing Powell's adaptation of Nick Clark Windo's novel of the same name.
Featuring Toussaint-White and Guy Burnet as married couple Kate and Tom Hatfield, The Feed takes place in a near future where humanity becomes inextricably linked with a technological advancement called the Feed. "Think Twitter, but in your brain" doesn't quite do the trick, but it gets you close to the idea. Spanning 10 episodes, the first season (currently streaming in its entirety on Amazon Prime Video) chronicles only a small portion of Windo's novel just 14 pages of it, according to what Toussaint-White tells The Hollywood Reporter. Without spoiling the outcome, the first series sets the stage for a much more primal and visceral second season, one that depicts a bleak world after a hard break from technological dependency.
Ahead, Toussaint-White opens up more on the premise of The Feed, the conversations it drove for her and her castmates, and what to expect should a second season come to pass.
From the perspective of someone who is about to dive into The Feed for the first timewhat are they about to get into?
It's a psychological thriller, set in the not-too-distant future, and it's based on a novel by Nick Clark Windo. The idea is that society as we know it has people connected to "The Feed." They have tiny chips installed in the backs of their brains. It allows them to store and share information. It allows them to share every emotion and memory within an instant. You can look around and make your surroundings more elaborate, more tasteful. It's like having a smartphone inside your brain. The series takes a dark turn very, very quickly. You witness the horrifying consequences our reliance on technology has on humankind, if things go wrong. The great thing about it is series one only takes us through the first 14 pages of the book. There's the potential to go much deeper into the world Nick created.
Did you spend a lot of time with the novel to prepare for the show?
I didn't. I know a lot of people who have read the book, and I have it on my shelf, but for methis was a very collaborative start. Myself, Guy Burnet and Carl Tibbetts, who directed episodes one and two, wanted to work together to create what it would look like to be inside The Feed. Nobody knew what that would look like, and we wanted to create it ourselves. For me personally, I felt that diving into the book would paint too much of a picture for me. I wanted creative hold over what my character was going to be like. Apparently, in the book, it's completely different.
Can you walk us through those conversations with Guy and Carl, designing what The Feed would look and, more important, feel like as you convey this world to the audience?
It's completely new to all of us on day one. The idea is let's say we're on the Feed, me and you. I can be in a coffee shop with you, having a cup of tea, while Skyping my mom at the same time through my brain. The viewer sees what's going on inside my character's brain. What we struggled with is this: I'm talking to you at the coffee shop, my mom calls me. How do we stay in the world we're in while also going into the Skype call? What we did a lot of times is my character is changing her baby, she's putting her to bed, but she's also talking to Guy's character Tom via the Feed. It's the same thing as being able to walk down the street with a phone in your hand. Looking at the screen, you can check your emails and do so much on your phone, while getting from A to B. It was a hard world to create at first. What we realized is I could be walking and talking to the people around me while still connecting to the Feed, and the viewers can see that through me.
What were some of your first thoughts as you started digging into the themes of the series, and your thoughts about the Feed as a technological premise?
As my career has evolved, I've hoped I would be in shows that I'd want to watch myself. When I first auditioned for this, I was completely drawn to the project. I was only given the first episode, but I read through it and fell in love with it. The script had a lot of similarities to Black Mirror, which is a series I absolutely love. This idea of a dystopian world, one that highlights people's dependency on and their addiction to technology, which I think we all need to open our eyes to a bit. Straight away, I fell in love with the project.
This kind of technology is billed as unifying us as a species, but there are arguments that it's dividing us, and that argument is certainly present within a faction of the characters in The Feed.
Working on this show has brought up a lot of these really interesting, eye-opening conversations about how much we really are so dependent on technology. It's become more integral to how we operate in our daily lives. The Feed is looking into the not-too-distant future, but what happens in the series is technically happening now. We've heard Elon Musk is creating neural implants to put into our brains so we can overcome technology, because at the moment, technology is surpassing the human brain. It's been created to connect. But then I'm watching programs like The Great Hack. Data has been weaponized, it's been used to steer votes. I'm sitting next to my phone now, and who knows what it's picking up? Next time I pick it up, it's going to mention something that I mentioned to you. So much of your privacy is taken away. Of course it does wonderful things. My character in this show is American, living in London, and she's able to connect to her family in America. She's even able to connect with her unborn child. It's not all bad. If I was told that by having an implant, I could cure myself if I had cancer, that might be a route I would want to take. But there are also so many consequences in relying too much on technology. We're losing connection. We're losing physical contact. Mental health [struggles] have risen so much, because we're so tapped into the net. We like to call it "science fact," rather than science fiction. It's happening now.
While making the series, how often did you and your co-stars dive into existential conversations about the way technology impacts our world?
I'm always one for having fun on set and not taking things too seriously. (Laughs.) Of course, I take the work seriously! But I also want to relax and have a good time with my colleagues. I don't know about everyone else, but for me, the process is you get episodes one and two, then you wait for episodes three and four, and then you wait for five and six, and so on. We didn't get all the scripts early on, so we didn't know how the story was going to evolve. I will be absolutely, brutally honest: I had so much to think with developing my character's American accent and developing my connection and chemistry with Tom that I just wanted to settle into the world, rather than try to unpack it. But what's happened is since putting the filming to bed, and now that I'm talking about it more, my eyes have been opened. I've had a rebirth as far as how damaging technology can be, social media and stuff like that. I've lessened my screen time by 50 percent. I'm just a bit more wary. That's through conversations with people like you, rather than on set, where we were creating the world.
What are your aspirations for beyond the first season?
Well, I haven't read the book, but what I know is the first 14 pages cover the first 10 episodes of series one. Well, by the end of episode 10, the shit hits the fan, excuse my French. We go from utopia to dystopia.
This interview has been edited and condensed for clarity.
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