Individualized Therapy

This study is pretty interesting. I’ve heard this before but it appears that they’re able to prove the efficiency of selecting different biologic therapies to people based on individual factors.

They believe that prescribing medication to psoriasis patients based on their individual factors will take into account that they also likely have other diseases that may limit the effectiveness of some treatments.

A new study advises selecting biologic therapies for psoriasis based on individual factors such as patients’ comorbidities, preferences and clinical situation, as well as the advantages and disadvantages of particular biologic treatments. The study appeared in the February 2018 issue of the American Journal of Clinical Dermatology. Authors led by Jashin J. Wu, M.D., reviewed available evidence to formulate expert-opinion algorithms for comorbidities such as psoriatic arthritis (PsA), tuberculosis and hepatitis B, as well as psoriasis in children and women of childbearing potential. Few patients present with psoriasis and no other health issues, said Dr. Wu, of Kaiser Permanente Los Angeles Medical Center, Los Angeles. Probably the most common comorbidity dermatologists see, he said, is PsA, which afflicts around one-third of patients with psoriasis. In such cases, Wu et al. recommend the TNF inhibitors adalimumab, etanercept and infliximab, in that order, as first-line options, as all have been shown to inhibit radiographic progression of PsA, as well as other disease signs and symptoms. Overall, they write, “The efficacy of TNF inhibitors for PsA is comparable. However, infliximab is more effective at clearing skin lesions, followed by adalimumab and then etanercept.” Source: Individualized biologic therapy | Dermatology Times

PSA Treatments

Good news for those of us suffering from psoriatic arthritis, it looks like another drug is showing good results in blocking IL-23. In the study, when IL-23 was blocked, patients showed not only pain and swelling improvements but their skin improved as well!

A new phase two study shows that guselkumab significantly improves signs and symptoms of psoriatic arthritis (PsA), supporting the importance of interleukin (IL)-23 as a therapeutic target in PSA. Published in the June 2018 issue of The Lancet, the study shows that guselkumab significantly outperformed placebo in terms of American College of Rheumatology (ACR) 20 response at week 24, as well as several secondary outcomes related to bones, joints and quality of life out to nearly a year. “This is the first published study of an IL-23-blocking drug, which offers a novel mechanism of action, in psoriatic arthritis,” said lead investigator Atul Deodhar, M.D., of the Oregon Health & Science University in Portland, Ore. Guselkumab seems to improve all manifestations of psoriatic disease, including skin, joint and enthesial involvement, along with dactylitis, he added. “The other exciting part is the significant improvement in patients’ functioning, which is not surprising because patients’ pain, swelling and skin improved.” Source: IL-23 guselkumab significantly improves symptoms in psoriatic arthritis | Dermatology Times

Mare’s Milk For Health

I haven’t heard of this before, but apparently drinking mare’s milk offers some kind of healing effect for those with psoriasis. Historically it’s been used by many cultures to cure different ailments.

Even if it works, I’m not sure I’m going to be beating down the barn door to get some nice warm horse milk any time soon.

While the idea of sipping mare’s milk might sound unusual to Western readers, it’s been a traditional staple in Central Asia, where it is often fermented into “koumiss,” a mildly alcoholic drink that was adopted by Russian doctors in the mid-19th century as a treatment for tuberculosis. Patients no less illustrious than the writers Anton Chekhov and Leo Tolstoy swore by its curative powers. In Europe today, mare’s milk remains a niche product, but its reputation as a health elixir is causing trouble for producers in a more regulated age. That includes dairy farms like Lindenhof Stud, located in the lush countryside of Brandenburg, Germany, a 45-minute train ride outside Berlin. The elegant bays, grays and chestnuts that wander over to nibble at my pockets are pedigreed sports mares. And their milk is consumed not just by their foals, but by humans. “We couldn’t start our own business ’til socialism ended,” Lindenhof’s owner, Siegfried Dörge, says. “And then in 1991 we bought mares to breed and to milk.” Source: Mare’s Milk For Health? Europeans Look To Horses For Ancient Remedy : The Salt : NPR

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