Rue shrubs and sea anemone venom for psoriasis?

Don't get your garden shears and snorkel out just yet, but researchers are hoping that two compounds they have created will one day help treat psoriasis and other immune system diseases. One, known as ShK(L5), is a synthetic version of a component of sea anemone venom. The other, PAP-1, is derived from a shrub, the common rue. Neither has yet been tested in humans.

Both compounds act to block channels that allow potassium ions to flow in or out of cells. These ion channels appear to play an important role in regulating the activity of cells in the immune system and are especially abundant on a type of immune cell implicated in diseases such as multiple sclerosis and psoriasis.

"This could be a completely new mechanism of immune suppression for patients who do not respond to or have side effects from current therapies," said UC Davis' Heike Wulff, assistant professor of medical pharmacology and toxicology.

Wulff is also a founder of a company hoping to commecialze these treatments. If they can help our psoriasis using sea anemone venom, more power to 'em!

(The rue shrub photo is from this website.)

Celgene psoriasis trial of CC-10004 - apremilast successful

Celgene announced today that its Phase Two trial of CC-10004 (also known as apremilast) showed promise against psoriasis, and the company pledged to accelerate its development for psoriasis and other inflammatory diseases. The treatment is novel in that it is an oral TNF alpha inhibitor; the TNF alpha inhibitors already available are injected or infused, not taken in pill form.

We have more here on the psoriasis research pipeline.

Methotrexate without liver biopsy?

One of the unpleasant features of taking methotrexate for psoriasis is the need for periodic liver biopsies. Methotrexate (MTX) can damage the liver in ways that can be missed by blood tests; a biopsy can detect this damage before it reaches a crisis point. (The fact that physicians do not seem to agree on how frequently patients should receive biopsies is a topic for another day.)

But new tests are emerging that may, before long, greatly reduce the role for invasive (and potentially dangeous) biopies. In a recent clinical trial, a pair of noninvasive, ultrasound-style tests, the Fibroscan and the Fibrotest, were shown to be accurate in most cases:

Fibrotest accurately predicted the presence of significant liver fibrosis while the Fibroscan accurately predicted the absence of significant liver fibrosis in MTX users [each in more than 80% of cases].

Methotrexate (read more on methotrexate here) is like the Timex of psoriasis treatments--this inexpensive cancer drug has been around since the Korean War and is still used widely for psoriasis and psoriatic arthritis, despite its potentially serious risks. If noninvasive alternatives to liver biopsies are perfected, methotrexate as an option may keep on ticking.

Doctor Fish for psoriasis revisited

In January, we brought you Reuters photos of the fish -- called Doctor Fish -- that actually nibble away at psoriasis lesions. (Those photos are no longer online.) Now we're back with a great Getty Image from China of the same phenomenon that appeared this week in the Washington Post. The Post has a big version of this photo.

But while we continue to snicker, a leading psoriasis doc says the fish (and the water) may provide decent temporary relief. Call your travel agent!

FDA bill could improve drug safety monitoring

The U.S. Senate passed a bill on May 9 that would expand the authority of the Food and Drug Administration to ensure drug safety:

The bill calls for a fundamental change in the philosophy and operations of the drug agency, requiring it to focus on the entire life cycle of a drug -- not just the years before its approval -- as well as the experience of patients who later take it.

Under the bill, the government would establish a surveillance system to track the adverse effects of prescription drugs. Scientists would analyze data on tens of millions of patients, looking for signals that particular drugs pose serious risks.

... Under the Senate bill, the government could order changes in a label and require the manufacturer to conduct more studies and clinical trials of a drug already on the market.

This is good news. Because psoriasis is a lifelong disease, psoriasis patients may need treatment for decades--far longer than drug testing could possibly cover before a product is approved for use. We have been advocating for the longterm monitoring of approved psoriasis treatments, and this bill may advance that goal.

The bill would also encourage testing of more treatments in children:

The bill would give financial incentives to drug companies to study the effects of their products in children. The reward would be scaled back for drugs that already had sales of more than $1 billion a year in the United States.

Experts estimate that two-thirds of the drugs prescribed for children have not been studied or labeled for pediatric use.

As was discussed in our podcast on psoriasis in children, there are few studies of how psoriasis treatments fare among pediatric patients.

A version of this bill is expected to be signed into law later this year.

National Nurses Week: Thanks to all

Take a moment this week (May 6-12, 2007) to think about and thank the nurses who have helped you and your loved ones over the years. People with psoriasis sometimes spend a lot of time with nurses--especially those dermatology nurses helping us with our UV light treatments, infusion nurses, and on and on.

Thanks for not appearing bothered by the trail of skin flakes! And for your intelligence and compassion.

ABT-874 psoriasis phase two data strong

Abbott today reported strong results in Phase Two testing for its experimental biologic currently known as ABT-874. The treatment, an antibody that targets interleukin-12 and interleukin-23, had a powerful effect in clearing psoriasis symptoms:

At 12 weeks, nine out of 10 patients with moderate to severe psoriasis achieved 75 percent improvement in psoriasis signs and symptoms in four of the five dosing groups receiving ABT-874, versus 3 percent of patients receiving placebo. Also, more than half of patients achieved 90 percent improvement, in the same four of five ABT-874 dosing groups, versus 0 percent of those receiving placebo.

These results are extremely rare for a psoriasis treatment, and bring to mind another anti-IL-12/IL-23 experimental treatment, Centocor's CNTO 1275, which recently posted similarly blockbuster results in clinical trials. CNTO 1275 appears to be further along in clinical testing, and thus should reach the FDA first. Let's hope these novel treatments prove safe and hit the market soon. The more options we have available, the better off we will be.

CariDee English - National Psoriasis Foundation working together

CariDee English, recent winner of the Fox TV show America's Next Top Model, and someone who has had psoriasis since childhood, has agreed to work with the National Psoriasis Foundation to help raise awareness of the disease. It is not clear if it is a paid position.

This is great news. For a disease with stigma (wrongly) attached to it, it can't hurt to have a gorgeous supermodel as a public face of our disease. She is also a testament to hanging in there and searching for a treatment that works for you. Her current treatment, reportedly a biologic therapy, is certainly working for her.

We hope she'll work with us, too....

Here's a video of CariDee discussing her psoriasis and her ANTM victory.