Patient description: The patient is a 60 year old man complaining of frequent headaches, generalized bone pain and difficulty chewing that started 6 years ago and is worsening. Examination shows bilateral swellings around the molars. The swellings have increased since his last examination. Several extraoral lesions are detected in the head and face. The swellings are non-tender and attached to the underlying bone. Further evaluation shows increased uptake of radioactive substance as well as an increase in urinary pyridinoline. His serum alkaline phosphatase is 300 IU/L (the normal range is 44- 147 IU/L). His family history is only significant for hypertension in his mother and DM type 2 in his father. The diagnosis of Paget's Disease of Bone was confirmed and Bisphosphonate will be started as first-line therapy.

Clinical trial eligibility criteria: eligible ages (years): 18.0-75.0,  Psoriasis Have a diagnosis of generalized chronic plaque and/or guttate psoriasis; 2. Are male and female patients aged between 18 and 75 years inclusive; 3. Have a psoriasis area and severity index (PASI) greater than 7 despite use of topical therapies; 4. Are due to undergo NB-UVB light therapy; 5. Have not required systemic psoriasis therapy during the past eight weeks; 6. Are unlikely to require systemic therapy for the duration of clinical trial involvement; 7. Have a negative pregnancy test at screening (women of child bearing potential only); and 8. Are willing to sign voluntarily a statement of informed consent to participate in the study  People with any of the following conditions will be excluded from the study: 1. Photosensitive disorders (lupus erythematosis etc); 2. Diabetes mellitus; 3. Use of medications that can cause photosensitivity; 4. Use of GLP-1 analogue therapy; 5. Conditions that could be made worse by phototherapy (cataract, epilepsy, etc); 6. Allergy or hypersensitivity to Januvia®; 7. Severe kidney disease as defined by a previous diagnosis of chronic kidney disease in the presence of an estimated glomerular filtration rate (eGFR) of less than 30ml/min/1.73m2; 8. Recent (within 8 weeks) receipt of NB-UVB light; 9. Current or recent (within 8 weeks) use of systemic therapy for psoriasis; 10. Severe heart disease as defined by a previous diagnosis of heart disease and a left ventricular ejection fraction which is known to be less than 35% (as measured by echocardiogram or cardiac catheterisation study); 11. Severe lung disease as defined by a previous diagnosis of chronic lung disease and a forced expiratory volume in 1 second (FEV1) or a forced vital capacity (FVC) that is known to be less than 50% that which would be estimated for a person of that age and gender; 12. Severe liver disease as defined by a previous diagnosis of chronic liver disease in the presence of an alanine transferase concentration greater than 150 international units/L (greater than three times the upper limit of the normal reference range); 13. Any other contraindications to Januvia® as stated in its SPC; 14. Female patients of child bearing potential who are pregnant, breastfeeding, or unwilling to practice an acceptable barrier and/or hormonal method of contraception during participation in the study abstinence will be permitted only if it is in keeping with a person's lifestyle; 15. Any clinically significant chronic disease that might in the opinion of the investigator, interfere with the evaluations or preclude completion of the trial; 16. A current or recent (within the past 4 weeks) acute serious illness, acute psychiatric illness or severe uncontrolled/unstable illness; 17. Previous randomisation into this study; 18. Concurrent participation in another clinical trial; and 19. Participation in another clinical trial during the twelve weeks prior to study entry (i.e. screening visit)