BACKGROUND: Although nail psoriasis occurs frequently in patients with psoriatic skin lesions, effective treatments are limited. OBJECTIVE: Occurrence of nail psoriasis by type and incidence of nail clearance using the Nail Psoriasis Severity Index were evaluated. METHODS: This was a 50-week, phase III study in which 378 patients with moderate to severe psoriasis were randomized 4:1 to infliximab (5 mg/kg) or placebo at weeks 0, 2, 6, and every 8 weeks through week 46, with placebo crossover to infliximab at week 24. RESULTS: Of the 373 evaluated patients, 305 (81.8%) had baseline nail psoriasis. The right thumbnail was most often the worst involved nail, and pitting and onycholysis were the most common lesions. Among patients with baseline nail psoriasis, 6.9%, 26.2%, and 44.7% in the infliximab group had nail disease clearance at weeks 10, 24, and 50, respectively, versus 5.1% in the placebogroup at week 24 (P < .001). Mean percent improvements in Nail Psoriasis Severity Index score at weeks 10 and 24 were 26.8% and 57.2%, respectively, in the infliximab group versus -7.7% and -4.1%, respectively, in the placebo group (both P < .001). At week 24, mean percent improvements in nail matrix and nail bed features were 52.9% and 69.2%, respectively (vs -1.9% and 18.4% for placebo; P < .001). LIMITATIONS: The study did not evaluate nail response beyond 1 year. CONCLUSIONS:Patients with psoriasis receivinginfliximab experienced marked and sustained nail improvement.
RCT Entities:
BACKGROUND: Although nail psoriasis occurs frequently in patients with psoriatic skin lesions, effective treatments are limited. OBJECTIVE: Occurrence of nail psoriasis by type and incidence of nail clearance using the Nail Psoriasis Severity Index were evaluated. METHODS: This was a 50-week, phase III study in which 378 patients with moderate to severe psoriasis were randomized 4:1 to infliximab (5 mg/kg) or placebo at weeks 0, 2, 6, and every 8 weeks through week 46, with placebo crossover to infliximab at week 24. RESULTS: Of the 373 evaluated patients, 305 (81.8%) had baseline nail psoriasis. The right thumbnail was most often the worst involved nail, and pitting and onycholysis were the most common lesions. Among patients with baseline nail psoriasis, 6.9%, 26.2%, and 44.7% in the infliximab group had nail disease clearance at weeks 10, 24, and 50, respectively, versus 5.1% in the placebo group at week 24 (P < .001). Mean percent improvements in Nail Psoriasis Severity Index score at weeks 10 and 24 were 26.8% and 57.2%, respectively, in the infliximab group versus -7.7% and -4.1%, respectively, in the placebo group (both P < .001). At week 24, mean percent improvements in nail matrix and nail bed features were 52.9% and 69.2%, respectively (vs -1.9% and 18.4% for placebo; P < .001). LIMITATIONS: The study did not evaluate nail response beyond 1 year. CONCLUSIONS:Patients with psoriasis receiving infliximab experienced marked and sustained nail improvement.
Authors: Peter Foley; Kenneth Gordon; Christopher E M Griffiths; Yasmine Wasfi; Bruce Randazzo; Michael Song; Shu Li; Yaung-Kaung Shen; Andrew Blauvelt Journal: JAMA Dermatol Date: 2018-06-01 Impact factor: 10.282
Authors: María Denise Takahashi; Edgardo Néstor Chouela; Gladys Leon Dorantes; Ana Maria Roselino; Jesùs Santamaria; Miguel Angel Allevato; Tania Cestari; Maria Eugenia Manzanera de Aillaud; Fernando Miguel Stengel; Daiana Licu Journal: Arch Drug Inf Date: 2010-03
Authors: C T Ritchlin; A Kavanaugh; D D Gladman; P J Mease; P Helliwell; W-H Boehncke; K de Vlam; D Fiorentino; O Fitzgerald; A B Gottlieb; N J McHugh; P Nash; A A Qureshi; E R Soriano; W J Taylor Journal: Ann Rheum Dis Date: 2008-10-24 Impact factor: 19.103