Kristian Reich1, Curdin Conrad2, Lars Erik Kristensen3, Saxon D Smith4,5, Luis Puig6, Phoebe Rich7, Christophe Sapin8, Thorsten Holzkaemper8, Uffe Koppelhus8, Christopher Schuster8,9. 1. Center for Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 2. Department of Dermatology, University Hospital Lausanne CHUV, Lausanne, Switzerland. 3. The Parker Institute, Lund University, Copenhagen, Denmark. 4. The Dermatology and Skin Cancer Centre, Sydney, Australia. 5. Discipline of Dermatology, The Sydney Adventist Hospital Clinical School, Sydney Medical School, The University of Sydney, Sydney, Australia. 6. Department of Dermatology, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 7. Oregon Dermatology and Research Center, Portland, OR, USA. 8. Eli Lilly and Company, Indianapolis, IN, USA. 9. Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Abstract
BACKGROUND: Nail psoriasis (NP) is common and of high importance in patients with psoriasis. Complete resolution of NP at week 24‒26 is an unambiguous nail outcome accessible for indirect treatment comparison of biologics. OBJECTIVE: To evaluate the comparative efficacy of approved biologics in achieving complete resolution of NP at week 24‒26. METHODS: A network meta-analysis (NMA) was conducted to indirectly compare the efficacy of six biologics in achieving complete resolution of NP at week 24‒26 in patients with moderate-to-severe psoriasis and concomitant NP. Complete resolution of NP was defined as a score of zero on the Nail Psoriasis Severity Index (NAPSI), modified NAPSI (mNAPSI) or Physician's Global Assessment of Fingernails (PGA-F). RESULTS: The probability of achieving complete resolution of NP was highest for ixekizumab (46.5%; 95% credibility interval [CrI] 35.1‒58.0; Surface Under the Cumulative RAnking curve [SUCRA] 97%), followed by brodalumab (37.0%; 17.0‒61.0; 79%), adalimumab (28.3%; 24.4‒32.4; 62%), guselkumab (27.7%; 21.1‒35.1; 58%), ustekinumab (20.8%; 10.2‒35.2; 37%), and infliximab (0.8%; 0.0‒8.9; 17%). CONCLUSION: In patients with moderate-to-severe psoriasis and concomitant NP, ixekizumab has the greatest likelihood among approved biologics of achieving complete resolution of NP at week 24‒26. Findings should be interpreted carefully because of inherent study limitations.
BACKGROUND: Nail psoriasis (NP) is common and of high importance in patients with psoriasis. Complete resolution of NP at week 24‒26 is an unambiguous nail outcome accessible for indirect treatment comparison of biologics. OBJECTIVE: To evaluate the comparative efficacy of approved biologics in achieving complete resolution of NP at week 24‒26. METHODS: A network meta-analysis (NMA) was conducted to indirectly compare the efficacy of six biologics in achieving complete resolution of NP at week 24‒26 in patients with moderate-to-severe psoriasis and concomitant NP. Complete resolution of NP was defined as a score of zero on the Nail Psoriasis Severity Index (NAPSI), modified NAPSI (mNAPSI) or Physician's Global Assessment of Fingernails (PGA-F). RESULTS: The probability of achieving complete resolution of NP was highest for ixekizumab (46.5%; 95% credibility interval [CrI] 35.1‒58.0; Surface Under the Cumulative RAnking curve [SUCRA] 97%), followed by brodalumab (37.0%; 17.0‒61.0; 79%), adalimumab (28.3%; 24.4‒32.4; 62%), guselkumab (27.7%; 21.1‒35.1; 58%), ustekinumab (20.8%; 10.2‒35.2; 37%), and infliximab (0.8%; 0.0‒8.9; 17%). CONCLUSION: In patients with moderate-to-severe psoriasis and concomitant NP, ixekizumab has the greatest likelihood among approved biologics of achieving complete resolution of NP at week 24‒26. Findings should be interpreted carefully because of inherent study limitations.
Entities:
Keywords:
Nail Psoriasis Severity Index (NAPSI); Nail psoriasis; Physician’s Global Assessment of Fingernails (PGA-F); biologics; complete clearance/resolution of nail psoriasis; ixekizumab; network meta-analysis
Authors: Kristian Reich; Lars Erik Kristensen; Saxon D Smith; Phoebe Rich; Christophe Sapin; Soyi Liu Leage; Robert McKenzie; Christopher Schuster; Elisabeth Riedl; Melinda Gooderham Journal: Dermatol Pract Concept Date: 2022-04-01