Baseline nail disease in patients with moderate to severe psoriasis and response to treatment with infliximab during 1 year.

Abstract

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: Phoebe Rich, Christopher E M Griffiths, Kristian Reich, Frank O Nestle, Richard K Scher, Shu Li, Stephen Xu, Ming-Chun Hsu, Cynthia Guzzo
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 58 Issue 2 Pg. 224-31 (Feb 2008) ISSN: 1097-6787 [Electronic] United States
• PMID: 18083272 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Infliximab

Topics

• Adult
• Antibodies, Monoclonal (therapeutic use)
• Female
• Humans
• Infliximab
• Male
• Middle Aged
• Nail Diseases (drug therapy)
• Psoriasis (drug therapy)