Efficacy of ixekizumab compared to etanercept and placebo in patients with moderate‐to‐severe plaque psoriasis and non‐pustular palmoplantar involvement: results from three phase 3 trials (<scp>UNCOVER</scp>‐1, <scp>UNCOVER</scp>‐2 and <scp>UNCOVER</scp>‐3)

Menter, Alan; Warren, Richard B; Langley, Richard; Merola, Joseph F.; Kerr, Lisa; Dennehy, Ellen B.; Shrom, David; Amato, David A.; Okubo, Yukari; Reich, Kristian

doi:10.1111/jdv.14237

Cited by 65 publications

(46 citation statements)

References 22 publications

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“…Methotrexate significantly improved modified palmoplantar psoriasis area and severity index (m‐PPPASI) scores relative to the retinoid acitretin (Table ) (Janagond, Kanwar, & Handa, ). Additionally, ustekinumab, secukinumab, and apremilast significantly improved palmoplantar psoriasis compared with placebo; and ixekizumab provided significant improvement compared to etanercept and placebo (Au et al, ; Bissonnette et al, ; Gottlieb et al, ; Menter et al, ; Paul et al, ). However, infliximab failed to meet a primary endpoint of m‐PPPASI 75 at week 14 compared with placebo (Bissonnette et al, ).…”

Section: Methodsmentioning

confidence: 99%

Underdiagnosed and undertreated psoriasis: Nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails

Merola

Qureshi

Husni

2018

Dermatologic Therapy

110

137

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Psoriasis of the scalp, face, intertriginous areas, genitals, hands, feet, and nails is often underdiagnosed, and disease management can be challenging. Despite the small surface area commonly affected by psoriasis in these locations, patients have disproportionate levels of physical impairment and emotional distress. Limitations in current disease severity indices do not fully capture the impact of disease on a patient's quality of life, and, combined with limitations in current therapies, many patients do not receive proper or adequate care. In this review, we discuss the clinical manifestations of psoriasis in these less commonly diagnosed areas and its impact on patient quality of life. We also examine clinical studies evaluating the effectiveness of therapies on psoriasis in these regions. This article highlights the need to individualize treatment strategies for psoriasis based on the area of the body that is affected and the emerging role of biologic therapy in this regard. The quality of life (QoL) of patients with psoriasis affecting less common areas may be disproportionately impacted relative to the affected area (Figure 1) (Augustin et al., 2010;Sampogna et al., 2004Sampogna et al., , 2014. For example, the presence of lesions in highly visible areas can affect a patient's self-esteem, whereas involvement of the palms can make even opening a jar challenging (Janowski, Steuden, & Bogaczewicz, 2014). Nail or hand psoriasis can cause increased financial burdens due to reduced workplace productivity from disease impairment (Augustin et al., 2010;Schmitt & Ford, 2006). Using current scoring systems to measure the severity of psoriasis, such as the Psoriasis Area Severity Index (PASI) and Physician's Global Assessment (PGA), will not capture the substantial impact of disease in these regions because they do not include a specific measurement of these areas nor do they incorporate QoL measures. If using only PASI scores, for example, the location of the skin findings may not be considered and patients can be greatly affected by location versus size alone.Thus, evaluation scales were developed that specifically measure disease impact in these areas such as the Nail Psoriasis and Severity Index | M ETH OD SPubMed literature searches were conducted with the following terms: psoriasis and face/facial, psoriasis and palmoplantar, psoriasis and intertriginous or inverse, psoriasis and genital, psoriasis and scalp, and psoriasis and nail. Abstracts from English-language articles in the last 10 years were screened for relevance.

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Section: Methodsmentioning

confidence: 99%

Underdiagnosed and undertreated psoriasis: Nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails

Merola

Qureshi

Husni

2018

Dermatologic Therapy

110

137

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“…Moreover, among the head-to-head trials, it was found to be significantly more effective than etanercept as well as ustekinumab after 12 weeks of treatment [10]. Similarly, ixekizumab has shown promising results on its efficacy in clinical trials [11], and a significant superiority has been reported respect to etanercept, adalimumab as well as ustekinumab [12][13][14]. Moreover, ixekizumab demonstrated persistent efficacy through 108 weeks [15].…”

Section: Limitations Of the Current Treatments And Future Perspectivementioning

confidence: 99%

Limitations of current monoclonal antibodies for plaque-type psoriasis and an outlook for the future

Raimondo

Balato

Megna

et al. 2018

Expert Opinion on Biological Therapy

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“…The disease is characterized by well‐distinguished, reddish, scaly plaques on the palms and/or soles and may or may not occur with psoriasis of other skin areas . Patients with palmoplantar psoriasis have great disability and discomfort, as lesions on palms and soles significantly affect daily activities and mobility due to symptoms such as burning, skin soreness and pain . Palmoplantar psoriasis is therefore associated with a greater impairment of health‐related quality of life (QoL) than plaque psoriasis on other parts of the body, and significant palmoplantar psoriasis is considered a severe form of psoriasis …”

mentioning

confidence: 99%

Sustained efficacy of secukinumab in patients with moderate‐to‐severe palmoplantar psoriasis: 2·5‐year results from GESTURE , a randomized, double‐blind, placebo‐controlled trial

Gottlieb

Kubanov²,

Doorn

et al. 2019

Br J Dermatol

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Summary Background Secukinumab has shown sustained efficacy and safety in several manifestations of psoriasis. Objectives GESTURE investigated the long‐term (2·5‐year) safety and efficacy of 150 mg and 300 mg subcutaneous secukinumab in 205 patients with moderate‐to‐severe palmoplantar psoriasis. Methods GESTURE was a randomized, double‐blind, placebo‐controlled, multicentre, phase IIIb trial conducted across 15 countries. The study was 140 weeks long and consisted of four periods: screening (up to 4 weeks), treatment period 1 (16 weeks), treatment period 2 (116 weeks) and post‐treatment follow‐up (8 weeks). Eligible patients were aged ≥ 18 years with moderate‐to‐severe palmoplantar psoriasis and at least one plaque outside of the palms and soles. Efficacy was assessed via a palmoplantar Investigator's Global Assessment (ppIGA) and the palmoplantar Psoriasis Area and Severity Index (PASI). Results The primary end point, a ppIGA score of 0 or 1, was met at week 16. The effect was sustained over 2·5 years with 59% [95% confidence interval (CI) 43·5–74·1] and 53% (95% CI 35·1–69·6) of patients in the secukinumab 300 mg and 150 mg groups, respectively, achieving clear or almost clear palms and soles (ppIGA 0 or 1). At 2·5 years, the mean palmoplantar PASI percentage was reduced in both the secukinumab 300 mg group (−74·7%) and the secukinumab 150 mg group (−61·6%). A total of 17% (secukinumab 300 mg group) and 18% (secukinumab 150 mg group) of patients experienced no difficulty in hands and feet functionality, as indicated by the palmoplantar quality of life instrument overall scores. The safety profile was favourable. Conclusions GESTURE revealed that secukinumab provides a strong and sustained response over 2·5 years in challenging‐to‐treat palmoplantar psoriasis.

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Efficacy of ixekizumab compared to etanercept and placebo in patients with moderate‐to‐severe plaque psoriasis and non‐pustular palmoplantar involvement: results from three phase 3 trials (UNCOVER‐1, UNCOVER‐2 and UNCOVER‐3)

Cited by 65 publications

References 22 publications

Underdiagnosed and undertreated psoriasis: Nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails

Underdiagnosed and undertreated psoriasis: Nuances of treating psoriasis affecting the scalp, face, intertriginous areas, genitals, hands, feet, and nails

Limitations of current monoclonal antibodies for plaque-type psoriasis and an outlook for the future

Sustained efficacy of secukinumab in patients with moderate‐to‐severe palmoplantar psoriasis: 2·5‐year results from GESTURE , a randomized, double‐blind, placebo‐controlled trial

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