Evaluation of the efficacy and safety of infliximab on psoriatic nails: an unblinded, nonrandomized, open-label study

Rigopoulos, Dimitrios; Gregoriou, Stamatis; Stratigos, Alexander J.; Larios, George; Korfitis, Chrysovalantis; Papaioannou, Diana; Antoniou, Christina; Ioannides, Dimitrios

doi:10.1111/j.1365-2133.2008.08686.x

Cited by 78 publications

(60 citation statements)

References 15 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The advent of high-resolution imaging in man to explore the nail, coupled with emerging immunogenetics and therapies, holds the key to a better understanding of nail disease and indeed systemic disorders that afflict the nail in man. The emerging data showing excellent response of psoriatic nail disease to anti-TNF therapies [44,45,46] that act principally on the innate arm of the immune response further support the idea of local innate immune responses in the nail-enthesis-bone apparatus as underscoring disease mechanisms at that site.…”

Section: Discussionmentioning

confidence: 88%

Nailing down the Genetic and Immunological Basis for Psoriatic Disease

et al. 2010

View full text Add to dashboard Cite

Psoriatic disease encompassing skin, joint and nail involvement is largely viewed as autoimmune – a finding supported by data from animal models, the human leucocyte antigen (HLA)-Cw6 disease association in man, T-lymphocyte infiltration in lesional skin and the favourable skin response to T-cell-directed therapies. However, this immunopathogenetic model only applies to the skin, as recent studies failed to demonstrate a HLA-Cw6 association with the nails or joints. Furthermore, the nails and joints are intimately associated with inflammation at points of ligament or tendon insertion (i.e., enthesitis), so it is now appreciated that both of these sites also share a common microanatomical basis. Moreover, inflammation at insertion sites and nails does not appear to be associated with a particular antigenic territory but is quite diffuse in nature. This suggests that an aberrant response to tissue stressing of the integrated nail-joint apparatus, rather than autoimmunity, is driving the inflammatory process. Therefore, HLA-Cw6-associated type 1 psoriasis is more closely linked to autoimmunity, whereas nail and joint disease may be linked to tissue-specific factors, including tissue biomechanical stressing and microtrauma, that lead to activation of aberrant innate immune responses. These observations that stem from nail disease point toward a relative differential involvement of adaptive and innate immunity in the psoriatic disease spectrum and offer a fresh perspective on the pathophysiology of psoriatic disease and how it can be classified along the immunological disease continuum of self-directed inflammation.

show abstract

Section: Discussionmentioning

confidence: 88%

Nailing down the Genetic and Immunological Basis for Psoriatic Disease

et al. 2010

View full text Add to dashboard Cite

show abstract

Section: The Advent Of New Treatment Options With Biologic Therapymentioning

confidence: 99%

“…Several trials and case reports have demonstrated that infliximab, a TNF inhibitor administered intravenously, provides significant improvement in patients with moderate to severe psoriasis with nail involvement [48,49,50,51]. …”

Section: The Advent Of New Treatment Options With Biologic Therapymentioning

confidence: 99%

“…An unblinded, non-randomised, open-label study of infliximab in 18 patients with nail psoriasis noted significant improvement in NAPSI scores after the third infusion of infliximab (week 14) [51]. A 47% reduction in mean NAPSI score was evident at week 14, and at week 38 (after 6 infusions), a 94% reduction in mean NAPSI score was evident, representing almost complete resolution of psoriatic nail involvement [51]. In another open-label, prospective study of 25 patients presenting with severe onychodystrophy, infliximab demonstrated the ability to completely clear nail disease (mean NAPSI = 0) in all patients at 22 weeks [49].…”

Section: The Advent Of New Treatment Options With Biologic Therapymentioning

confidence: 99%

See 1 more Smart Citation

Treatment and Management of Psoriasis with Nail Involvement: A Focus on Biologic Therapy

Langley

Daudén

2010

Dermatology

View full text Add to dashboard Cite

Nail involvement in psoriasis is typically overlooked, although it can affect up to 50% of patients with psoriasis and cause functional impact as well as psychological stress that can significantly affect quality of life. In addition, psoriatic patients with nail disease tend to have a more severe skin condition, a higher rate of unremitting and progressive arthritis and more associated anxiety and depression. Historically, the treatment of nail psoriasis has proven difficult, with most patients feeling that the treatment for their nail disease was unsatisfactory. The current management of nail psoriasis includes topical, intralesional and systemic therapies, although little clinical evidence is available on the effectiveness of conventional treatments and, consequently, no specific treatment approach has been fully supported. Biologic agents are beginning to emerge as a viable option to treat patients with both cutaneous and nail clinical manifestations of psoriasis and psoriatic arthritis. The extra disease burden that nail symptoms place on the patient can be considered indicative of a more severe form of the disease and should be taken into consideration when assessing treatment options.

show abstract

“…Recent reports have demonstrated that biologicals such as tumor necrosis factor (TNF) antagonists (etanercept [7], infliximab [8,9]) may have significant influence on psoriatic nail disease. Adalimumab is a fully human IgG1 monoclonal antibody of the IgG1 isotype that binds to human TNF-α with high affinity and specificity, suppressing TNF-associated biologic responses by blocking its interaction with the p55 and p75 cell surface TNF receptors [10].…”

Section: Introductionmentioning

confidence: 99%

Marked Improvement in Nail Psoriasis during Treatment with Adalimumab

Irla

Yawalkar

2009

Dermatology

View full text Add to dashboard Cite

Background: Nail involvement is known as a common finding in psoriatic patients and represents a significant impact on patients’ quality of life. The treatment of nail psoriasis is often challenging, and there is a need for new therapeutic options. Biologicals effective in the treatment of moderate to severe chronic plaque psoriasis may represent a new therapeutic modality for this disease. Adalimumab is a fully human IgG1 monoclonal antibody that binds to tumor necrosis factor α with high affinity and specificity. Observations: We report two cases of rapid improvement in nail psoriasis under adalimumab monotherapy with maintained effectiveness despite intermittent treatment as well as long remission after therapy discontinuation. Conclusion: The marked improvement of our two cases indicates that adalimumab may also help ameliorate nail psoriasis and warrants further controlled studies to establish the effectiveness and therapeutic regimes.

show abstract

Evaluation of the efficacy and safety of infliximab on psoriatic nails: an unblinded, nonrandomized, open-label study

Abstract: Alphalthough there is no control group, this data suggests that infliximab is effective for psoriatic nail disease in the context of severe skin and joint involvement.

Cited by 78 publications

References 15 publications

Nailing down the Genetic and Immunological Basis for Psoriatic Disease

Nailing down the Genetic and Immunological Basis for Psoriatic Disease

Treatment and Management of Psoriasis with Nail Involvement: A Focus on Biologic Therapy

Marked Improvement in Nail Psoriasis during Treatment with Adalimumab

Contact Info

Product

Resources

About