Marked Improvement in Nail Psoriasis during Treatment with Adalimumab

Irla, N.; Yawalkar, Nikhil

doi:10.1159/000252853

Cited by 15 publications

(6 citation statements)

References 22 publications

(14 reference statements)

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“…18,19 Nail psoriasis affects up to 55% of patients with cutaneous psoriasis and up to 90% of patients with psoriatic arthritis. [20][21][22] In the present study, target fingernail NAPSI scores improved relative to baseline in patients who be- …”

Section: Commentsupporting

confidence: 47%

“…Of these, 40 of 41 patients (98%) in the adalimumab group and 13 of 17 patients (77%) in the placebo group (switched to adalimumab) completed the open-label extension period (weeks [17][18][19][20][21][22][23][24][25][26][27][28]. The most frequent primary reason for discontinuation during each period was an adverse event.…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Figure 1, the study was divided into 2 periods: the placebo-controlled period (week 0-16) and the extension period (week [17][18][19][20][21][22][23][24][25][26][27][28]. During the placebo-controlled period, enrolled patients were randomized in a 2:1 ratio to receive either active adalimumab (initial dose of two 40-mg injections subcutaneously [SC] at week 0 followed by 40 mg SC every other week from week 1 to 15) or matching placebo (2 injections SC at week 0 followed by 1 placebo injection SC every other week from week 1 to 15).…”

Section: Methodsmentioning

confidence: 99%

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Adalimumab for Treatment of Moderate to Severe Chronic Plaque Psoriasis of the Hands and Feet

Leonardi

Langley²,

Papp³

et al. 2011

Arch Dermatol

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To determine the efficacy, safety, and sustainability of response to adalimumab therapy for moderate to severe chronic plaque psoriasis involving hands and/or feet.Design: Sixteen-week, randomized, double-blind, placebo-controlled evaluation of adalimumab therapy for moderate to severe chronic plaque psoriasis involving the hands and/or feet with a 12-week open-label extension (Randomized Controlled Evaluation of Adalimumab in Treatment of Chronic Plaque Psoriasis of the Hands and Feet [REACH]).Setting: Multicenter outpatient study in the United States and Canada.Participants: Patients with chronic plaque psoriasis on the hands and/or feet with a Physician's Global Assessment of hands and/or feet (hfPGA) score of "moderate" or above.Intervention: Patients were randomized 2:1 to adalimumab (80 mg at week 0, then 40 mg every other week starting at week 1) or to matching placebo.Main Outcome Measure: Percentage of patients achieving an hfPGA score of "clear" or "almost clear" at week 16.Results: Seventy-two patients (adalimumab [n = 49]; placebo [n=23]) were evaluated. Baseline percentages of patients with moderate and severe hfPGA scores were 76% and 24%, respectively, for the adalimumab group and 74% and 26%, respectively, for the placebo group. At week 16, 31% and 4% of patients randomized to adalimumab and placebo, respectively, achieved an hfPGA score of clear or almost clear (P =.01). At week 28, 80% of the hfPGA clear or almost clear response was maintained from week 16 (25% for patients randomized to adalimumab). Adverse events in both groups were generally mild to moderate. In both periods combined, nasopharyngitis (27% and 13% for adalimumab-and placebo-treated patients, respectively) was most frequently reported. Conclusion:Adalimumab is efficacious and well tolerated for treatment of chronic plaque psoriasis of hands and/or feet, with efficacy largely maintained to 28 weeks.

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Section: Commentsupporting

confidence: 47%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Adalimumab for Treatment of Moderate to Severe Chronic Plaque Psoriasis of the Hands and Feet

Leonardi

Langley²,

Papp³

et al. 2011

Arch Dermatol

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“…On binding TNFα, adalimumab neutralizes the biological activities of this cytokine by blocking its interaction with the p55 and p75 cell surface TNF receptors, and modulating biological responses that are induced or regulated by TNFα. Initially, its efficacy in nail psoriasis was claimed in a case report [ 115 ] but clinical studies have followed (Table 3 ). The first study was an open-label study in patients with mild to moderate nail psoriasis [ 96 ].…”

Section: Biologicsmentioning

confidence: 99%

Nail Psoriasis: A Review of Treatment Options

Pasch¹

2016

Drugs

115

129

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Nail involvement affects 80–90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.

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“…Similar results were reported in two patients with severe nail psoriasis who had dramatic improvement under adalimumab monotherapy. 56 In a 12-week, open-label, uncontrolled study of 442 patients with psoriatic arthritis treated with adalimumab, the median NAPSI score was reduced by 57% (14 at baseline, 5 at week 12). 57 At week 20, the median NAPSI score was even further reduced to 91% in the patients who remained in the optional extension period.…”

Section: Adalimumabmentioning

confidence: 99%

The Treatment of Nail Psoriasis: A Review

2011

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Nail disease affects most patients with psoriasis and has a substantial medical and psychological impact on the lives of those affected. Frequently, nail psoriasis is associated with severe pain, restriction in daily activity, and emotional agony that require the dermatologist to know the most up-to-date therapies. Unfortunately, no single treatment is paramount, and the choice of therapy must be individualized to disease severity, patient tolerability, cost, and risk of adverse events. Some clinical manifestations include nail pitting, discoloration, onycholysis, subungual hyperkeratosis, and splinter hemorrhages. Currently, no standardized therapeutic regimen exists; and, given the variability in clinical manifestations, multiple modalities may be needed for adequate results. More recently added to the armamentarium of topical and injectable therapies for nail disease are systemic agents, such as biologics, and photochemotherapeutic treatments. These therapies have been used with varying degrees of success. This review highlights the current treatments available for the treatment of nail psoriatic disease.

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Marked Improvement in Nail Psoriasis during Treatment with Adalimumab

Cited by 15 publications

References 22 publications

Adalimumab for Treatment of Moderate to Severe Chronic Plaque Psoriasis of the Hands and Feet

Adalimumab for Treatment of Moderate to Severe Chronic Plaque Psoriasis of the Hands and Feet

Nail Psoriasis: A Review of Treatment Options

The Treatment of Nail Psoriasis: A Review

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