75, PASI 90, PASI 100, sPGA (0,1), and sPGA (0) were all similar between patients, regardless of nail psoriasis presence or severity (P>0.05).
DISCUSSION
In this post-hoc analysis, ixekizumab was more effective than etanercept or placebo in clearance of plaque psoriasis in patients with or without concurrent nail involvement. Ixekizumab and etanercept were both effective in reducing signs and symptoms of nail and plaque psoriasis within 12 weeks.
Very few studies to date have compared treatment responses in patients with moderate-to-severe plaque psoriasis with and without nail psoriasis. One retrospective study examined 127 patients who were treated with topical therapy and one of four biologic treatments for 24 weeks: adalimumab, ustekinumab, etanercept, or infliximab. While all four biologic agents were effective in reducing nail and plaque psoriasis, patients with nail psoriasis had delayed skin clearance, with lower PASI 75 responses at weeks 8, 16, and 24 compared to patients without nail involvement.8 Similarly, a post-hoc analysis of a randomized, controlled, phase 3 clinical trial of adalimumab (BELIEVE, NCT00574249) examined a subset of enrolled patients who had nail psoriasis at baseline. At all time points (weeks 2, 4, 8, 12, and 16), PASI 75 response was lower for patients with nail psoriasis (n=457) compared to those without (n=267).9 In this report, there was no evidence to suggest nail involvement reduced the efficacy of ixekizumab treatment.
A challenge with all nail psoriasis treatments is the slow growth
Very few studies to date have compared treatment responses in patients with moderate-to-severe plaque psoriasis with and without nail psoriasis. One retrospective study examined 127 patients who were treated with topical therapy and one of four biologic treatments for 24 weeks: adalimumab, ustekinumab, etanercept, or infliximab. While all four biologic agents were effective in reducing nail and plaque psoriasis, patients with nail psoriasis had delayed skin clearance, with lower PASI 75 responses at weeks 8, 16, and 24 compared to patients without nail involvement.8 Similarly, a post-hoc analysis of a randomized, controlled, phase 3 clinical trial of adalimumab (BELIEVE, NCT00574249) examined a subset of enrolled patients who had nail psoriasis at baseline. At all time points (weeks 2, 4, 8, 12, and 16), PASI 75 response was lower for patients with nail psoriasis (n=457) compared to those without (n=267).9 In this report, there was no evidence to suggest nail involvement reduced the efficacy of ixekizumab treatment.
A challenge with all nail psoriasis treatments is the slow growth
