of the nail plate. Optimal effect may take up to or exceed 52 weeks of therapy.16 In UNCOVER-3, continued improvement of fingernail psoriasis was seen in patients treated with ixekizumab through 60 weeks.12,14 Long-term efficacy and safety of ixekizumab for treatment of moderate-to-severe plaque psoriasis has been reported to 108 weeks.17 Taken together, ixekizumab demonstrated early efficacy in fingernail psoriasis within 12 weeks and continued efficacy in open-label treatment to 60 weeks.
In conclusion, this study demonstrated that patients both with and without nail psoriasis responded well to ixekizumab. In contrast to previous reports in which the presence of nail psoriasis was a negative prognostic factor for psoriasis,8,9 the presence of nail psoriasis did not negatively affect skin response in patients treated with ixekizumab.
In conclusion, this study demonstrated that patients both with and without nail psoriasis responded well to ixekizumab. In contrast to previous reports in which the presence of nail psoriasis was a negative prognostic factor for psoriasis,8,9 the presence of nail psoriasis did not negatively affect skin response in patients treated with ixekizumab.
DISCLOSURES
Dr. Rich has received research and educational grants from
AbbVie, Allergan, Anacor Pharmaceuticals, Boehringer
Ingelheim, Cassiopea SpA, Dermira, Eli Lilly and Company,
Galderma Laboratories LP, Janssen Ortho Inc., Kadmon
Corporation, Leo Pharma, Merck, Moberg Derma, Novartis, Pfizer,
Ranbaxy Laboratories Limited, Sandoz, Viamet Pharmaceutical
Inc., Innovation Pharmaceuticals (Cellceutix), and Cutanea Life
Sciences. Dr. Merola is a consultant and/or investigator for
Merck Research Laboratories, AbbVie, Dermavant Sciences
Ltd., Eli Lilly and Company, Novartis, Janssen, UCB, Samumed
LLC, Celgene, Sanofi Regeneron, GlaxoSmithKline, Almirall,
Sun Pharma, Biogen, Pfizer, Incyte, Aclaris Therapeutics, EMD
Serono and Leo Pharma. Dr. Elewski has received research
and support from AbbVie, AnaptysBio, Boehringer Ingelheim,
Bristol Myers Squibb, Celgene, Incycte, Leo Pharma, Eli Lilly
and Company, Merck, Menlo Therapeutics, Novartis, Pfizer,
Regeneron Pharmaceuticals, Sun Pharma, Bausch Health
(Valeant Pharmaceuticals), and Vanda Pharmaceuticals and is
a consultant for Boehringer Ingelheim, Celgene, Leo Pharma,
Eli Lilly and Company, and Menlo Therapeutics. Dr. Goldblum
and Dr. Lin own stock in and are employees of Eli Lilly and
Company. Dr. Disch is an Eli Lilly and Company retiree and owns
stock in Lilly and other pharmaceutical companies under the
independent management of a financial advisor.
ACKNOWLEDGMENTS
This study was sponsored by Eli Lilly and Company. The authors
would like to thank the patients and the investigators who participated
in these studies. Medical writing services was provided
by Sarah Beckman, PhD, and editorial support was provided by
Noelle Gasco of Syneos Health, which were funded by Eli Lilly
and Company.
REFERENCES
1. Lowes MA, Bowcock AM , Krueger JG. Pathogenesis and therapy of psoriasis. Nature. 2007;445:866-873.
2. Kyriakou A, Patsatsi A, Sotiriadis D. Detailed analysis of specific nail psoriasis features and their correlations with clinical parameters: a cross-sectional study. Dermatology. 2011;223:222-229.
3. Klaassen KM, van de Kerkhof PC, Pasch MC. Nail Psoriasis, the unknown burden of disease. J Eur Acad Dermatol Venereol. 2014;28:1690-1695.
4. Rigopoulos D, Baran R, Chiheb S, et al. Recommendations for the definition, evaluation, and treatment of nail psoriasis in adult patients with no or mild skin psoriasis: a dermatologist and nail expert group consensus. J Am Acad Dermatol. 2019;81:228-240.
5. Sobolewski P, Walecka I, Dopytalska K. Nail involvement in psoriatic arthritis. Reumatologia. 2017;55:131-135.
6. de Jong EM, Seegers BA, Gulinck MK, et al. Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients. Dermatology. 1996;193:300-303.
7. Sanchez-Regana M, Sola-Ortigosa J, Alsina-Gibert M et al. Nail psoriasis: a retrospective study on the effectiveness of systemic treatments (classical and biological therapy). J Eur Acad Dermatol Venereol. 2011;25:579-586.
8. Bardazzi F, Lambertini M, Chessa MA, et al. Nail involvement as a negative prognostic factor in biological therapy for psoriasis: a retrospective study. J Eur Acad Dermatol Venereol. 2017;31:843-846.
9. Thaci D, Unnebrink K, Sundaram M, et al. Adalimumab for the treatment of moderate to severe psoriasis: subanalysis of effects on scalp and nails in the BELIEVE study. J Eur Acad Dermatol Venereol. 2015;29:353-360.
10. Gordon KB, Blauvelt A, Papp KA, et al; UNCOVER-1 Study Group; UNCOVER- 2 Study Group; UNCOVER-3 Study Group. Phase 3 trials of ixekizumab in moderate-to-severe plaque psoriasis. N Engl J Med. 2016;375:345-356.
11. Griffiths CE, Reich K, Lebwohl M, et al; UNCOVER-2 and UNCOVER-3 investigators. Comparison of ixekizumab with etanercept or placebo in moderateto- severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials. Lancet. 2015;386:541-551.
12. Dennehy EB, Zhang L, Amato D, et al. Ixekizumab is effective in subjects with moderate to severe plaque psoriasis with significant nail involvement: results from UNCOVER 3. J Drugs Dermatol. 2016;15:958-961.
13. Langley RG, Rich P, Menter A, et al. Improvement of scalp and nail lesions with ixekizumab in a phase 2 trial in patients with chronic plaque psoriasis. J Eur Acad Dermatol Venereol. 2015;29:1763-1770.
14. van de Kerkhof P, Guenther L, Gottlieb AB, et al. Ixekizumab treatment improves fingernail psoriasis in patients with moderate-to-severe psoriasis: results from the randomized, controlled and open-label phases of UNCOVER- 3. J Eur Acad Dermatol Venereol. 2017;31:477-482.
15. Taltz [package insert]. Indianapolis, IN: Eli Lilly and Company; 2019.
16. Elewski BE, Baker CS, Crowley JJ, et al. Adalimumab for nail psoriasis: efficacy and safety over 52 weeks from a phase-3, randomized, placebo-controlled trial. J Eur Acad Dermatol Venereol. 2019;33:2168-2178.
17. Blauvelt A, Gooderham M, Iversen L, et al. Efficacy and safety of ixekizumab for the treatment of moderate-to-severe plaque psoriasis: results through 108 weeks of a randomized, controlled phase 3 clinical trial (UNCOVER-3). J Am Acad Dermatol. 2017;77:855-862.
2. Kyriakou A, Patsatsi A, Sotiriadis D. Detailed analysis of specific nail psoriasis features and their correlations with clinical parameters: a cross-sectional study. Dermatology. 2011;223:222-229.
3. Klaassen KM, van de Kerkhof PC, Pasch MC. Nail Psoriasis, the unknown burden of disease. J Eur Acad Dermatol Venereol. 2014;28:1690-1695.
4. Rigopoulos D, Baran R, Chiheb S, et al. Recommendations for the definition, evaluation, and treatment of nail psoriasis in adult patients with no or mild skin psoriasis: a dermatologist and nail expert group consensus. J Am Acad Dermatol. 2019;81:228-240.
5. Sobolewski P, Walecka I, Dopytalska K. Nail involvement in psoriatic arthritis. Reumatologia. 2017;55:131-135.
6. de Jong EM, Seegers BA, Gulinck MK, et al. Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients. Dermatology. 1996;193:300-303.
7. Sanchez-Regana M, Sola-Ortigosa J, Alsina-Gibert M et al. Nail psoriasis: a retrospective study on the effectiveness of systemic treatments (classical and biological therapy). J Eur Acad Dermatol Venereol. 2011;25:579-586.
8. Bardazzi F, Lambertini M, Chessa MA, et al. Nail involvement as a negative prognostic factor in biological therapy for psoriasis: a retrospective study. J Eur Acad Dermatol Venereol. 2017;31:843-846.
9. Thaci D, Unnebrink K, Sundaram M, et al. Adalimumab for the treatment of moderate to severe psoriasis: subanalysis of effects on scalp and nails in the BELIEVE study. J Eur Acad Dermatol Venereol. 2015;29:353-360.
10. Gordon KB, Blauvelt A, Papp KA, et al; UNCOVER-1 Study Group; UNCOVER- 2 Study Group; UNCOVER-3 Study Group. Phase 3 trials of ixekizumab in moderate-to-severe plaque psoriasis. N Engl J Med. 2016;375:345-356.
11. Griffiths CE, Reich K, Lebwohl M, et al; UNCOVER-2 and UNCOVER-3 investigators. Comparison of ixekizumab with etanercept or placebo in moderateto- severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials. Lancet. 2015;386:541-551.
12. Dennehy EB, Zhang L, Amato D, et al. Ixekizumab is effective in subjects with moderate to severe plaque psoriasis with significant nail involvement: results from UNCOVER 3. J Drugs Dermatol. 2016;15:958-961.
13. Langley RG, Rich P, Menter A, et al. Improvement of scalp and nail lesions with ixekizumab in a phase 2 trial in patients with chronic plaque psoriasis. J Eur Acad Dermatol Venereol. 2015;29:1763-1770.
14. van de Kerkhof P, Guenther L, Gottlieb AB, et al. Ixekizumab treatment improves fingernail psoriasis in patients with moderate-to-severe psoriasis: results from the randomized, controlled and open-label phases of UNCOVER- 3. J Eur Acad Dermatol Venereol. 2017;31:477-482.
15. Taltz [package insert]. Indianapolis, IN: Eli Lilly and Company; 2019.
16. Elewski BE, Baker CS, Crowley JJ, et al. Adalimumab for nail psoriasis: efficacy and safety over 52 weeks from a phase-3, randomized, placebo-controlled trial. J Eur Acad Dermatol Venereol. 2019;33:2168-2178.
17. Blauvelt A, Gooderham M, Iversen L, et al. Efficacy and safety of ixekizumab for the treatment of moderate-to-severe plaque psoriasis: results through 108 weeks of a randomized, controlled phase 3 clinical trial (UNCOVER-3). J Am Acad Dermatol. 2017;77:855-862.
AUTHOR CORRESPONDENCE
Orin Goldblum MD goldblum_orin_m@lilly.com
