Nail Psoriasis Improvement During Tildrakizumab Therapy: A Real-Life Experience

August 2022 | Volume 21 | Issue 8 | 914 | Copyright © August 2022


Published online July 15, 2022

Alexandra Maria Brunasso MD

Department of Dermatology, Villa Scassi Hospital ASL-3, Genoa, Italy

Abstract
The aim of this retrospective study of patients affected by plaque psoriasis who underwent tildrakizumab therapy was to describe and compare the response of the nail psoriasis and the plaque psoriasis elsewhere in the body. Eight patients treated with tildrakizumab, 4 males and 4 females with a mean age of 61 years affected by psoriasis (mean baseline-PASI:13) with nail involvement (mean baseline mNAPSI: 51.9), were followed for at least 20 weeks. At week 4, the mean PASI was 6.6 (49% improvement), and the mean mNAPSI was 30.8 (40.6% improvement). At week 20, the mean PASI was 2.1 (84% improvement), and the mean mNAPSI was 5.1 (90% improvement).

The fast improvement of the nail psoriasis in the 8 patients was unexpected, considering the fact that Tildrakizumab is a molecule that in RCTs (reSURFACE-1 and 2) studies has proved to be efficacious against plaque psoriasis but not strikingly fast, requiring at least 20 weeks to achieve the best PASI-improvements in most patients. Evidence regarding nail improvement during tildrakizumab are scarce. Studies including a higher number of patients are required in order to confirm our observation of the fast improvement of nail psoriasis during Tildrakizumab.

J Drugs Dermatol. 2022;21(8):914-916. doi:10.36849/JDD.6828

INTRODUCTION

In this retrospective study of patients affected by plaque psoriasis who underwent tildrakizumab therapy, the aim was to describe and compare the response of the nail psoriasis and the plaque psoriasis elsewhere in the body. Clinical charts were reviewed for: demographics, psoriasis severity (Psoriasis Area Severity Index [PASI], mNAPSI [modified Nail Psoriasis Area Severity Index], F-PGA [fingernail physician global assessment]), disease duration, and previous therapies.

Eight patients treated with tildrakizumab - 4 males and 4 females with a mean age of 61 years affected by psoriasis (mean baseline- PASI:13) with nail involvement (mean baseline mNAPSI: 51.9) - were followed for at least 20 weeks. Demographics, disease duration, previous therapies, and severity indexes are reported in Table 1. Four patients were naïve to biological therapies.

At week 4, the mean PASI was 6.6 (49% improvement), and the mean mNAPSI was 30.8 (40.6% improvement). At week 20, the