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Joint and nail symptoms common in psoriasis, improve with etanercept
By Lucy Piper
15 May 2009
J Eur Acad Dermatol Venereol 2009; Advance online publication

MedWire News: Patients with moderate-to-severe plaque psoriasis often have joint and nail symptoms, say researchers who found etanercept significantly reduced these symptoms.

In their post-hoc analyses of 711 patients with psoriasis participating in the CRYSTEL study, T Luger (University of Münster, Germany) and colleagues found that 64% reported joint pain and 79% reported nail psoriasis.

“Our analyses showed that joint and nail symptoms were not only very common in this population of psoriasis patients but also caused significant health-related Quality of Life (HR-QoL) impairment in these patients,” they write.

For the CRYSTEL (Clinical Randomized Year-long Study assessing the safety and efficacy of EnbreL in psoriasis) study, patients received etanercept either continuously or as paused therapy for 54 weeks.

Luger et al report that scores on the Dermatology Life Quality Index (DLQI) and EuroQoL-5D (EQ-5D) utility scores indicated that psoriasis patients with joint pain had worse problems with work or school, daily activities, personal relationships and prior treatments than other patients, and suffered more pain and discomfort. They also rated their own health on the EQ-5D visual analogue scale (VAS) worse than did patients without joint pain.

Patients with nail psoriasis scored lower on the DLQI and the EQ-5D VAS than other patients, although the difference was only clinically meaningful for the latter measure.

After treatment with etanercept, joint pain improved by 36.2% and patients’ scores on the DLQI, EQ-5D utility and EQ-5D VAS improved by 61%, 29% and 23%, respectively.

Similarly, etanercept treatment led to significant and clinically meaningful improvements on the DLQI and EQ-5D measures for patients with nail psoriasis.

“Because of the prevalence of joint and nail symptoms in moderate-to-severe plaque psoriasis and their impact on patients’ quality of life and psychological well-being, dermatologists should evaluate these symptoms and ensure that these patients are adequately treated,” the team concludes in the Journal of the European Academy of Dermatology and Venereology.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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