MedWire News: Infliximab is effective for reducing nail lesions in patients with psoriasis, study findings show.
"Nail disease response to infliximab treatment was extremely rapid and persistent," C Fabroni and colleagues, from the University of Florence in Italy, report in the Journal of the European Academy of Dermatology and Venereology.
The researchers performed an uncontrolled study involving 121 patients affected by moderate-to-severe psoriasis, who had been treated with infliximab from January 2008 to July 2009.
Of these 121 patients, 61 (50.4%) had baseline nail psoriasis. After the exclusion of 11 patients because they were using concomitant therapies or had positive mycological tests, 48 patients with baseline nail psoriasis were included in the study.
At baseline, the mean nail psoriasis severity index (NAPSI) score was 49.68. This fell rapidly to 18.58 at week 14, to 9.54 at week 22, and to 7.21 at week 38.
"Unfortunately, we do not have data of follow-up after 38 weeks to evaluate the long-term results of this therapy," the researchers acknowledge.
Complete clearance of nail lesions was observed in five (10.4%) patients, and a 90% improvement in NAPSI (NAPSI-90) was seen in 2.1%, 22.9%, and 29.2% of patients at weeks 14, 22, and 38, respectively. The corresponding rates of NAPSI-75 were 22.9%, 64.6%, and 81.25%.
Fabroni and colleagues note that only one patient failed to achieve a 50% improvement in NAPSI score after 38 weeks, which they say demonstrates "a low frequency of non-responders to infliximab."
Psoriatic skin lesions are the primary reason to start biological treatments, but the researchers highlight that "nail psoriasis should be taken in account as soon as possible because of its important correlation with the early stage of arthritis."
Their findings suggest that infliximab may be one means of rapidly reducing such nail lesions.
"A longer follow-up will further prove whether the NAPSI improvement observed until week 38 will be maintained longer," the team concludes.
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