Network meta-analysis comparing the efficacy of biologic treatments for achieving complete resolution of nail psoriasis

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  • Kristian Reich
  • Curdin Conrad
  • Kristensen, Lars Erik Vølund
  • Saxon D. Smith
  • Luis Puig
  • Phoebe Rich
  • Christophe Sapin
  • Thorsten Holzkaemper
  • Uffe Koppelhus
  • Christopher Schuster

Background: Nail psoriasis (NP) is common and of high importance in patients with psoriasis. Complete resolution of NP at week 24‒26 is an unambiguous nail outcome accessible for indirect treatment comparison of biologics. Objective: To evaluate the comparative efficacy of approved biologics in achieving complete resolution of NP at week 24‒26. Methods: A network meta-analysis (NMA) was conducted to indirectly compare the efficacy of six biologics in achieving complete resolution of NP at week 24‒26 in patients with moderate-to-severe psoriasis and concomitant NP. Complete resolution of NP was defined as a score of zero on the Nail Psoriasis Severity Index (NAPSI), modified NAPSI (mNAPSI) or Physician’s Global Assessment of Fingernails (PGA-F). Results: The probability of achieving complete resolution of NP was highest for ixekizumab (46.5%; 95% credibility interval [CrI] 35.1‒58.0; Surface Under the Cumulative RAnking curve [SUCRA] 97%), followed by brodalumab (37.0%; 17.0‒61.0; 79%), adalimumab (28.3%; 24.4‒32.4; 62%), guselkumab (27.7%; 21.1‒35.1; 58%), ustekinumab (20.8%; 10.2‒35.2; 37%), and infliximab (0.8%; 0.0‒8.9; 17%). Conclusion: In patients with moderate-to-severe psoriasis and concomitant NP, ixekizumab has the greatest likelihood among approved biologics of achieving complete resolution of NP at week 24‒26. Findings should be interpreted carefully because of inherent study limitations.

Original languageEnglish
JournalJournal of Dermatological Treatment
Volume33
Issue number3
Pages (from-to)1652-1660
Number of pages9
ISSN0954-6634
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2021 The Author(s). Published with license by Taylor & Francis Group, LLC.

    Research areas

  • biologics, complete clearance/resolution of nail psoriasis, ixekizumab, Nail psoriasis, Nail Psoriasis Severity Index (NAPSI), network meta-analysis, Physician’s Global Assessment of Fingernails (PGA-F)

ID: 345016327