Abstract
Background
Nail are important for both function and esthetic appearance and although they represent a small body surface area, dermatologic disorders affecting the nails can have a detrimental effect to the patient. Deciding on the best systemic antipsoriatic drug to treat nail psoriasis can be difficult due to the lack of nail data on their Food and Drug Administration-approved labels, as well as the variety of scoring systems used for nail psoriasis.
Methods
We performed a literature review and included randomized control trials or articles based on randomized control trials for different systemic antipsoriatic drugs. Only articles and studies utilizing Nail Psoriasis Severity Index (NAPSI) or target NAPSI as outcome measures were included. Data was taken directly from articles, directly from clincaltrials.gov or directly from data on file at various pharmaceutical companies.
Results
Data for NAPSI and PASI were collected for 10 antipsoriatic drugs including three oral medications and seven biologic agents. We found that NAPSI or target NAPSI was strongly predicted based on the change in PASI and duration of treatment (R2 = 0.71, p = .0002). PASI alone (R2 = 0.52, p = .001) and duration alone (R2 = 0.21, p = .07) predict NAPSI response.
Conclusion
According to this model, there is a relationship between skin and nail response, with improvement in nails correlating with improvement in skin and longer duration of treatment.
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Disclosure statement
Dr. Fleischer is a consultant for Dermavant, Incyte, Qurient, and SCM Lifescience. He is an investigator for Galderma, Menlo, and Trevi. He has no other potential conflicts including Honoraria, Speakers bureau, Stock ownership or options, Expert testimony, Grants, Patents filed, received, pending, or in preparation, Royalties, or Donation of medical equipment.