Infliximab Significantly Improves Nail Psoriasis

After one year, nail clearance rates are nearly 50 percent in treated patients

WEDNESDAY, Feb. 13 (HealthDay News) -- In patients with moderate to severe psoriasis, infliximab monotherapy is associated with significant improvements in affected nails as well as skin, according to a report published in the February issue of the Journal of the American Academy of Dermatology.

Phoebe Rich, M.D., of the Oregon Health Sciences University in Portland, Ore., and colleagues conducted a 50-week, phase III study of 378 patients, including 305 (81.8 percent) who had baseline nail psoriasis. The researchers randomly assigned patients to receive either infliximab (5 mg/kg) or placebo at weeks 0, 2, 6 and every eight weeks through week 46, with placebo crossover to infliximab at week 24.

In the infliximab-treated subjects who had baseline nail psoriasis, the investigators found that rates of nail clearance at 10, 24 and 50 weeks were 6.9 percent, 26.2 percent and 44.7 percent, respectively, compared to 5.1 percent in the placebo group at week 24.

"Significant and sustained nail improvement was observed in patients with and without associated psoriatic arthritis, and improvement in nail psoriasis tended to correlate with that in skin psoriasis over time," the authors conclude. "Although infliximab would likely be used to treat nail disease only in candidates eligible for treatment of their skin psoriasis, the significant efficacy demonstrated for nail disease is an important clinical benefit of such treatment."

The study was supported by Centocor Inc. of Malvern, Pa., and Schering-Plough in Kenilworth, N.J. Several authors report financial ties to the pharmaceutical industry.

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