ReportBaseline nail disease in patients with moderate to severe psoriasis and response to treatment with infliximab during 1 year
Section snippets
Procedures
Detailed methods and study design for EXPRESS have been reported elsewhere.10 Briefly, this phase III, randomized, double-blind, placebo-controlled study enrolled 378 patients with moderate to severe psoriasis. Eligible patients (ie, those with diagnosis for at least 6 months, PASI score ≥12, and psoriasis ≥ 10% of body surface area) were randomly assigned in a 4:1 ratio to receive either infliximab (Remicade, Centocor, Inc, Malvern, Pa) or placebo. Patients in the infliximab group were
Results
The mean percent improvement in NAPSI score from baseline for infliximab-treated patients was significantly greater than that for placebo-treated patients at week 10 (26.8% vs –7.7%; P < .001); this difference was more pronounced by week 24 (57.2% vs –4.1%; P < .001), indicating continued improvement. The mean percent improvement in NAPSI score from baseline to week 50 was 59.7% for the patients originally randomized to infliximab. These analyses of observed data were consistent with those
Discussion
We have documented in detail that, in addition to the significant efficacy in skin psoriasis shown in the EXPRESS trial,10 infliximab demonstrates efficacy with respect to improving nail psoriasis. Significant improvements were apparent in nail psoriasis features as early as week 10 in infliximab-treated patients compared with placebo. The percentage of treated patients with nail improvement continued to increase over time, and improvement was sustained in a high percentage of patients through
References (26)
Psoriasis of the nail
Dermatol Clin
(1985)- et al.
Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy
J Am Acad Dermatol
(2007) - et al.
Infliximab induction and maintenance therapy for moderate-to-severe psoriasis: a phase III, multicenter, double-blind trial
Lancet
(2005) - et al.
Nail Psoriasis Severity Index: a useful tool for evaluation of nail psoriasis
J Am Acad Dermatol
(2003) - et al.
Low-dose short-term cyclosporine versus etretinate in psoriasis: improvement of skin, nail, and joint involvement
J Am Acad Dermatol
(1995) - et al.
Alefacept in the treatment of psoriatic nail disease: a small case series
J Am Acad Dermatol
(2005) - et al.
Remission and time of resolution of nail psoriasis during infliximab therapy
J Am Acad Dermatol
(2005) - et al.
Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients
Dermatology
(1996) - et al.
Psoriatic arthritis in psoriatic patients
Br J Rheum
(1984) - et al.
The nails in psoriatic arthritis
Acta Derm Venereol
(1994)
Extended report: nail disease in psoriatic arthritis–clinically important, potentially treatable and often overlooked
Rheumatology
Psoriatic nails: a prospective clinical study
J Cutan Med Surg
Management of nail psoriasis
Clin Exp Dermatol
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Supported by Centocor Inc, Malvern, Pa, and Schering-Plough, Kenilworth, NJ.
Disclosure: Dr Rich has received advisory board honoraria from Abbott and investigator grants from Centocor, Wyeth, and Genentech. Dr Griffiths has received grants and/or honoraria as a speaker, investigator, and/or advisory member for Centocor, Wyeth, Schering-Plough, Serono, UCB, Abbott, Novartis, Galderma, Leo, and Novo Nordisk. Dr Reich has received honoraria as a consultant, investigator, speaker, and advisory board member for Centocor and Schering Plough. Dr Nestle has received honoraria as a consultant, speaker, and advisory board member for Centocor. Dr Scher has received honoraria as a consultant, advisory broad member, and/or speaker for Centocor, Stiefel Laboratories, Allergan, Galderma, Medicis, and Biovail. Dr Guzzo and Ms Li receive employee salaries and have received stock and stock options from Centocor. Dr Hsu and Mr Xu receive employee salaries from Centocor.
Partially presented as an abstract and as a poster at the American Academy of Dermatology Annual Meeting, Washington, DC, February 2007 and at the American Academy of Dermatology Summer Meeting, San Diego, California, July 2006.