Brodalumab safe option for nail psoriasis treatment: Study
Courtesy- Journal of American Academy of Dermatology
Athens, Greece: The administration of brodalumab significantly improves nail psoriasis, finds a recent study in the Journal of the European Academy of Dermatology and Venereology.
Nail involvement is common among psoriasis patients that may significantly impair quality of life (QoL). Still, nail psoriasis treatment is largely not standardized. Brodalumab is a recombinant, fully human, anti-interleukin-17 receptor A, monoclonal antibody that exhibits long-term efficacy in plaque psoriasis due to concurrent inhibition of proinflammatory cytokines IL-17A, IL-17C, IL-17E, IL-17F and IL-17A/F heterodimer. A. Tsiogka, National and Kapodistrian University of Athens, Athens, Greece, and colleagues aimed to evaluate its efficacy in nail psoriasis as assessed by the Nail Psoriasis Severity Index (NAPSI) and the Dermatology Life Quality Index (DLQI) in a open-label, unblinded study.
For the purpose, the researchers gave subcutaneous injections of brodalumab 210 mg at baseline, weeks 1, 2, 3, and every 2 weeks thereafter to dermatology patients at the Andreas Sygos Hospital in Athens, Greece with confirmed severe plaque-type psoriasis and evident psoriatic nail disease. Nails of the patients were assessed at baseline and weeks 12 and 24.
30 patients were enrolled in the study.
Key findings of the study include:
- The mean NAPSI score for fingernails at baseline was 19.6 (standard deviation [SD], 9.3).
- At week 12 it was 9.6 (SD, 5.3) and at week 24 it was 2.63 (SD, 2.3).
- The mean NAPSI score for toenails was 24.9 (SD, 13.6) at baseline. At week 12 it was 16.1 (SD, 9.7) and at week 24 it was 7.2 (SD, 6.1).
- The mean DLQI score for finger and toenails was 22.8 (SD, 4.4) at baseline and 3.7 (SD, 2.2) at week 24.
- There was improvement in 57% (n=17) of patients with a fingernail NAPSI score of 50 by week 12 and in 100% (n=30) of patients by week 24.
- There was improvement in 23% (n=7) patients with a toenail NAPSI score of 50 by week 12 and in 97% (n=29) patients by week 24.
- The only adverse events recorded were headache in 2 patients and diarrhea in 1 patient, all of which resolved spontaneously in a few days.
The study showed brodalumab's rapid onset, high efficacy, and safety for nail psoriasis.
"Our results support the need of prolonged therapy before evaluating the full efficacy of biologics in psoriasis of this specific body site," concluded the authors.
The study titled, "Treatment of nail psoriasis with brodalumab: an open‐label unblinded study," is published in the Journal of the European Academy of Dermatology and Venereology.
DOI: https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.17055
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