Anti-TNF agents and nail psoriasis: a single-center, retrospective, comparative study

Abstract

Background: Anti-tumor necrosis factor (TNF) agents' effect on psoriatic nails is still under investigation.

Objective: To evaluate the therapeutic potentials of anti-TNF agents on psoriatic nails of patients suffering from moderate-to-severe plaque psoriasis.

Materials and methods: A retrospective study was conducted based on the medical records of 12 patients treated with infliximab, 14 with adalimumab and 13 with etanercept in daily practice. The Nail Psoriasis Severity Index (NAPSI) was recorded at baseline, week 12, 24 and 48.

Results: At week 12, NAPSI was improved compared to baseline by 48.0% (range: 40.2-66.6%) with infliximab, 35.0% (range: 25.0-52.6%) with adalimumab and 41.7% (range: 39.5-46.4%) with etanercept. At week 24, NAPSI was improved by 80.4% (range: 66.6-90.2%) with infliximab, 70.2% (66.6-80.2%) with adalimumab and 76.1% (62.5-85.5%) with etanercept. At week 48, NAPSI was improved by 95.1% (range: 89.5-97.3%) with infliximab, 89.5% (75.0-94.8%) with adalimumab and 92.8% (84.3-96.0%) with etanercept. NAPSI percentage improvement was statistically significant across follow-up period (p = 0.000) for each anti-TNF treatment, as well as among treatments at all time points (week 12, p = 0.000; week 24, p = 0.001; week 48, p = 0.000).

Conclusion: All anti-TNF agents result in a significant improvement of NAPSI score, with infliximab given the precedence and followed by etanercept and adalimumab.