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3 Best Biologic for Nail Psoriasis

Recent years have seen the appearance of numerous biologic agents within the therapeutic arsenal for the treatment of psoriasis. Three are currently available in Spain for the treatment of plaque psoriasis (efalizumab, etanercept, and infliximab). Favorable results have also been reported with alefacept, a drug which is not authorized in Canada. To date, there have been no studies specifically addressing the usefulness in nail psoriasis of adalimumab, a biologic agent that is not as yet indicated for use in plaque psoriasis. Clearly, none of these drugs are indicated in nail psoriasis, as is also true for systemic treatment; however, they are all clearly effective at that site.

Efalizumab. There is currently little information available on the effectiveness of efalizumab in nail psoriasis. In our study of 30 patients treated with efalizumab, the scientists assessed the clinical response based on PASI and modified NAPSI scores, course of pruritus, and lesions on the scalp, palms, and soles.29 After 24 weeks, we observed a significant reduction in the NAPSI score, thereby demonstrating the effectiveness of the drug for the treatment of nail psoriasis.

Infliximab. For the moment, along with alefacept, infliximab is the biologic agent for which the most information is available regarding its efficacy in nail psoriasis. Just as it leads to rapid improvement of cutaneous lesions, significant improvement was observed by the tenth week, up to a 56% reduction in the NAPSI score was observed at week 24, and the effect was sustained until week 50.4

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