INTRODUCTION
Psoriasis is a chronic, inflammatory disease that affects millions of people in North America and Europe and is characterized by plaques that may appear on various parts of the body.1 While skin manifestations are the most common characteristic of the disease, nail involvement is an often-overlooked clinical symptom. The prevalence of nail psoriasis is greater than 50% in patients with plaque psoriasis.2
Nail involvement may have a negative impact on patient’s quality of life in addition to skin manifestations alone, and the management of nail psoriasis can be challenging.3,4 The presence of nail psoriasis may be an indicator of disease chronicity or severity, as well as a strong indicator of psoriatic arthritis.4, 5 Many patients with nail psoriasis have reported pain as well as interference with daily activities and work productivity.6 Nail psoriasis is widely acknowledged to be more difficult to treat than skin lesions.7 Although there have been many recent advances in the treatment of skin psoriasis, the options for nail psoriasis are more limited. Additionally, previous studies have shown that patients with nail psoriasis treated with biological agents had delayed skin clearance compared to those without nail psoriasis.8,9
Ixekizumab, a humanized immunoglobulin G subclass 4 (IgG4), high-affinity, anti-interleukin (IL)-17A monoclonal antibody, has been shown in phase 2 and phase 3 clinical trials, including UNCOVER-2 and UNCOVER-3, to be effective in the clearance of plaque and nail psoriasis.10-14 This post-hoc, integrated analysis of the UNCOVER-2 and UNCOVER-3 trials evaluates the effects of ixekizumab on plaque psoriasis in patients with varying levels of baseline nail involvement after 12 weeks of treatment.
Nail involvement may have a negative impact on patient’s quality of life in addition to skin manifestations alone, and the management of nail psoriasis can be challenging.3,4 The presence of nail psoriasis may be an indicator of disease chronicity or severity, as well as a strong indicator of psoriatic arthritis.4, 5 Many patients with nail psoriasis have reported pain as well as interference with daily activities and work productivity.6 Nail psoriasis is widely acknowledged to be more difficult to treat than skin lesions.7 Although there have been many recent advances in the treatment of skin psoriasis, the options for nail psoriasis are more limited. Additionally, previous studies have shown that patients with nail psoriasis treated with biological agents had delayed skin clearance compared to those without nail psoriasis.8,9
Ixekizumab, a humanized immunoglobulin G subclass 4 (IgG4), high-affinity, anti-interleukin (IL)-17A monoclonal antibody, has been shown in phase 2 and phase 3 clinical trials, including UNCOVER-2 and UNCOVER-3, to be effective in the clearance of plaque and nail psoriasis.10-14 This post-hoc, integrated analysis of the UNCOVER-2 and UNCOVER-3 trials evaluates the effects of ixekizumab on plaque psoriasis in patients with varying levels of baseline nail involvement after 12 weeks of treatment.
