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Improvement of psoriatic nail disease in psoriatic arthritis patients treated with adalimumab: Results of an observational cohort up to 36 months
Background
Patients with psoriatic arthritis (PsA) who have nail involvement may suffer impaired physical capability, pain and reduced quality of life. Additionally, nail involvement can be a predictor of enthesitis. While TNF inhibitors (TNFi) can be used to treat PsA, published real world data on the effectiveness of TNFi in patients with nail disease are lacking. This study describes outcome measures for a cohort of patients prescribed adalimumab as first line treatment in real-world clinical practice, over a 36 months observation.
Methods
Retrospective data were collected from cohort study at the Royal National Hospital for Rheumatic Diseases, for patients diagnosed with, and prescribed adalimumab for, PsA. Patients with nail involvement were identified on the basis of the Bath nail score; each nail of the hands was assessed for the presence/absence of nail pitting, onycholysis, hyperkeratosis or severe deformity resulting in a total score: 0-40. Baseline data included demographics, nail scores and Psoriasis Area and Severity Index (PASI) scores. Nail and PASI scores were recorded at three, six, 12, 18, 24 and 36 months post-baseline.
Results
36 patients were included; 63.9% male; mean (standard deviation [SD]) age of 37.9 (15.4) years at PsA symptom onset, and 40.3 (SD 15.0) years at diagnosis. Mean disease duration at baseline: 10.1 years (SD 10.3). At baseline, mean (SD) nail score: 5.8 (4.7 [n = 36]); mean (SD) PASI score: 5.0 (5.4 [n = 36]). At six months, mean and median nail and PASI scores had reduced significantly (p < 0.05, paired t-tests) and these reductions were maintained at 36 months (Table 1 available on request). Based on nail scores, 62% of patients had no activity at six months (vs. 64% at 36 months); based on PASI scores, 35% had no activity at six months (vs. 36% at 36 months).
Conclusions
In this patient cohort, treatment with adalimumab led to overall reductions in nail and skin disease activity, as assessed by Bath nail and PASI scores. In both measures, an overall reduction was observed after 6 months of treatment, and maintained at 36 months.
Authors
N McHugh, C Cavill, E Korendowych, J Hickey, D Mohammed, W Tillett
Journal
Rheumatology
Therapeutic Area
Rheumatology
Center of Excellence
Real-world Evidence & Data Analytics
Year
2018
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