Noiles Kristin, Vender Ronald
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON.
J Cutan Med Surg. 2009 Jan-Feb;13(1):1-5. doi: 10.2310/7750.2008.08012.
Since the advent of biologic therapies for psoriasis, reports of efficacy in nail psoriasis have appeared in the literature and at international conferences with increasing frequency.
This article aims to review the existing literature on the use of biologics in the treatment of nail psoriasis.
An extensive literature review was conducted using OVID Medline. Studies examining the efficacy of biologics in the treatment of nail psoriasis were documented.
A literature review revealed few clinical trials specifically concentrating on nail psoriasis; however, nails have been assessed in larger clinical trials for cutaneous psoriasis. A large, multicenter, phase III, double-blind, placebo-controlled study of infliximab administered as a brief induction regimen at weeks 0, 2, and 6 followed by a single infusion every 8 weeks revealed statistically significant mean percent improvement in the Nail Psoriasis Severity Index (NAPSI) score over placebo at both week 10 (26.8% vs -7.7%, respectively; p < .001) and week 24 (57.2% vs -4.1%, respectively; p < .001). For other biologics, evidence has thus far been largely anecdotal, appearing as either case studies or extracted secondarily from open-label prospective trials in plaque psoriasis or psoriatic arthritis.
Infliximab appears to be the most effective treatment for nail psoriasis to date.
自从用于治疗银屑病的生物疗法问世以来，有关甲银屑病疗效的报道在文献和国际会议上出现的频率越来越高。
本文旨在综述有关生物制剂用于治疗甲银屑病的现有文献。
使用OVID Medline进行了广泛的文献综述。记录了研究生物制剂治疗甲银屑病疗效的研究。
文献综述显示，专门针对甲银屑病的临床试验很少；然而，在较大规模的皮肤银屑病临床试验中对指甲情况进行了评估。一项大型、多中心、III期、双盲、安慰剂对照研究，在第0、2和6周给予英夫利昔单抗短期诱导方案，随后每8周单次输注，结果显示，在第10周（分别为26.8%对-7.7%；p <.001）和第24周（分别为57.2%对-4.1%；p <.001）时，与安慰剂相比，指甲银屑病严重程度指数（NAPSI）评分的平均改善百分比具有统计学意义。对于其他生物制剂，目前的证据大多是轶事性的，表现为病例研究或从斑块状银屑病或银屑病关节炎的开放标签前瞻性试验中二次提取。
迄今为止，英夫利昔单抗似乎是治疗甲银屑病最有效的疗法。
