title: A 24-week randomized clinical trial investigating the efficacy and safety of two doses of etanercept in nail psoriasis.
abstract: BACKGROUND
  Nail psoriasis is common in patients with psoriasis and can seriously affect their quality of life. Current treatments are limited and there is no standard course of therapy.
  
  
  OBJECTIVE
  To assess the efficacy and safety of etanercept (ETN) on nail psoriasis in patients with moderate-to-severe psoriasis.
  
  
  METHODS
  Patients with moderate-to-severe plaque psoriasis, who had previously failed at least one form of systemic therapy for nail psoriasis, were randomized to receive open-label ETN 50 mg twice weekly (BIW) for 12 weeks followed by once weekly (QW) for 12 weeks (BIW/QW group) or ETN 50 mg QW for 24 weeks (QW/QW group). The primary endpoint was the mean improvement in the Nail Psoriasis Severity Index (NAPSI; score range 0-8) over 24 weeks in the target fingernail with the most severe abnormalities.
  
  
  RESULTS
  Seventy-two patients received one or more doses of ETN (38 BIW/QW; 34 QW/QW) and 69 patients were included in the modified intent-to-treat population. At baseline, mean (standard error) target fingernail NAPSI score was 6.0 (0.3) in the BIW/QW group and 5.8 (0.3) in the QW/QW group. At week 24, mean target fingernail NAPSI score had decreased significantly by -4.3 [95% confidence interval (CI) -4.9 to -3.7; P < 0.0001] in the BIW/QW group and by -4.4 (95% CI -5.0 to -3.7; P < 0.0001) in the QW/QW group. Improvement in NAPSI showed significant correlation with Psoriasis Area and Severity Index improvement. ETN was well tolerated with no unexpected safety findings.
  
  
  CONCLUSIONS
  Both ETN regimens were effective at treating nail psoriasis in this patient population.
authors.affiliation: Service de Dermatologie, Hôpital L'Archet 2, 151 route St-Antoine de Ginestière, 06202 Nice Cedex 3, France. ortonne@unice.fr
authors.forename: J P
authors.initials: JP
authors.lastname: Ortonne
authors.forename: C
authors.initials: C
authors.lastname: Paul
authors.forename: E
authors.initials: E
authors.lastname: Berardesca
authors.forename: V
authors.initials: V
authors.lastname: Marino
authors.forename: G
authors.initials: G
authors.lastname: Gallo
authors.forename: Y
authors.initials: Y
authors.lastname: Brault
authors.forename: J M
authors.initials: JM
authors.lastname: Germain
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage* / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000188:drug therapy*; D009262:Nails; D011565:Psoriasis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept