Spondyloarthritis & psoriatic arthritis
Nail psoriasis dynamics during biologic treatment and withdrawal in patients with psoriasis who may be at high risk of developing psoriatic arthritis: a post hoc analysis of the VOYAGE 2 randomized trial
Authors' conclusion
Higher skin efficacy at week 16 was associated with better nail responses during guselkumab treatment. Nail psoriasis improvements reflected skin improvements. Following guselkumab withdrawal, nail response was maintained longer than skin response.
Study context
- Population
- Patients with moderate-to-severe plaque psoriasis and baseline nail involvement
- Participants
- 272 vs 132
- Comparison
- Guselkumab vs adalimumab, followed by treatment withdrawal
- Guselkumabn = 272
- Adalimumabn = 132reference
- Primary endpoint
- Factors associated with NAPSI 0/1 with guselkumab
- Follow-up
- Week 24/week 48
Methodological detailsphase III, multiple logistic regression
- Phase III
- Multiple logistic regression
Primary result
As reported in the abstract
Baseline Nail Psoriasis Severity Index (NAPSI), OR, week 24
0.685
95% CI 0.586, 0.802
Week 16 Psoriasis Area and Severity Index (PASI), OR, week 24
0.469
0.281, 0.782
Baseline NAPSI, OR, week 48
0.784
0.674, 0.914
Week 16 PASI, OR, week 48
0.557
0.331, 0.937
Further findings
| Outcome | Guselkumab | Adalimumab |
|---|---|---|
| Mean NAPSI after withdrawal at week 28 · week 24 and week 48 | 1.7 | 1.4 |
| Week 48 | 1.9 | 2.3 |
- Mean NAPSI after withdrawal at week 28: value = week 24
NAPSI response by prior biologic experience
- Previous biologic experience did not impact NAPSI response
Mean NAPSI after withdrawal at week 28 · week 24 and week 48
- Maintained with guselkumab; increased slightly with adalimumab
Mean PASI after withdrawal
- Mean PASI increased across both treatment arms
Original publication
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