Network meta-analyses comparing the efficacy of biologic treatments for achieving complete resolution of nail psoriasis at 24-28 and 48-52 weeks

J Dermatolog Treat. 2023 Dec;34(1):2263108. doi: 10.1080/09546634.2023.2263108. Epub 2023 Oct 2.

Abstract

Background: Available network meta-analyses (NMAs) comparing the efficacy of biologics in nail psoriasis (NP) have not included recently approved biologics such as bimekizumab nor have they provided comparisons up to 1 year.

Objective: We conducted two NMAs that update and extend results from a previous NMA comparing biologics for achieving complete resolution of NP.

Methods: Bayesian NMAs were performed using a generalized linear model with a logit link to model the binary outcome of nail clearance at weeks 24-28 and 48-52.

Results: For the NMA at weeks 24-28, which included seven biologics and placebo, the absolute probability of achieving complete resolution of NP was highest for ixekizumab (46.4%; 95% credibility interval [CrI] 35.2-58.0), followed by brodalumab (37.1%; 95% CrI 17.1-62.2) and bimekizumab (30.3%; 95% CrI 12.7-53.9). For the NMA at weeks 48-52, which included six biologics, the absolute probability was highest for ixekizumab (77.2%; 95% CrI 51.1-93.4), followed by adalimumab (75.6%; 95% CrI 61.5-87.3) and brodalumab (71.9%; 95% CrI 38.4-93.2).

Conclusion: Among biologics included in these two NMAs, ixekizumab has the highest absolute probability of achieving complete resolution of NP. Results may help to inform treatment decisions for patients with NP.

Keywords: Nail Psoriasis Severity Index (NAPSI); Nail psoriasis; Physician’s Global Assessment of Fingernails (PGA-F); biologics; complete clearance/resolution of nail psoriasis; ixekizumab; network meta-analysis.

MeSH terms

  • Adalimumab / therapeutic use
  • Bayes Theorem
  • Biological Products* / therapeutic use
  • Humans
  • Nail Diseases* / drug therapy
  • Network Meta-Analysis
  • Psoriasis* / drug therapy
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Adalimumab
  • Biological Products