Ixekizumab Improves Nail, Scalp, and Skin Response and Quality of Life Independent of Baseline Psoriasis Severity: Results From the Psoriasis in Special Areas (PSoSA) Study

Abstract

Background: Ixekizumab has shown impressive efficacy among patients with nail, skin, and scalp psoriasis. Here, we present real-world data from the PSoSA study evaluating effectiveness of ixekizumab by cohorts of patients with mild and moderate/severe nail psoriasis.

Methods: PSoSA is an ongoing, prospective, multicenter, single-arm, observational study enrolling adult patients with confirmed diagnosis of moderate-to-severe psoriasis and nail involvement, with or without scalp involvement, initiating ixekizumab in a US dermatology clinic. Assessment of improvements in nail (by modified Nail Psoriasis Severity Index [mNAPSI], with scoring range 0–130), skin (by Psoriasis Area and Severity Index [PASI], with scoring range 0–72), and scalp (by Psoriasis Scalp Severity Index [PSSI], with scoring range 0–72) response and in quality of life (by Dermatology Life Quality Index [DLQI], with scoring range 0–30) were collected at weeks (W) 4, 12, 24, and 52. Percent change was calculated for patients with non-missing baseline values. Data were stratified by nail psoriasis severity at baseline; patients with mNAPSI scores <20 were categorized as mild while those with scores ≥20 were categorized as moderate/severe. In our second interim analysis, we will be reporting data to W24.

Results: Of 182 patients included in the analysis, 101 patients had baseline mNAPSI scores <20 and 81 had scores ≥20. Median percent changes from baseline in mNAPSI response at W4, W12, and W24 were −12.2, −33.3, and −71.9, respectively, for patients with baseline scores <20 and −6.1, −38.7, and −68.6, respectively, for patients with scores ≥20. Median percent changes from baseline in PASI response at W4, W12, and W24 were −60.0, −91.2, and −100.0, respectively, for patients with baseline mNAPSI scores <20 and −62.7, −91.4, and −96.7, respectively, for patients with scores ≥20. Median percent changes from baseline in PSSI response at W4, W12, and W24 were −79.3, −100.0, and −100.0, respectively, for patients with baseline mNAPSI scores <20 and −87.5, −100.0, and −100.0, respectively, for patients with scores ≥20. Median percent changes from baseline in DLQI response at W4, W12, and W24 were −66.7, −77.8, and −89.7, respectively for patients with baseline mNAPSI scores <20, and −57.1, −70.0, and −88.7, respectively, for patients with scores ≥20.

Conclusions: In a real-world setting, patients with moderate-to-severe psoriasis initiating ixekizumab saw major improvements in nail, skin, and scalp response as well as quality of life as early as 4 weeks and sustained through 24 weeks, independent of nail psoriasis severity at baseline.