{Reference Type}: Journal Article
{Title}: Small molecule inhibitors and biologics in treating nail psoriasis: A systematic review and network meta-analysis.
{Author}: Huang IH;Wu PC;Yang TH;Li H;Huang YT;Cheng YC;Kuo PH;Lee YH;Huang YC;Tu YK;
{Journal}: J Am Acad Dermatol
{Volume}: 85
{Issue}: 1
{Year}: Jul 2021
{Factor}: 15.487
{DOI}: 10.1016/j.jaad.2021.01.024
{Abstract}: <B>BACKGROUND: </B>Various systemic immunomodulating therapies have been investigated to treat nail psoriasis, but the efficacy remains unclear.<BR><B>OBJECTIVE: </B>To perform a systematic review and network meta-analysis to evaluate the efficacy of small molecule inhibitors and biologics in treating nail psoriasis.<BR><B>METHODS: </B>Eligible studies in online databases were identified until March 10, 2020. To assess the efficacy of small molecule inhibitors and biologics, network meta-analyses with surface under the cumulative ranking curve of improvement in nail score at 10 to 16 and at 24 to 26 weeks, as well as 100% improvement of Nail Psoriasis Severity Index (NAPSI), were performed.<BR><B>RESULTS: </B>Thirty-nine studies with a total of 13 treatment arms involving 15,673 patients with nail psoriasis were included. An network meta-analysis showed that tofacitinib (weighted mean difference, 56.67; 95% confidence interval [CI], 35.87-77.48) and ixekizumab (weighted mean difference, 59.40; 95% CI, 45.87-72.93) presented the most improvement of nail score at 10 to 16 weeks and 24 to 26 weeks, respectively. For 100% improvement of the Nail Psoriasis Severity Index, ixekizumab showed the best efficacy among all treatments (odds ratio, 2.98; 95% CI, 1.74-5.10).<BR><B>CONCLUSIONS: </B>Insufficiency of eligible data and no long-term follow-up data.<BR><B>CONCLUSIONS: </B>Tofacitinib and ixekizumab presented the best efficacy for treating nail psoriasis in 10 to 16 weeks and 24 to 26 weeks, respectively.