Management of Nail Disease in Patients With Psoriatic Arthritis: An Updated Literature Review Informing the 2021 GRAPPA Treatment Recommendations

Abstract

ObjectiveNail psoriasis is common, impairs fine motor finger functioning, affects cosmesis, and is associated with a lower quality of life. This review updates the previous Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations for nail psoriasis.MethodsThis systematic literature review of the PubMed, MEDLINE, Embase, and Cochrane databases examined the updated evidence since the last GRAPPA nail psoriasis treatment recommendations published in 2014. Recommendations are based on preformed PICO (Patient/Population - Intervention - Comparison/Comparator - Outcome) questions formulated by an international group of dermatologists, rheumatologists, and patient panel members. Data from this literature review were evaluated in line with Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.ResultsOverall, there is insufficient evidence to make any recommendation for the use of topical corticosteroids, topical calcipotriol, topical tazarotene, topical cyclosporine, dimethyl fumarates/fumaric acid esters, phototherapy, and alitretinoin. There is a low strength of evidence to support the use of calcipotriol and corticosteroid preparations, topical tacrolimus, oral cyclosporine, oral methotrexate, intralesional corticosteroids, pulsed dye laser, acitretin, Janus kinase inhibitors, and apremilast.ConclusionThe highest strength of supporting evidence is for the recommendation of biologic agents including tumor necrosis factor inhibitors, and interleukin 12/23, 17, and 23 inhibitors.

Therapy of netakimab in nail psoriasis

“…GRAPPA (международная группа по изучению псориаза и псориатического артрита) c 2016 г. в качестве первой линии терапии пациентов с псориазом ногтей рекомендует генно-инженерные биологические препараты (ГИБП). В обновленных рекомендациях 2021 г. GRAPPA уточняет, что терапию псориаза ногтей следует начинать с ингибиторов ФНО, ИЛ12/23, ИЛ-17, ИЛ-23 и ингибиторов фосфодиэстеразы 4-го типа [40]. В случае исходной неудачи при лечении псориатической ониходистрофии ГИБП следует перейти на антиИЛ-17 [41].…”