Abstract
Introduction: Nail involvement occurs in about 80% of patients with psoriatic arthritis, and it can seriously affect the quality of life. Up to now, there is no evidence about which biological drug is the most effective on nail lesions in our country.
Objectives: The aim of this study was to compared the effectiveness of two well-known biological drugs in our country, adalimumab and etanercept, on nail lesions of psoriatic arthritis.
Patients and Methods: A prospective longitudinal study conducted on psoriatic arthritis patients with nail lesions referred to the Golestan hospital in Ahvaz from 2020 to 2022. A total of 57 patients in two groups of receiving adalimumab (CinnoRA 40 mg; n=28) and etanercept (Altebrel 50 mg; n=29) for 12 weeks. Clinical response and characteristics of nail lesions were evaluated with Nail Psoriasis Severity Index (NAPSI) and Lesion Quadrant Index (LQI) at baseline and after 12 weeks.
Results: There was a statistically significant improvement in LQL and NAPSI scores after 12-week treatment with etanercept and adalimumab. However, after the treatment, there was no significant difference in median of NAPSI of (P=0.685) and LQL (P=0.779) between the two groups etanercept and adalimumab. The complete improvement of NAPSI score with etanercept and adalimumab after 12 weeks was observed in 14 patients (48.3%) in etanercept group and 11 patients (39.3%) in adalimumab group (P=0.494). No adverse effects were observed as well.
Conclusion: Etanercept and adalimumab have been shown to ameliorate nail lesions in psoriatic arthritis during 12 weeks. However, the effectiveness of etanercept and adalimumab in improving nail lesions in psoriatic arthritis patients was similar.