OBJECTIVE: To compare the efficacy and safety of matrix phenolization and nail bed reconstruction for pincer nail deformity (PND). METHODS: This study included 34 patients with 37 nails divided into matrix phenolization...OBJECTIVE: To compare the efficacy and safety of matrix phenolization and nail bed reconstruction for pincer nail deformity (PND). METHODS: This study included 34 patients with 37 nails divided into matrix phenolization group ( = 21) and nail bed reconstruction group ( = 16). The width index, height index, curvature index of nail plate and visual analog scale (VAS) of pain were recorded preoperatively, 6 and 12 months postoperatively. Early postoperative pain, treatment effect, postoperative complications and patient satisfaction were also recorded. RESULTS: The width index was higher, and the height index, curvature index, and VAS were lower at 6 and 12 months after both surgeries ( < 0.05). At 6 months after surgery, the height index and curvature index of nail bed reconstruction were lower than matrix phenolization ( < 0.05). There was no significant difference in the width index and VAS between two groups. At 12 months after surgery, there was no significant difference in the width index, height index, curvature index and VAS between two groups. Two cases had recurrence after matrix phenolization and two cases had nail fold pain after nail bed reconstruction. All patients were satisfied. CONCLUSION: Matrix phenolization and nail bed reconstruction both showed good efficacy and safety in the treatment of PND. Matrix phenolization has simple operation, mild pain and fast postoperative recovery, which is recommended in clinical practice.
BACKGROUND: The emergence of systemic targeted therapies for atopic dermatitis (AD) has significantly transformed the treatment landscape. OBJECTIVE: This network meta-analysis aims to systematically evaluate the relativ...BACKGROUND: The emergence of systemic targeted therapies for atopic dermatitis (AD) has significantly transformed the treatment landscape. OBJECTIVE: This network meta-analysis aims to systematically evaluate the relative efficacy of approved systemic targeted therapies in adult patients with moderate-to-severe AD. METHODS: Phase 3 or 4 randomized controlled trials (RCTs) assessing approved systemic targeted therapies for moderate-to-severe AD published up to July 29, 2025, were systematically identified. A Bayesian network meta-analysis was performed to analyze the proportion of patients achieving key efficacy indicators, including EASI-75, EASI-90, IGA 0/1, and NRS response. RESULTS: A total of 27 reports encompassing 33 trials and 16,334 participants were included. The network meta-analysis demonstrated that Upadacitinib 30 mg consistently exhibited the highest probability of achieving each clinical endpoint. While pairwise comparisons revealed statistically significant differences among multiple targeted therapies, no significant differences were observed between dupilumab 300 mg and stapokibart 300 mg, or between ivarmacitinib 8 mg and upadacitinib 15 mg. CONCLUSION: Among currently approved targeted systemic therapies, upadacitinib 30 mg once daily ranked highest across all evaluated efficacy outcomes. However, these findings are derived primarily from indirect comparisons, and head-to-head randomized trials are needed to confirm the relative effectiveness of these therapies.
UNLABELLED: To characterize and compare the post-marketing safety profiles of Janus kinase (JAK) inhibitors used in alopecia areata (AA), including tofacitinib, baricitinib, ruxolitinib, and ritlecitinib. METHODS: Report...UNLABELLED: To characterize and compare the post-marketing safety profiles of Janus kinase (JAK) inhibitors used in alopecia areata (AA), including tofacitinib, baricitinib, ruxolitinib, and ritlecitinib. METHODS: Reports associated with JAK inhibitors in AA (2015-2025) were retrieved from the FDA Adverse Event Reporting System (FAERS). Disproportionality analyses utilized within-class and external non-JAK comparisons. Additionally, time-to-onset (TTO), serious adverse event (SAE) profiles, and sensitivity analyses were assessed. RESULTS: Among 1,905 identified reports (baricitinib [ = 881], ritlecitinib [ = 515], tofacitinib [ = 489], ruxolitinib [ = 20]), safety signals varied across agents. Tofacitinib showed signals involving neuropsychiatric and autoimmune events; baricitinib was associated with thrombocytosis, deep vein thrombosis, and breast cancer; ruxolitinib with pyrexia and elevated blood cholesterol; and ritlecitinib with gastrointestinal events and creatine phosphokinase elevation. TTO patterns were also heterogeneous, with earlier onset for tofacitinib and ruxolitinib, clustering within the first month for ritlecitinib, and a relatively delayed onset for baricitinib. Across the class, serious outcomes were most commonly related to infections, although the distribution of clinical outcomes differed by agent. CONCLUSIONS: JAK inhibitors used in AA demonstrated heterogeneous post-marketing safety patterns not fully captured by class-level warnings. These findings support agent-specific surveillance and individualized risk assessment in clinical practice.
BACKGROUND: Seborrheic dermatitis (SD) is a chronic inflammatory skin disease with limited long-term treatment options. The association between physical activity and incident SD, as well as the potential mediating role o...BACKGROUND: Seborrheic dermatitis (SD) is a chronic inflammatory skin disease with limited long-term treatment options. The association between physical activity and incident SD, as well as the potential mediating role of depressive symptoms, remains unclear. OBJECTIVE: To investigate the association between physical activity and incident SD and to assess whether depressive symptoms mediate this relationship. METHODS: Data from 396,903 participants in the UK Biobank were analyzed. Cox proportional hazards models were used to examine the association between physical activity and incident SD. Regression-based mediation analyses were performed to quantify the extent to which depressive symptoms mediated this association. RESULTS: Physical activity above the recommended minimum (≥600 MET-min/week) was associated with a lower risk of incident SD. The greatest risk reduction was observed at 3-5 times the recommended level (1,800-3,000 MET-min/week; HR 0.80, 95% CI 0.71-0.90). Participants meeting criteria for healthy physical activity had a 28% lower risk of incident SD (HR 0.72, 95% CI 0.64-0.81). Mediation analyses showed that 17% of the protective association was explained by reduced depressive symptoms (indirect HR 0.83, 95% CI 0.77-0.88), while 16% was attributable to the direct effect of physical activity (direct HR 0.84, 95% CI 0.77-0.93). CONCLUSIONS: Physical activity may serve as a non-pharmacologic strategy for the prevention of SD, partly through alleviating depressive symptoms. The maximal benefit was observed at 3-5 times the recommended minimum activity level.
Chronic hand eczema (CHE) is a complex, multifactorial inflammatory skin disease that significantly impairs patients' quality of life. This multinational, prospective, observational study evaluated the burden of CHE on h...Chronic hand eczema (CHE) is a complex, multifactorial inflammatory skin disease that significantly impairs patients' quality of life. This multinational, prospective, observational study evaluated the burden of CHE on health-related quality of life (HRQoL) in adults across six countries: Canada, France, Germany, Italy, Spain, and the United Kingdom. Participants who self-reported a physician-diagnosed CHE completed the patient-reported outcome measures, including the Hand Eczema Impact Scale (HEIS), Dermatology Life Quality Index (DLQI), and EQ-5D 5 Level Version (EQ-5D-5L). Data were stratified by disease severity, history of suboptimal response to topical corticosteroids (TCS), and current treatment type. Results demonstrated a substantial HRQoL burden associated with CHE, specifically in participants with moderate to severe CHE compared to those with mild CHE (DLQI: 7.7 ± 6.3 vs 3.7 ± 4.7; EQ-5D-5L: 0.682 ± 0.259 vs 0.742 ± 0.237; HEIS total score: 1.5 ± 1.0 vs 0.7 ± 0.8; < 0.001 for all). A particularly high burden was reported among participants for whom TCS was suboptimal and those receiving systemics/phototherapy. Present study findings highlight the need for more effective management strategies and targeted treatment options to improve the HRQoL of individuals suffering from CHE.
BACKGROUND: Neurocutaneous dysesthesia (ND) is characterized by abnormal skin sensations such as pruritus or burning without an underlying skin condition. It is caused by nerve damage or compression. Location and extent...BACKGROUND: Neurocutaneous dysesthesia (ND) is characterized by abnormal skin sensations such as pruritus or burning without an underlying skin condition. It is caused by nerve damage or compression. Location and extent of symptoms vary greatly depending on the affected somatosensory site(s). Treatment is challenging and step-by-step guidelines are lacking. Local therapy offers a valuable first step, especially in mild cases or when systemic agents are contraindicated. Although numerous studies have described a variety of local treatment options for ND, no clear overview of these options existed. AIM: In this review, we provide an overview of available local treatment modalities for ND and explain their mechanisms of action. FINDINGS: The following local treatment options are described: capsaicin, calcineurin inhibitors, menthol, pramoxine/lidocaine/prilocaine, ambroxol, phenytoin, strontium, amitriptyline, doxepin, duloxetine, baclofen, gabapentin, cannabinoids, loperamide, naltrexone, clonidine, prazosin, acetylsalicylic acid, diclofenac, aprepitant, ketamine, calamine, polidocanol, and botulinum toxin type A. CONCLUSIONS: Local therapy offers a valuable and often well-tolerated first step in managing ND. Unfortunately, high-quality evidence is scarce and treatment efficacy remains unpredictable. Clinicians are advised to start with low concentrations, discuss off-label use, and monitor for side effects. Until robust guidelines are available, a cautious trial-and-error approach remains the cornerstone of management.
OBJECTIVES: Understanding patient priorities in nonsegmental vitiligo is essential for developing therapies that address unmet needs. This study used a modified Outcome-Driven Innovation approach to quantify unmet need b...OBJECTIVES: Understanding patient priorities in nonsegmental vitiligo is essential for developing therapies that address unmet needs. This study used a modified Outcome-Driven Innovation approach to quantify unmet need by considering patients' perspectives on the importance of, and their satisfaction with, treatment attributes. METHODS: A cross-sectional survey of 522 patients with nonsegmental vitiligo in the United States quantified the relative importance participants placed on 26 treatment attributes. Participants also rated their satisfaction with how well available treatments performed on those attributes. K-means clustering was used to segment participants based on priorities. RESULTS: Three segments, focusing on efficacy, administration and dosing, or safety, were identified. The two most underserved attributes, identified by >10% of participants as important for which satisfaction was low, were improvement in emotional well-being from repigmentation (15.6% of participants) and access to systemic therapy (15.1% of participants). Participants with ≥5% body surface area affected, including the face, more often identified efficacy and systemic treatment that targets the entire body as unmet needs than did those reporting facial involvement only. CONCLUSIONS: These findings highlight substantial unmet needs in nonsegmental vitiligo treatment, underscoring the importance of developing systemic therapies that align with patients' priorities to deliver meaningful repigmentation that improves emotional well-being.
BACKGROUND: Acne vulgaris is a common skin disorder that negatively affects adolescents' quality of life. Recent evidence suggests that combining isotretinoin with desloratadine may enhance treatment outcomes. OBJECTIVES...BACKGROUND: Acne vulgaris is a common skin disorder that negatively affects adolescents' quality of life. Recent evidence suggests that combining isotretinoin with desloratadine may enhance treatment outcomes. OBJECTIVES AND METHODS: This study aimed to develop a practical algorithm for SSD management in Italy, by gathering insights from Italian dermatology experts on diagnosis, treatment and long-term management of SSD. RESULTS: According to literature review and clinical experience, accurate diagnosis of SSD requires medical history, clinical evaluation, disease severity assessment and trichoscopy. The differentiation of SSD from psoriasis, eczema, and tinea capitis is essential to guide appropriate treatment, which should counteract the main pathogenic mechanisms underlying the disease and be tailored to the severity of clinical manifestations. Topical antifungals are the first-line treatments due to their efficacy in reducing Malassezia colonization. The use of topical anti-inflammatory agents, including corticosteroids, is useful for moderate-to-severe cases, but should be limited due to potential adverse effects. Selenium disulfide may be a useful option for both acute symptom control and long-term maintenance because of its antifungal, sebostatic, keratolytic, and microbiome-restoring properties, associated with a high degree of patient satisfaction. Systemic antifungals may be considered in refractory cases. CONCLUSION: This experts' view provides a structured approach to SSD management in Italy, integrating clinical experience and scientific evidence.
BACKGROUND: Acne vulgaris is a common skin disorder that negatively affects adolescents' quality of life. Recent evidence suggests that combining isotretinoin with desloratadine may enhance treatment outcomes. OBJECTIVE:...BACKGROUND: Acne vulgaris is a common skin disorder that negatively affects adolescents' quality of life. Recent evidence suggests that combining isotretinoin with desloratadine may enhance treatment outcomes. OBJECTIVE: To evaluate the efficacy and safety of oral isotretinoin plus desloratadine compared with isotretinoin monotherapy in acne vulgaris patients. METHODS: A systematic search in PubMed, Web of Science, and CENTRAL was conducted until August 2025, encompassing nine clinical trials with 608 patients. Risk of bias was assessed using the ROB-2 tool, and data were analyzed with RevMan version 5.4.1. RESULTS: Combination therapy significantly reduced GAGS scores at 4 weeks (MD: -2.53; 95% CI: -4.10 to -0.96; = 0.002), 12 weeks (MD: -3.62; 95% CI: -4.98 to -2.26; < 0.00001), 16 weeks (MD: -2.13; 95% CI: -3.43 to -0.84; = 0.001), and 24 weeks (MD: -2.52; 95% CI: -3.58 to -1.46; < 0.00001). Clinical efficacy (>90% GAGS reduction) was higher with combination therapy (OR: 2.39; 95% CI: 1.19 to 4.78; = 0.01). In addition, combination therapy was associated with reduced flare-ups (OR: 0.38; = 0.009) and pruritus (OR: 0.13; < 0.00001). Patient satisfaction was greater, with no significant changes observed in laboratory safety parameters. CONCLUSION: Isotretinoin with desloratadine offers superior efficacy and tolerability, ensuring higher patient satisfaction without safety risks.
BACKGROUND: Healthcare resource utilization (HCRU) costs in those on conventional systemics for mild-moderate psoriasis are poorly described. OBJECTIVES: This study aimed to describe HRCU, disease severity and health-rel...BACKGROUND: Healthcare resource utilization (HCRU) costs in those on conventional systemics for mild-moderate psoriasis are poorly described. OBJECTIVES: This study aimed to describe HRCU, disease severity and health-related quality of life in patients with mild-moderate psoriasis requiring systemic therapy. METHODS: UK single-center retrospective longitudinal cohort study including adults with mild-moderate psoriasis (PASI < 10, no historical PASI ≥ 10, no prior biologics) on conventional systemic therapy with 3-year data capture from first PASI recording (2014-2019, pre-COVID). Patients discontinued due to reaching PASI ≥ 10, starting biologics or being lost to follow-up. RESULTS: The median annual HCRU cost was £1923 (mean £3361), largely driven by visit costs. A total of 50.8% patients achieved a PASI ≤ 2 and 30.6% achieved PASI ≤ 2 and DLQI ≤ 5 during follow-up. The difference between the maximum and minimum PASI for a patient and follow-up time were statistically significant predictors of total costs ( < 0.05). CONCLUSION: Despite high healthcare costs, nearly half of the patients did not achieve clear/nearly clear skin. These data, in the context of reducing costs for biosimilars, may provide a basis to challenge care pathways and access criteria for 'high-cost' treatments.
AIM: To describe the clinical response to the JAK inhibition, upadacitinib, in a patient with cutaneous infectious granulomatosis. METHODS: We reported a 36-year-old female with chronic, treatment-resistant facial and le...AIM: To describe the clinical response to the JAK inhibition, upadacitinib, in a patient with cutaneous infectious granulomatosis. METHODS: We reported a 36-year-old female with chronic, treatment-resistant facial and leg plaques. Histopathology supported a diagnosis of infectious granuloma, but no exact pathogen was detected after antifungal therapy. Immunohistochemical analysis indicated elevated levels of cytokines. This patient was treated with upadacitinib 15 mg daily. RESULTS: The symptoms had worsened despite prior antifungal therapy. This patient experienced rapid improvement and sustained remission following treatment with upadacitinib for pathogen-negative, immune-mediated granulomatosis. No recurrences were observed at the 8-month follow-up. CONCLUSION: This case-report highlights a potential role for JAK inhibition, upadacitinib, in managing refractory cutaneous granulomatosis with an excessive immune response despite no identifiable pathogen and pathogen clearance.
Silverberg JI, Bieber T, Eyerich K
… +12 more, Armstrong AW, Nickoloff BJ, Natalie CR, Gallo G, Okragly A, Wolf E, Xu C, Moser BA, Rueda MJ, Elmaraghy H, Uluckan O, Gudjonsson JE
AIM OF THE STUDY: Lebrikizumab monotherapy demonstrated efficacy for adults and adolescents with moderate-to-severe atopic dermatitis (AD). This study aims to evaluate the relationship between lebrikizumab serum levels a...AIM OF THE STUDY: Lebrikizumab monotherapy demonstrated efficacy for adults and adolescents with moderate-to-severe atopic dermatitis (AD). This study aims to evaluate the relationship between lebrikizumab serum levels and stable deep response after treatment cessation in Week 16-responder patients who maintained stable EASI 90 response post-induction up to Week 52. MATERIALS AND METHODS: Analysis was pooled from two identically designed, randomized, double-blind, placebo-controlled, phase 3 trials, ADvocate1 (NCT04146363; conducted from September 24, 2019, to May 3, 2022) and ADvocate2 (NCT04178967; conducted from October 29, 2019, to April 28, 2022). The analysis subgroup includes those patients who were Week-16 responders, have been re-randomized to receive placebo (withdrawal arm), and maintained a stable EASI 90 response for at least 80% of visits up to 52 weeks, without rescue medication. Serum lebrikizumab was measured at Weeks 4, 16, 32, and 52. RESULTS: During withdrawal, 28% of responders (17/60) maintained a stable EASI 90 response with no or minimal fluctuations, including at Week 52, without rescue medication. Mean serum lebrikizumab decreased by 92% and over 99% from Week 16 to Weeks 32 and 52, respectively (Week 16 = 92.4 μg/mL; Week 32 = 7.3 μg/mL; Week 52 = 0.15 μg/mL). CONCLUSION: Lebrikizumab demonstrated off-therapy maintenance of response in an AD patient subset for at least 38 weeks post-discontinuation.
BACKGROUND: Lebrikizumab, a high-affinity monoclonal antibody targeting interleukin-13, effectively treats moderate-to-severe atopic dermatitis (AD). METHODS: Lebrikizumab-treated patients in ADvocate1&2 achieving per-pr...BACKGROUND: Lebrikizumab, a high-affinity monoclonal antibody targeting interleukin-13, effectively treats moderate-to-severe atopic dermatitis (AD). METHODS: Lebrikizumab-treated patients in ADvocate1&2 achieving per-protocol response-IGA (0,1) or EASI 75 at Week 16-were re-randomized 2:2:1 to lebrikizumab 250 mg every 2 weeks (Q2W), Q4W, or placebo (lebrikizumab withdrawal). Patients completing Week 52 could enroll in the extension study, ADjoin. Deep response was defined as IGA (0), EASI 100, or Pruritus Numerical Rating Scale score 0 or 1 (NRS [0,1]). This analysis reports as-observed data. RESULTS AND CONCLUSIONS: From Week 16-104, among IGA (0,1) responders at Week 16, increased proportions of patients achieved IGA (0) with lebrikizumab Q2W (33.8% [Nx = 77] to 52.3% [Nx = 44]) and Q4W (29.9% [Nx = 77] to 45.5% [Nx = 55]); among EASI 75 responders at Week 16, increased proportions of patients achieved EASI 100 with lebrikizumab Q2W (21.4% [Nx = 112] to 39.7% [Nx = 68]) and Q4W (20.0% [Nx = 115] to 41.3% [Nx = 80]); and among per-protocol responders, increased proportions of patients reported Pruritus NRS (0,1) with lebrikizumab Q2W (35.2% [Nx = 108] to 57.4% [Nx = 61]) and Q4W (34.2% [Nx = 114] to 55.4% [Nx = 65]). Continued lebrikizumab treatment for 2 years resulted in approximately half of per-protocol responders achieving complete skin clearance (IGA 0) and itch relief, raising the bar of treatment goals for AD patients.
PURPOSE: Discoid lupus erythematosus (DLE) is a chronic autoimmune skin disorder that primarily affects sun-exposed areas and may lead to permanent scarring and dyspigmentation if inadequately treated. Therapeutic option...PURPOSE: Discoid lupus erythematosus (DLE) is a chronic autoimmune skin disorder that primarily affects sun-exposed areas and may lead to permanent scarring and dyspigmentation if inadequately treated. Therapeutic options for DLE remain limited, and long-term use of topical corticosteroids or calcineurin inhibitors is often constrained by adverse effects, particularly on facial skin. This report aims to describe the clinical response of facial DLE to topical crisaborole treatment. MATERIALS AND METHODS: We report the case of a 20-year-old woman with a 7-year history of a persistent erythematous plaque on the nose, previously misdiagnosed and refractory to multiple treatments, including systemic antimalarials and topical agents. Histopathological examination and direct immunofluorescence findings supported a diagnosis of DLE without systemic involvement. The patient was treated with topical crisaborole 2% ointment once daily in combination with hydroxychloroquine. RESULTS: Marked clinical improvement was observed after two months of treatment. Sustained remission was maintained during a seven-month follow-up period with continued crisaborole use and dose reduction of hydroxychloroquine, without recurrence or adverse effects. CONCLUSIONS: Crisaborole, a topical phosphodiesterase-4 inhibitor approved for atopic dermatitis, may represent a well-tolerated nonsteroidal therapeutic option for facial DLE, particularly in patients who are unresponsive to or intolerant of conventional treatments. Further studies are needed to clarify its efficacy and long-term safety in DLE.
Kim BS, Kwatra SG, Yosipovitch G
… +13 more, Ständer S, Elmariah SB, Metz M, Tsai TF, Murota H, Gao XH, Hong HC, Bansal A, Makhija M, Thomas RB, Bahloul D, Zahn J, Wiggins S
BACKGROUND: Prurigo nodularis (PN) is a complex to manage heterogenous disease with limited available treatments. Patients with PN are usually older, with multiple comorbidities adding to the complexity of their care, fr...BACKGROUND: Prurigo nodularis (PN) is a complex to manage heterogenous disease with limited available treatments. Patients with PN are usually older, with multiple comorbidities adding to the complexity of their care, frequently having failed to control symptoms with other treatments. OBJECTIVE: The objective of this analysis was to evaluate the efficacy of dupilumab across various patient subgroups based on their comorbidities, previous use of other medication or demographic characteristics. METHODS: In the PRIME and PRIME2 studies 311 adult patients with PN were randomized to either dupilumab (300 mg every 2 weeks [q2w]) or matching placebo for 24 weeks. Data from both studies were pooled, and the proportion of patients achieving improvement in itch (measured by Worst-Itch Numerical Rating Scale [WI-NRS] ≥ 4) and lesions (measured by Investigator's Global Assessment [IGA] PN-S [PN-Stage] 0 or 1) or the combination of both at 24 weeks was analyzed according to subgroups stratified by age, gender, body mass index (BMI), presence of comorbidities, and prior treatment use. RESULTS: Dupilumab treatment resulted in itch and lesion improvements at Week 24 compared with placebo in all subgroups studied, with statistical superiority demonstrated in most subgroups tested in this analysis. CONCLUSION: Targeting type 2 inflammation with dupilumab was beneficial independent of age, gender, comorbidities and prior medication.
BACKGROUND: Real-world comparative evidence on systemic agents, phototherapy, and biologics for atopic dermatitis (AD) remains limited. OBJECTIVE: To compare 24-week effectiveness and safety of methotrexate (MTX), cyclos...BACKGROUND: Real-world comparative evidence on systemic agents, phototherapy, and biologics for atopic dermatitis (AD) remains limited. OBJECTIVE: To compare 24-week effectiveness and safety of methotrexate (MTX), cyclosporine, narrowband ultraviolet B (NB-UVB) phototherapy, upadacitinib, and dupilumab in adults with AD. METHODS: In this multicenter retrospective cohort ( = 1000; 200 per monotherapy group) across Saudi Arabia, SCORAD was extracted at baseline and mapped to prespecified weeks 2, 6, 12, and 24. Confounding was addressed using a multinomial propensity score (baseline SCORAD, age, sex, nationality) with overlap weighting; balance was assessed using Max |SMD|. Longitudinal change from baseline (ΔSCORAD) was analyzed using overlap-weighted generalized estimating equations with a treatment-by-time interaction, reporting adjusted marginal mean ΔSCORAD (95% CI). RESULTS: Unadjusted 24-week improvement was highest with dupilumab (75.8%) and upadacitinib (74.1%) ( < 0.001). In overlap-weighted models, both were associated with the largest week-24 improvements (ΔSCORAD -27.04 and -26.68). NB-UVB and methotrexate were intermediate, whereas cyclosporine had smaller sustained improvement. Upadacitinib had the highest recorded adverse-event frequency (68.5%), whereas dupilumab had the lowest (9%). CONCLUSION: Dupilumab and upadacitinib were associated with larger 24-week SCORAD improvements than conventional systemic therapies and NB-UVB within this stratified analytic cohort. Results are associative and may be affected by residual confounding.
UNLABELLED: To investigate bimekizumab efficacy in scalp, nail and palmoplantar psoriasis. In this analysis, data are included from the BE SURE, BE VIVID, BE READY, and BE RADIANT phase 3/3b trials (48-56 weeks) and BE B...UNLABELLED: To investigate bimekizumab efficacy in scalp, nail and palmoplantar psoriasis. In this analysis, data are included from the BE SURE, BE VIVID, BE READY, and BE RADIANT phase 3/3b trials (48-56 weeks) and BE BRIGHT open-label extension (144 weeks). Adults with moderate to severe plaque psoriasis and scalp/palmoplantar Investigator's Global Assessment (IGA) score ≥3 or modified Nail Psoriasis Severity Index (mNAPSI) >10 at baseline were randomized to bimekizumab or comparators (adalimumab, ustekinumab, secukinumab, placebo). Higher rates of complete clearance of scalp and palmoplantar psoriasis were generally observed at Week 4 with bimekizumab than comparators. At Week 24, rates of complete resolution of scalp/nail/palmoplantar psoriasis were 77.7%/39.8%/78.7% with bimekizumab and 58.1%/24.5%/73.3% with adalimumab; at Week 52, 71.9%/54.0%/85.2% with bimekizumab and 51.8%/30.6%/75.0% with ustekinumab; and at Week 48, 80.6%/69.5%/82.4% with bimekizumab and 71.6%/52.5%/76.8% with secukinumab. Complete scalp/nail/palmoplantar clearance rates were sustained through 4 years' bimekizumab treatment (79.5%/61.6%/88.7%). Bimekizumab consistently showed higher rates of complete clearance of psoriasis in high-impact areas along with greater patient-reported health-related quality of life benefits than comparators. Responses were sustained over 4 years, which may lead to improvements in patients' quality of life. TRIAL REGISTRATION: BE SURE (NCT03412747), BE VIVID (NCT03370133), BE RADIANT (NCT03536884), BE READY (NCT03410992), BE BRIGHT (NCT03598790).