| Background and objective:Nail psoriasis is one of the most common nail diseases in dermatology.It not only affects appearance of nail,but also causes pain and inflammation.In severe cases,it can result in dysfunction,and the patient’s life quality is significantly affected.Due to the special physiological,anatomical structure of the disease,and long period of treatment,the drug adverse reactions of traditional treatment are of high incidence,and the curative effect is not ideal.At present,there is no corresponding expert consensus or diagnosis and treatment guidelines for the treatment of nail psoriasis.In the existing treatments,whether traditional treatments or biological agents,can have certain effects on the improvement of the disease.But a lack of statistical data for these methods leads to our research which compares therapeutic effects of different agents treating with nail psoriasis.Our study is a single-center,open clinical observation trial that recruite patients with nail psoriasis and then divide them into three groups randomly to use cyclosporin,secukinumab and adalimumab for treatment.The clinical efficacy,improvement of patients’ quality of life and drug safety were evaluated,so as to explore different treatments of nail psoriasis.Methods:91 patients with nail psoriasis in our hospital were randomly divided into cyclosporin group(30 cases),adalimumab group(31 cases)and secukinumab group(30 cases).The NAPSI and DLQI of the three groups were compared before the treatment,12 weeks after the treatment,and 24 weeks after the treatment.Clinical effectiveness and adverse reactions were observed.Results:Before treatment,there was no significant difference in NAPSI and DLIQ scores between the three groups(P>0.05).After 12 weeks of treatment,the NAPSI of adalimumab group and secukinumab group were lower than those of cyclosporin group(32.16±13.82、32.37±10.97 <42.20 ± 16.66,P<0.05).The average improvement rate of NAPSI in the adalimumab group and the secukinumab group were both higher than that in the cyclosporin group(37.34 ±13.00,35.42±9.61 > 20.38±8.15(%),P<0.05).After 24 weeks of treatment,the NAPSI of adalimumab group and secukinumab group were significantly lower than those of cyclosporin group(17.81±14.72、19.27±9.90 < 31.17±15.14,P<0.05).The average improvement rate of NAPSI in the adalimumab group and the secukinumab group were both higher than that in the cyclosporin group(66.86±22.97,61.86±15.68>42.84±15.29(%),P<0.05).DLQI in adalimumab group and secukinumab group were both lower than those in cyclosporin group(4.71 ± 4.52,6.30 ± 5.04 < 10.43 ± 8.50,P<0.05).The difference value of DLQI in the adalimumab group and the secukinumab group were both higher than that in the cyclosporin group(-6.23 ± 5.70,-5.90 ± 3.83,higher than-3.20 ± 4.92,P<0.05).Adalimumab group and secukinumab group both showed higher clinical effective rate than cyclosporin(64.52%,60.00% > 23.33%,P<0.05).There was no significant difference in the NAPSI and improvement rate between the adalimumab and secukinumab group after 12 and 24 weeks of treatment,and the DLQI and difference value between the above mentioned two groups were also of no significant difference after 24 weeks of treatment(P>0.05).There was no significant difference in adverse reactions between the three groups.(P>0.05).Conclusions:1.Cyclosporin,secukinumab and adalimumab have certain curative effects on nail psoriasis,and the improvement rate of NAPSI by adalimumab and secukinumab are both significantly higher than that of cyclosporin.There was no significant difference between adalimumab and secukinumab.2.DLQI of patients with nail psoriasis can be improved by cyclosporin,secukinumab and adalimumab,and the efficacy of secukinumab and adalimumab are both better than that of cyclosporin.There was no significant difference between adalimumab and secukinumab.3.The safety of cyclosporin,secukinumab and adalimumab in the treatment of nail psoriasis are all within the tolerance range,and there is no significant difference among the three agents. |
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