Determination of the nail psoriasis severity index (NAPSI) improvement rate standards for nail psoriasis treatment in a phase IV clinical trial of ustekinumab: the MARCOPOLO study

Clinical trials of psoriasis use efficacy assessment tools including the psoriasis area and severity index (PASI), body surface area, physicians' global assessment (PGA) score, and Dermatology Life Quality Index (DLQI). A 75% improvement in the PASI score (PASI75) is generally accepted as an indicator of therapeutic effectiveness, and a 90% improvement (PASI90) is thought to depict almost complete clearance. Nail psoriasis is also the target of biologics trials. The nail psoriasis and severity index (NAPSI) is used to evaluate nail improvement.¹ However, NAPSI-specific target improvement rates like PASI75 or PASI90 have not been established. Establishing standard rates would be helpful because they can be used to compare efficacy across trials and evaluate individuals objectively.

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