Impact of Pretreatment Systemic Inflammatory Markers on Treatment Persistence with Biologics and Conventional Systemic Therapy: A Retrospective Study of Patients with Psoriasis Vulgaris and Psoriatic Arthritis

Abstract

Systemic inflammation plays a central role in the pathophysiology of psoriasis. This study examined accessible systemic inflammatory markers in patients with psoriasis vulgaris and psoriatic arthritis. We aimed to evaluate their association with psoriasis severity, the presence of arthritis, and drug continuation rates. The findings revealed that neutrophil, monocyte, and platelet count, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, systemic inflammation response index, systemic immune/inflammation index (SII), and CRP were positively correlated with Psoriasis Area and Severity Index scores. Patients presenting with higher platelet/lymphocyte ratio (PLR) or CRP values were more likely to be diagnosed with psoriatic arthritis than with psoriasis vulgaris in the multivariate regression analysis. Importantly, patients with higher pretreatment neutrophil or platelet count, PLR, and SII were associated with lower treatment continuation rates of conventional systemic agents. Higher pretreatment scores of systemic inflammatory markers did not affect treatment retention rates of biologics. These findings suggest that several accessible systemic inflammatory markers may effectively assess underlying systemic inflammation and may provide an indication for a therapeutic approach in patients with psoriasis vulgaris and psoriatic arthritis.

Association between systemic immune-inflammation index and psoriasis: a population-based study

“…A major challenge and limitation is to find better predictors of treatment response to determine which patients are more likely to benefit from specific biologics. SII is positively correlated with PASI scores ( 30 – 32 ), and the correlation with treatment response ( 31 , 33 , 34 ) has been confirmed by some studies. In addition, correlations have been found between SII and metabolic syndrome ( 64 ), cardiovascular disease ( 65 ), and depression ( 66 ) in psoriasis comorbidities.…”

“…More recently, Sugimoto et al. also demonstrated a positive correlation between SII and PASI scores and found that patients with higher SII scores had lower persistence of treatment with conventional systemic medications ( 31 ). Dincer Rota et al.…”

Effect of Treatment With Biologic Agents on the Novel Inflammatory Biomarkers Systemic Immune Inflammation Index and Systemic Inflammation Response Index for Psoriasis

“…Psoriasis is a chronic inflammatory cutaneous disorder which has been related to comorbidities such as psoriatic arthritis, diabetes, obesity, cardiovascular diseases and depression due to underlying systemic inflammation [ 1 ]. It has been suggested that proinflammatory cytokines, which have been implicated in the development of cutaneous findings such as tumor necrosis factor (TNF)-α, interleukin (IL)-17, IL-23, were increased in both skin and the circulation [ 2 ].…”

“…Inflammatory biomarkers, especially obtained from blood samples, may be easily performed and used in the follow-up of patients with psoriasis [ 5 ]. Various biomarkers such as neutrophil/lymphocytes ratio, platelet/lymphocytes ratio and systemic immune inflammation index have been proposed to be used to detect systemic inflammation in patients with psoriasis [ 1 , 5 ]. However, there is no consensus on the biomarkers that can be used to create an optimized treatment strategy in the management of psoriasis [ 5 ].…”

“…In a few studies, high SII levels have been reported in patients with psoriasis [ 10 , 11 ]. Recently, Sugimoto et al reported that patients with psoriatic arthritis were likely to have high SIRI levels [ 1 ]. However, SII and SIRI have not been adequately studied in patients with psoriasis.…”