Biomarkers and Predictive Factors for Treatment Response to Tumor Necrosis Factor-α Inhibitors in Patients with Psoriasis

Abstract

We performed a retrospective and observational study of patients with psoriasis. The aim of this study was to define the laboratory indicators reflecting the treatment response to tumor necrosis factor (TNF)-α inhibitors and the predictors for the treatment response. From January 2010 to June 2022, 28, 15 and 12 patients with psoriasis were treated with infliximab (IFX), adalimumab (ADA) and certolizumab pegol (CZP), respectively. The values of C-reactive protein (CRP), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio decreased in parallel with psoriasis area and severity index (PASI) at weeks 12 and 52 of treatment. The percentage reduction of the CRP was correlated with that of the PASI at week 52 in all patients and subgroups treated with IFX. The percentage reduction of the PLR was correlated with that of the PASI at week 52 in all patients. Linear multivariate regression analyses revealed that the presence of scalp lesions was associated with a high percentage reduction of the PASI at week 52 in the ADA subgroup. The CRP and PLR might act as biomarkers reflecting the treatment response to TNF-α inhibitors in patients with psoriasis. The presence of scalp lesions might be a predictive factor for a high treatment response to ADA in patients with psoriasis.

Keywords: C-reactive protein; adalimumab; certplizumab pegol; infliximab; platelet to lymphocyte ratio; psoriasis; scalp; tumor necrosis factor-α inhibitor.

Figure 1

The achievement rates of psoriasis area and severity index (PASI) 75, 90 and absolute PASI ≤ 2 during treatment with individual TNF-α inhibitors in patients with psoriasis. PASI 75 response rate (a), PASI 90 response rate (b) and PASI ≤ 2 response rate (c), respectively.

Figure 2

PASI (a), NLR (b), MLR (c), PLR (d) and CRP (e) values at 0, 12 or 52 weeks of individual TNF-α inhibitor treatments in patients with psoriasis. The ADA and CZP data in (a), CZP data in (c), IFX and CZP data in (d) and CZP data in (e) are provided as mean ± standard deviation and analyzed by repeated measure analysis of variance. Otherwise, data are provided as the median (interquartile range) and analyzed by Friedman’s test. * p < 0.05; ** p < 0.01.