INTRODUCTION
Psoriasis is a chronic inflammatory skin disease characterized by the proliferation and abnormal differentiation of keratinocytes and massive infiltration of inflammatory immune cells. Discovery of the pathogenic role of cytokines such as interleukin (IL)-17 and IL-23 in psoriasis led to a shift in treatment strategies for this disease.1 Therapeutic agents targeting these cytokines (biologics) are effective. The evaluation of psoriasis treatment is often based on severity measured with the Psoriasis Area and Severity Index (PASI).2 However, data from clinical trials have shown that clinically similar patients with psoriasis may respond differently to biologics. Some patients achieve clear or almost clear skin (ie, PASI 90 to PASI 100) within the first 4 to 8 weeks of therapy.3,4 However, some patients are classified as late responders or never full responders. The clinical significance of early response to biologics is not fully understood. It has recently been stated that patients with PASI 2 or less six months after initiation therapy with biologics show markedly more stable psoriasis with lower risk of flares and treatment discontinuation compared to those with PASI greater than 2 within five years of follow-up.5 Thus, it has been suggested that the best response to biologics should be regarded not only as a significant reduction in PASI but clear or almost clear skin (ie, PASI 2 or less) within the first several weeks of therapy (ie, early response).
Some recent studies have shown that higher body weight and smoking may be associated with a lower probability of treatment response, as well as early response, to different biologics (ie, adalimumab, ustekinumab, secukinumab).4,6 Identifying the factors that affect early response to biologics (ie, PASI 2 or less six months after initiation of therapy) could be helpful in selecting the most effective medication for patients with psoriasis and may avoid expensive switching between biologics. Thus, the main aim of this study was to identify clinical and laboratory markers of achieving PASI 2 or less in the first six months of treatment with secukinumab (anti-IL-17A) among patients with plaque psoriasis.
Some recent studies have shown that higher body weight and smoking may be associated with a lower probability of treatment response, as well as early response, to different biologics (ie, adalimumab, ustekinumab, secukinumab).4,6 Identifying the factors that affect early response to biologics (ie, PASI 2 or less six months after initiation of therapy) could be helpful in selecting the most effective medication for patients with psoriasis and may avoid expensive switching between biologics. Thus, the main aim of this study was to identify clinical and laboratory markers of achieving PASI 2 or less in the first six months of treatment with secukinumab (anti-IL-17A) among patients with plaque psoriasis.
MATERIALS AND METHODS
Patients
The study included 29 patients with active plaque psoriasis (PASI 18 or greater), all aged 18 years or older. All participants had no history of systemic treatment or phototherapy for at least three months prior to entering the study. Patients with autoimmune disorders, such as thyroiditis and psoriatic arthritis, were excluded. The following patient characteristics were collected: sex, age, body weight, smoking, hypertension, hyperlipidemia, PASI and BSA, and basic blood test results such as CBC, liver, and kidney function test.
The study included 29 patients with active plaque psoriasis (PASI 18 or greater), all aged 18 years or older. All participants had no history of systemic treatment or phototherapy for at least three months prior to entering the study. Patients with autoimmune disorders, such as thyroiditis and psoriatic arthritis, were excluded. The following patient characteristics were collected: sex, age, body weight, smoking, hypertension, hyperlipidemia, PASI and BSA, and basic blood test results such as CBC, liver, and kidney function test.
