Abstract
Background:
Real-world, primary data on the
treatment of
psoriasis are scarce, especially concerning the
role of soluble
biomarkers as outcome predictors.
Objective:
The authors evaluated the utility of Th1/Th17
serum cytokines along with clinical characteristics as predictors of
drug survival in the
treatment of
psoriasis.
Methods:
The authors consecutively included participants with moderate to severe
psoriasis who were followed up for 6 years. Baseline
interferon-α,
tumor necrosis factor-α, and inter-leukin (IL)-2,
IL-4,
IL-6,
IL-10, and
IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated
hazard ratios (HRs) for
drug survival using a
Cox proportional hazards model.
Results:
The authors included 262
patients, most of whom used systemic
immunosuppressants or
biologics. In the multivariate model, poor
quality of life measured by the
Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01-1.07; p = 0.012) and elevated baseline
IL-6 (HR = 1.99; 95% CI 1.29-3.08; p = 0.002) were associated with
treatment interruption. Study
limitations:
The main limitation of any
cohort study is the presence of confounders that could not be detected in clinical evaluation.
Conclusions:
Poor
quality of life and elevated baseline
serum IL-6 level predicted
treatment interruption in
patients with moderate to severe
psoriasis. Although
IL-6 is not the most important mediator of the inflammatory pathway in the
skin environment, it is an interesting
biomarker candidate for predicting
psoriasis treatment response.