Blood Monocyte Count Can Predict Early Response to Secukinumab Therapy in Patients With Psoriasis.

Early response to treatment with biologics, defined as Psoriasis Area and Severity Index (PASI) of 2 or less six months after initiation of therapy, seems to be associated with more stable psoriasis and a lower risk of flares and treatment discontinuation. This study aimed to identify markers that can predict early response to treatment with secukinumab in patients with plaque psoriasis. Treatment with secukinumab was initiated in 29 biologic-naive patients with plaque psoriasis (75.9% males). After six months, the patients were stratified as (1) PASI 2 or less responders or (2) PASI greater than 2 responders. Patients who achieved PASI 2 or less six months after initiation of secukinumab therapy already had significantly greater PASI reductions after the first month of therapy compared to those with PASI greater than 2 six months after treatment. Baseline blood monocyte counts significantly correlated with PASI, both before and six months after initiating secukinumab therapy. A lower monocyte count with a cutoff value set at less than 0.69 × 103/microL (based on ROC curve analysis) was found in multivariate analysis to be an independent factor for achieving PASI 2 or less six months after initiation of therapy with secukinumab (R2 = 0.7; beta = -0.67; P = 0.03). We showed that baseline monocyte count may be useful for predicting early response to secukinumab therapy in plaque psoriasis patients. Identifying such a marker may help clinicians choose the most appropriate biologics for patients with plaque psoriasis and help avoid the expense of switching from one biologic to another. J Drugs Dermatol. 2024;23(2):74-77.     doi:10.36849/JDD.7525.

The vicious circle effect: stress as effect and cause in patients with psoriasis.

Psoriasis is a common immune-mediated, chronic inflammatory disease, causing adverse effects on patients' quality of life and disease burden. In psychodermatology, psoriasis is included both in the group of dermatological diseases, in which the psychophysiological background plays a key role, and in dermatoses being a potential source of emotional disturbances or being a trigger for the development of secondary mental disorders. A comprehensive view of the patient with psoriasis, not only from the point of view of skin disease, but also as a result of a wide impact of stress, including low self-esteem and inappropriate social perception may have a key influence on improvement of quality of life of these patients.