BMI, CCI linked to biologic response in psoriasis patients

Several factors, including BMI and Charlson Comorbidity Index (CCI), can help predict treatment response among patients with psoriasis, suggests a study.

A total of 737 patients participated in this study, of whom 140 (19.0 percent) were super-responders (SRs) and 34 (4.6 percent) were biologic-refractory patients (BRPs).

BMI <25 kg/m², lower CCI, the absence of psoriatic arthritis, a family history of psoriasis, and lower insulin resistance levels significantly correlated with SRs. On the other hand, BMI ≥30 kg/m², the presence of nonalcoholic fatty liver disease, higher psoriasis area and severity index, and higher erythrocyte sedimentation rate levels were independently associated with BRPs.

Furthermore, SRs often resulted in treatment persistence of biologic agents, while BRPs were associated with poor persistence and higher incidences of adverse events, particularly paradoxical eczema.

“Our study identified predictors of response that may facilitate accurate drug targeting with good persistence and reassuring safety for psoriasis patients,” the investigators said.

This retrospective study involved patients with psoriasis who started treatment with biologics. Predictors for SRs and BRPs were identified using multivariable logistic regression. Finally, Kaplan-Meier plot analysis was performed to assess drug survival.

The study was limited by its single-centre design and small sample.

“Despite advances in the availability of effective biologics in psoriasis over the past decade, clinical characteristics, persistence, and safety associated with treatment response have never been systematically investigated,” according to the investigators.