Jochen H.O. Hoffmann, Christian Knoop, Alexander Enk, Eva N. Hadaschik
DOI: 10.2340/actadv.v101.271

Psoriasis is thought to be associated with a reduced life expectancy through systemic inflammation. A comparative, retrospective analysis of neutrophil-to-lympho-cyte ratio, a biomarker of systemic inflammation and cardiovascular risk, under 196 treatments with tumour necrosis factor-α and interleukin-12/23 antagonists was performed. Neutrophil-to-lympho-cyte ratio decreased significantly within 3 months of initiation of treatment and remained stable at reduced levels for at least 33 months. Dynamics were more pronounced and neutrophil-to-lympho-cyte ratio under treatment was lower in patients treated with tumour necrosis factor-α compared with interleukin-12/23 antagonists (geometric mean (95% confidence interval): 2.03 (1.9, 2.1) vs 2.63 (2.2, 3.2), respectively, p = 0.014). tumour necrosis factor-α antagonist treatment and baseline neutrophil-to-lympho-cyte ratio were independent predictors of a median low cardiovascular risk neutrophil-to-lympho-cyte ratio (< 2.15) during treatment (odds ratio (95% confidence interval): 0.53 (0.4–0.8) and 4.68 (1.0–19.1), p = 0.001 and p = 0.032, respectively). These results demonstrate a rapid and sustained reduction in biomarkers of systemic inflammation under biologic treatment. Furthermore, these data suggest class-specific effects on systemic inflammation, which may be relevant for the prevention of psoriasis co-morbidity by systemic treatment.

Psoriasis is thought to be associated with a reduced life expectancy through systemic inflammation. Analysis of neutrophil-to-lymphocyte ratio, which is a biomarker of systemic inflammation and cardiovascular risk, under 196 treatments with biologicals from 2 different classes was performed. While biologicals from both classes reduced the neutrophil-to-lymphocyte ratio, the effects were more pronounced under treatment with tumour necrosis factor-α compared with interleukin-12/23 antagonists. The reduction and prevention of systemic comorbidity is an emerging field in psoriasis treatment. These results support class-specific differences in the effects of biologicals on systemic inflammation, which may be relevant for treatment decisions.