# Blood MALT1 expression could help predict treatment outcomes in psoriasis patients, especially in those receiving biologics

## TL;DR

Measuring MALT1 in blood could help predict how well psoriasis patients will respond to treatment, especially biologics.

## Contribution

This study shows that pretreatment blood MALT1 levels predict treatment outcomes in psoriasis patients.

## Key findings

- MALT1 levels were higher in psoriasis patients compared to controls.
- Higher MALT1 levels predicted better PASI75 and PASI90 outcomes at 6 months.
- MALT1 was a stronger predictor in patients receiving biologics than in those without.

## Abstract

Mucosa‐associated lymphoid tissue 1 (MALT1) modulates T helper cell differentiation, pro‐inflammatory cytokine production, and epidermal hyperplasia to participate in the pathology of psoriasis. This study aimed to explore the correlation of blood MALT1 with treatment outcomes in psoriasis patients.

MALT1 was detected in peripheral blood mononuclear cells by reverse transcription‐quantitative polymerase chain reaction in 210 psoriasis patients before starting or converting to a new therapy, 50 disease controls, and 50 healthy controls. The psoriasis area severity index (PASI) score was evaluated at month (M)1, M3, and M6 in psoriasis patients.

MALT1 was increased in psoriasis patients versus disease controls and healthy controls (both p < .001); and positively related to body mass index (p = .019) and PASI score (p < .001) in psoriasis patients. PASI75 rate at M1, M3, and M6 was 22.9%, 46.2%, and 71.0%, respectively; while PASI90 rate at M1, M3, and M6 was 3.8%, 29.0%, and 50.5%, respectively, in psoriasis patients. PASI75/90 rates at M1, M3, and M6 were increased in psoriasis patients receiving biologics versus those without (all p < .05). Pretreatment MALT1 was higher in psoriasis patients who achieved PASI75 (p = .001) and PASI90 (p < .001) at M6 compared to those who did not achieve that. Subgroup analyses discovered that pretreatment MALT1 had a stronger ability to predict PASI75 and 90 realizations in psoriasis patients receiving biologics (area under the curve [AUC]: 0.723 and 0.808) versus those without (AUC: 0.594 and 0.675).

Blood MALT1 measurement may assist in predicting outcomes in psoriasis patients, especially in those receiving biologics.

Blood mucosa‐associated lymphoid tissue possesses the potential to estimate increased disease activity and favorable treatment response, especially to systemic biologic therapy, in psoriasis patients.