# Blood-Count-Derived Inflammatory Biomarkers and Characterization of Super-Responder Profile in Psoriatic Patients Receiving Biological Treatment: A Single-Center Study

## TL;DR

This study identifies factors, including age and blood markers, that predict a complete response to biological treatments in psoriasis patients.

## Contribution

The study introduces a profile of super-responders to biological therapy based on clinical and inflammatory markers.

## Key findings

- Younger patients with no lesions on palms and soles are more likely to achieve a super-response.
- Higher derived Neutrophil-to-Lymphocyte Ratio (dNLR) at baseline predicts better treatment outcomes.
- Previous methotrexate use and absence of non-alcoholic fatty liver disease correlate with super-response.

## Abstract

In recent years, monoclonal antibodies targeting key cytokines underlying the occurrence of psoriatic skin lesions and joint involvement, i.e., Tumor Necrosis Factor-alpha (TNF-α), Interleukin 17 (IL-17), Interleukin 12 (IL-12), and Interleukin 23 (IL-23), have become more commonly used in the therapy of psoriasis. Due to the high effectiveness, a favorable safety profile, and growing availability of biological treatment methods, the number of patients receiving chronic monoclonal antibody therapy is increasing each year. However, the factors affecting the effectiveness of biological drugs are not fully recognized. The study aimed at analyzing the clinical profile of patients and non-specific inflammatory markers in terms of the response to the psoriasis treatment with IL-17, IL-23, IL-12/23, and TNF-α inhibitors. The analysis involved 185 patients receiving biological therapy in the Department of Dermatology and Venereology at the Medical University of Lodz, which resulted in a total of 222 treatment cycles (TC). The super-response was defined as 100% reduction in the Psoriasis Area and Severity Index (PASI 100), at week 16 (±4 weeks) of therapy. Our study indicates that the chance of achieving a super-response was higher among younger patients with no psoriatic lesions on palms and soles, not suffering from non-alcoholic fatty liver disease, previously treated with methotrexate, and characterized by a higher level of derived Neutrophil-to-Lymphocyte Ratio (dNLR) at the beginning of treatment.