Predictors of Early and Complete Skin Clearance (PASI100) in Patients With Psoriasis Receiving Biologic Therapy: A Real-World Cohort Study
DERMATOLOGIC THERAPY, cilt.2026, sa.1, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 2026 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1155/dth/3143741
- Dergi Adı: DERMATOLOGIC THERAPY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Trakya Üniversitesi Adresli: Evet
Özet
BackgroundEarly achievement of complete skin clearance (PASI100) is a key therapeutic goal in the management of moderate-to-severe psoriasis. Identifying predictors of early response to biologic therapy may improve treatment selection and optimize patient outcomes.MethodsThis retrospective cohort study included adult patients with moderate-to-severe plaque psoriasis treated with biologic agents at a tertiary referral center between January 2015 and October 2024. Patients were categorized according to early PASI100 achievement (<= 16 weeks) and nonearly response. Clinical and laboratory parameters, including inflammatory biomarkers (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], and neutrophil-to-lymphocyte ratio [NLR]), were evaluated. Multivariable logistic regression analysis was performed to identify independent predictors of early PASI100 response.ResultsA total of 394 patients were included. Overall, 300 patients (76.1%) achieved PASI100 during follow-up, and 209 (53.0%) achieved early PASI100. Biologic-naive status independently predicted early PASI100 (OR 1.65, 95% CI 1.06-2.58; p = 0.026), while psoriatic arthritis was associated with a reduced likelihood of early response (OR 0.61, 95% CI 0.37-0.99; p = 0.045). CRP and NLR were not independent predictors; baseline ESR showed a borderline inverse association with early response without reaching significance in multivariable analysis. In secondary analysis, biologic-naive status predicted PASI100 achievement at any time during follow-up (OR 2.46, 95% CI 1.33-4.56; p = 0.004), and comorbidities were associated with lower response rates (OR 0.53, 95% CI 0.28-1.00; p = 0.049). NLR and ESR declined significantly over time, with a more pronounced ESR reduction among nonearly responders at Weeks 48-52.ConclusionsBiologic-naive status and the absence of psoriatic arthritis are associated with a higher likelihood of early complete skin clearance in psoriasis patients receiving biologic therapy. Among inflammatory biomarkers, ESR has limited utility as a baseline predictor of early response but may serve as a useful indicator for monitoring treatment dynamics.