The reduction of systemic inflammation associated with biologic therapy may be associated with improvements in renal function in patients with psoriasis, according toresearch findings published in Dermatologic Therapy.
The study was a retrospective analysis of 92 patients with moderate to severe plaque psoriasis who were referred to a dermatology unit in Italy from 2010 to 2019. All patients had a psoriasis area severity index (PASI) score of greater than 10 and were on 1-year of continuous treatment with a biologic agent. Patients underwent renal function assessment at each monitoring visit. In their analysis, the investigators correlated PASI and serum creatinine levels at baseline as well as after 6 months and more than 1 year of continuous biologic therapy.
At diagnosis, the mean age of the population was 31.9 years, and the mean age at the start of biologic therapy was 49.9 years. Prior therapies included methotrexate (62.5%), cyclosporine (75.4%), psoralen and ultraviolet A (20.2%), and acitretin (20.2%). Biologic therapies received by the patient cohort included anti-interleukin (IL)-17 secukinumab (80%) and ixekizumab (20%), anti-TNF-alpha adalimumab (73.5%) and etanercept (26.5%), and anti-IL-12/23 ustekinumab (25%).
Before initiating biologic therapy, the mean PASI was 17.55. The mean PASI dropped to 1.20 after 1 year of treatment with the biologic agents. In addition, 59 patients achieved PASI 0 with clinical skin resolution. The mean creatinine levels before initiation of biologic therapy and after 1 year of treatment were 0.98 ml/min and 0.90 ml/min, respectively. There was a decrease in the mean creatinine levels in 86.9% of patients. In the paired t-test, the investigators observed a significant mean difference in the creatinine level after 1 year of treatment with biologic therapy (P <.001).
Correlations between PASI reduction and decreases in creatinine were observed throughout the study’s observational period. A greater improvement in creatinine levels was correlated with PASI 0.
Limitations of the study were the small sample size, retrospective nature, as well as the single-center design.
The investigators concluded that their findings suggest that “the improvement of the systemic inflammatory state linked to psoriasis could have overall benefits also on some comorbidities strictly related to psoriasis including renal dysfunction.”
Veronesi G, Guglielmo A, Gardini A, et al. Biological therapy in patients with psoriasis: What we know about the effects on renal function. Dermatol Ther. Published online November 13, 2021. doi:10.1111/dth.15202