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The Effects of Systemic Psoriasis Therapies on the C-Reactive Protein and the Neutrophil-Lymphocyte Ratio

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초록

Background: Currently, no generally accepted laboratory marker for monitorizing the disease activity and therapy response of psoriasis is known. Objective: The aim of the study is to evaluate the effects of systemic therapies on C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR) in psoriasis. Methods: One hundred patients with psoriasis treated with narrow band ultraviolet B, acitretin, cyclosporine, methotrexate, adalimumab, etanercept, and ustekinumab were prospectively evaluated. At baseline and at week 12, CRP, NLR, and Psoriasis Area and Severity Index (PASI) were evaluated. Results: A statistically significant decrease was observed in PASI scores, CRP, and NLR values from the baseline to the 12-week visit (p=0.001, p=0.001, p=0.001, respectively). The reduction in PASI scores and NLR values was positively correlated (r=0.460, p=0.001). The comparisons between treatment groups revealed that the median decrease in NLR values was statistically higher in the adalimumab group than in the methotrexate group (p=0.007). And the median decrease in PASI scores was significantly higher in the adalimumab group compared with the methotrexate and acitretin therapy group (p=0.007, p=0.042, respectively). Conclusion: In the present study, systemic therapy of psoriasis was demonstrated to decrease the levels of CRP and NLR, which are known to be indicators of systemic inflammation and cardiovascular comorbidities.

Abstract

Background: Currently, no generally accepted laboratory marker for monitorizing the disease activity and therapy response of psoriasis is known. Objective: The aim of the study is to evaluate the effects of systemic therapies on C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR) in psoriasis. Methods: One hundred patients with psoriasis treated with narrow band ultraviolet B, acitretin, cyclosporine, methotrexate, adalimumab, etanercept, and ustekinumab were prospectively evaluated. At baseline and at week 12, CRP, NLR, and Psoriasis Area and Severity Index (PASI) were evaluated. Results: A statistically significant decrease was observed in PASI scores, CRP, and NLR values from the baseline to the 12-week visit (p=0.001, p=0.001, p=0.001, respectively). The reduction in PASI scores and NLR values was positively correlated (r=0.460, p=0.001). The comparisons between treatment groups revealed that the median decrease in NLR values was statistically higher in the adalimumab group than in the methotrexate group (p=0.007). And the median decrease in PASI scores was significantly higher in the adalimumab group compared with the methotrexate and acitretin therapy group (p=0.007, p=0.042, respectively). Conclusion: In the present study, systemic therapy of psoriasis was demonstrated to decrease the levels of CRP and NLR, which are known to be indicators of systemic inflammation and cardiovascular comorbidities.

참고문헌 (28)

  1. Biljan D, "Acute phase proteins in psoriasis", Coll Antropol, 33, pp.83~86 (2009)
  2. Langley RG, "Evaluating psoriasis with Psoriasis Area and Severity Index, Psoriasis Global Assessment, and Lattice System Physician's Global Assessment", J Am Acad Dermatol, 51, pp.563~569 (2004)
  3. Coimbra S, "C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy", J Eur Acad Dermatol Venereol, 24, pp.789~796 (2010)
  4. Coimbra S, "Circulating adipokine levels in Portuguese patients with psoriasis vulgaris according to body mass index, severity and therapy", J Eur Acad Dermatol Venereol, 24, pp.1386~1394 (2010)
  5. Ctirad A, "Goeckerman’s therapy for psoriasis with special reference to serum pentraxin 3 level", Int J Dermatol, 47, pp.1011~1014 (2008)
  6. Chodorowska G, "C-reactive protein and alpha2-macroglobulin plasma activity in medium-severe and severe psoriasis", J Eur Acad Dermatol Venereol, 18, pp.180~183 (2004)
  7. Coimbra S, "Interleukin(IL)-22, IL-17, IL-23, IL-8, vascular endothelial growth factor and tumour necrosis factor-α levels in patients with psoriasis before, during and after psoralenultraviolet A and narrowband ultraviolet B therapy", Br J Dermatol, 163, pp.1282~1290 (2010)
  8. Sen BB, "Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis", Cutan Ocul Toxicol, 33, pp.223~227 (2014)
  9. Yurtdaş M, "Neutrophil-to-lymphocyte ratio may predict subclinical atherosclerosis in patients with psoriasis", Echocardiography, 31, pp.1095~1104 (2014)
  10. Ataseven A, "The importance of neutrophil lymphocyte ratio in patients with psoriasis", Mater Sociomed, 26, pp.231~233 (2014)
  11. Kim DS, "Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis", J Dermatol, 43, pp.305~310 (2016)
  12. Polat M, "Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in Turkish patients with chronic plaque psoriasis", Acta Dermatovenerol Alp Pannonica Adriat, 26, pp.97~100 (2017)
  13. Gerkowicz A, "Biochemical markers of psoriasis as a metabolic disease", Folia Histochem Cytobiol, 50, pp.155~170 (2012)
  14. Strober BE, "Changes in C-reactive protein in patients with moderate-to-severe psoriasis switched to adalimumab therapy after suboptimal response to etanercept, methotrexate or phototherapy", J Eur Acad Dermatol Venereol, 28, pp.1701~1706 (2014)
  15. Strober B, "Effects of etanercept on C-reactive protein levels in psoriasis and psoriatic arthritis", Br J Dermatol, 159, pp.322~330 (2008)
  16. Zhang L, "Neutrophil-to-lymphocyte ratio decreases after treatment of psoriasis with therapeutic antibodies", J Eur Acad Dermatol Venereol, 31, pp.e491~e492 (2017)
  17. Asahina A, "Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis : response to therapy with biologics", J Dermatol, 44, pp.1112~1121 (2017)
  18. Nast A, "European S3-Guidelines on the systemic treatment of psoriasis vulgaris-update 2015-short version-EDF in cooperation with EADV and IPC", J Eur Acad Dermatol Venereol, 29, pp.2277~2294 (2015)
  19. Alexandroff AB, "More than skin deep : atherosclerosis as a systemic manifestation of psoriasis", Br J Dermatol, 161, pp.1~7 (2009)
  20. Ahlehoff O, "Cardiovascular disease event rates in patients with severe psoriasis treated with systemic antiinflammatory drugs : a Danish real-world cohort study", J Intern Med, 273, pp.197~204 (2013)
  21. Adışen E, "Prevalence of smoking, alcohol consumption and metabolic syndrome in patients with psoriasis", An Bras Dermatol, 93, pp.205~211 (2018)
  22. Fortes C, "Relationship between smoking and the clinical severity of psoriasis", Arch Dermatol, 141, pp.1580~1584 (2005)
  23. Kinahan CE, "Impact of smoking on response to systemic treatment in patients with psoriasis : a retrospective case-control study", Br J Dermatol, 172, pp.428~436 (2015)
  24. Daulatabad D, "Clinical and serological characteristics of nail psoriasis in Indian patients : a cross-sectional study", Indian J Dermatol Venereol Leprol, 83, pp.650~655 (2017)
  25. Abuabara K, "The effect of systemic psoriasis therapies on the incidence of myocardial infarction : a cohort study", Br J Dermatol, 165, pp.1066~1073 (2011)
  26. Boehncke S, "Effective continuous systemic therapy of severe plaque-type psoriasis is accompanied by amelioration of biomarkers of cardiovascular risk : results of a prospective longitudinal observational study", J Eur Acad Dermatol Venereol, 25, pp.1187~1193 (2011)
  27. Coimbra S, "Psoriasis therapy and cardiovascular risk factors : a 12-week follow-up study", Am J Clin Dermatol, 11, pp.423~432 (2010)
  28. Montaudié H, "Impact of systemic treatment of psoriasis on inflammatory parameters and markers of comorbidities and cardiovascular risk : results of a prospective longitudinal observational study", J Eur Acad Dermatol Venereol, 28, pp.1186~1191 (2014)

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