Elevated serum IL-6 levels predict treatment interruption in patients with moderate to severe psoriasis: a 6-year real-world cohort study.

Allergy and immunology Autoimmune disease Biomarkers Immunosuppression therapy Psoriasis

Journal

Anais brasileiros de dermatologia
ISSN: 1806-4841
Titre abrégé: An Bras Dermatol
Pays: Spain
ID NLM: 0067662

Informations de publication

Date de publication:
25 Aug 2023
Historique:
received: 17 11 2022
revised: 09 02 2023
accepted: 11 03 2023
medline: 28 8 2023
pubmed: 28 8 2023
entrez: 27 8 2023
Statut: aheadofprint

Résumé

Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01‒1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29‒3.08; p = 0.002) were associated with treatment interruption. The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

Sections du résumé

BACKGROUND BACKGROUND
Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors.
OBJECTIVE OBJECTIVE
The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis.
METHODS METHODS
The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and interleukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model.
RESULTS RESULTS
The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01‒1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29‒3.08; p = 0.002) were associated with treatment interruption.
STUDY LIMITATIONS CONCLUSIONS
The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation.
CONCLUSIONS CONCLUSIONS
Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

Identifiants

pubmed: 37634972
pii: S0365-0596(23)00188-5
doi: 10.1016/j.abd.2023.03.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.

Auteurs

Natália Ribeiro de Magalhães Alves (NRM)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil.

Patrícia Shu Kurizky (PS)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Serviço de Dermatologia, Hospital Universitário de Brasília, Brasília, DF, Brazil.

Licia Maria Henrique da Mota (LMH)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Serviço de Reumatologia, Hospital Universitário de Brasília, Brasília, DF, Brazil; Programa de Pós-Graduação em Patologia Molecular, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil.

Cleandro Pires de Albuquerque (CP)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Serviço de Reumatologia, Hospital Universitário de Brasília, Brasília, DF, Brazil.

Juliana Tomaz Esper (JT)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Serviço de Dermatologia, Hospital Universitário de Brasília, Brasília, DF, Brazil.

Aridne Souza Costa Campos (ASC)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Serviço de Dermatologia, Hospital Universitário de Brasília, Brasília, DF, Brazil.

Vitoria Pereira Reis (VP)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil.

Henrique Metzker Ferro (HM)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil.

Natalia Gil-Jaramillo (N)

Laboratório de Interação Patógeno-Hospedeiro, Instituto de Ciências Biológicas, Universidade de Brasília, Brasília, DF, Brazil.

Joaquim Pedro Brito-de-Sousa (JP)

Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.

Luana Cabral Leão Leal (LCL)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil.

Otávio de Toledo Nóbrega (OT)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil.

Carla Nunes de Araújo (CN)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Laboratório de Interação Patógeno-Hospedeiro, Instituto de Ciências Biológicas, Universidade de Brasília, Brasília, DF, Brazil.

Agenor de Castro Moreira Dos Santos Júnior (ACMD)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Laboratório Central de Saúde Pública do Distrito Federal, Secretaria de Saúde do Distrito Federal, Brasília, DF, Brazil.

Gladys Aires Martins (GA)

Serviço de Dermatologia, Hospital Universitário de Brasília, Brasília, DF, Brazil.

Olindo Assis Martins Filho (OA)

Instituto René Rachou, Fundação Oswaldo Cruz, Fiocruz Minas, Belo Horizonte, MG, Brazil.

Ciro Martins Gomes (CM)

Programa de Pós-Graduação de Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Programa de Pós-Graduação em Patologia Molecular, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil; Laboratório Central de Saúde Pública do Distrito Federal, Secretaria de Saúde do Distrito Federal, Brasília, DF, Brazil. Electronic address: cirogomes@unb.br.

Classifications MeSH