While patients with psoriasis a chronic skin condition respond well to treatment with biologics, inflammation can linger, leading to broader health implications such as obesity and cardiovascular and fatty liver disease, according to a study.
Psoriasis, with its systemic inflammatory nature, high risk of cardiovascular disease, and frequent use of biologic drugs, could provide a valuable framework for studying residual inflammation.The study, published in the Journal of Investigative Dermatology, could lead to more targeted and effective treatments that address the systemic aspects of psoriasis, beyond just the skin.
"Despite excellent control of skin disease, a substantial percentage of psoriasis patients demonstrate residual systemic inflammation," said Joel M. Gelfand, Department of Dermatology, at the University of Pennsylvania's Perelman School of Medicine, US.
"These findings emphasise that just treating the skin signs of psoriatic disease is not sufficient, and patients often need additional approaches to lowering systemic inflammation," Gelfand added.For the observational study, the team assessed residual inflammation in 209 psoriasis patients across three international cohorts (Spain, the US, and Sweden) who had achieved a no or mild psoriasis on stable biologic therapy.
They found that residual inflammation was present in 36.3 per cent of these patients and was significantly linked to higher body mass index (BMI), metabolic dysfunction-associated steatotic liver disease (MASLD), increased baseline systemic inflammation, and greater adipose tissue.
"The findings underscore a critical unmet need to address the systemic inflammatory burden beyond skin symptoms in psoriasis, potentially requiring interventions targeting obesity and metabolic dysfunction to improve overall patient outcomes," said lead investigator Álvaro González-Cantero, from the Department of Dermatology at Hospital Universitario Ramón y Cajal in Spain.
The researchers suggest a more intensive cardiovascular risk assessment and management of psoriasis patients. This could involve closer monitoring of inflammatory markers like high-sensitivity C-reactive protein, as well as parameters related to liver health, by integrating lifestyle modifications or weight management strategies, potentially leading to earlier detection and intervention for associated comorbidities, the team said, while also calling for further studies to confirm the findings.