Ann Dermatol.  2019 Dec;31(6):601-610. 10.5021/ad.2019.31.6.601.

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

• AktaÅŸ Karabay E
• Aksu Çerman A
• Demir D
• Kıvanç Altunay I

• KMID: 2461982
• DOI: http://doi.org/10.5021/ad.2019.31.6.601

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.

Keyword

Cardiovascular diseases; Inflammation; Psoriasis; Treatment

MeSH Terms

Acitretin
Adalimumab
Biomarkers
C-Reactive Protein*
Cardiovascular Diseases
Comorbidity
Cyclosporine
Etanercept
Humans
Inflammation
Methotrexate
Prospective Studies
Psoriasis*
Ustekinumab
Acitretin
Adalimumab
Biomarkers
C-Reactive Protein
Cyclosporine
Etanercept
Methotrexate
Ustekinumab

Figure

• 

  Fig. 1 Correlations between PASI scores and the values of CRP and NLR at baseline. PASI: Psoriasis Area and Severity Index, CRP: C-reactive protein, NLR: neutrophil-lymphocyte ratio.

• 

  Fig. 2 Values of PASI, CRP, and NLR at baseline and week 12. PASI: Psoriasis Area and Severity Index, CRP: C-reactive protein, NLR: neutrophil-lymphocyte ratio.

• 

  Fig. 3 Changes in PASI scores in therapy subgroups. PASI: Psoriasis Area and Severity Index, ADA: adalimumab, NB-UVB: narrow-band ultraviolet B, ETA: etanercept, MTX: methotrexate, UST: ustekinumab.

• 

  Fig. 4 Changes in NLR values in therapy subgroups. NLR: neutrophil-lymphocyte ratio, ADA: adalimumab, NB-UVB: narrowband ultraviolet B, ETA: etanercept, MTX: methotrexate, UST: ustekinumab.

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