Journal Article Epublish
PubMed: 42930039 DOI: 10.3390/antib15050097
Long-Term Changes in Complete Blood Count-Derived Inflammatory Indices During Risankizumab Treatment for Psoriasis: A 208-Week Multicenter Real-World Study.
Antibodies (Basel) 15(5)
Authors: Riccardo Balestri, Chiara Pallanch, Michela Magnano, Jacopo Colombini, Giacomo Clarizio, Federico Bardazzi, Vito Di Lernia, Francesca Satolli, Giulia Ganzetti, Cinzia Buligan, Vanessa Mazzoletti, Lucrezia Pacetti, Giulia Odorici, Alessandro Borghi, Rosita Saraceno, Massimiliano Mengarino, Paolo Gisondi, Giampiero Girolomoni, Rossella Lacava, Giulia Rech, Francesco Bellinato
Affiliations
- Division of Dermatology, Psoriasis Outpatient Service, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT)-Trento Hospital, P.O. Villa Igea, Via Malta 16, 38121 Trento, Italy.
- Unit of Dermatology, Lucca Hospital, Azienda USL Toscana Nord Ovest, 55100 Lucca, Italy.
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, 40138 Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy.
- Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
- Unit of Dermatology, University of Parma, 43126 Parma, Italy.
- UOC Dermatologia, Ospedale Carlo Urbani, 60035 Jesi, Italy.
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy.
- Dermatologia, Dipartimento Ospedaliero Oncologico-Medico Specialistico, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy.
- Dermatology and Venereology Unit, Franz Tappeiner Hospital, 39012 Merano, Italy.
- Department of Medicine, Section of Dermatology, University of Verona, 37126 Verona, Italy.
Abstract
Background/Objectives: Blood count-derived inflammatory indices have been proposed as accessible biomarkers of systemic inflammation in psoriasis, but their longitudinal behavior during selective interleukin-23 blockade remains uncertain. We evaluated these indices in psoriasis patients treated with risankizumab. Methods: We conducted a multicenter retrospective real-world study (DERMIS), including adults with cutaneous psoriasis, with or without psoriatic arthritis, treated with risankizumab across 10 Italian centers, from national reimbursement up to 1 December 2025. Psoriasis Area and Severity Index (PASI) and complete blood count-derived indices-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI)-were assessed at baseline and at weeks 12, 24, 52, 104, 156, and 208. Analyses used available data and sensitivity cohorts with follow-up at weeks 52, 104, and 208. Results: Among 250 patients, 43 had data at week 208. PASI scores decreased significantly at all follow-up time points. In contrast, systemic indices showed heterogeneous, non-linear trajectories: NLR, SII, and SIRI fluctuated without consistent sustained reductions, whereas MLR remained broadly stable. PLR showed the most reproducible downward trend, with nominal reductions at weeks 24 and 52; after Bonferroni correction across the six repeated visits within PLR, the reduction at week 52 remained statistically significant, whereas the week-24 reduction did not. Body mass index (BMI)-related differences were inconsistent and did not remain significant after Bonferroni correction. Sex, cardiometabolic comorbidities, and previous biological exposure showed no consistent effect. Conclusions: These findings challenge the use of routine blood count-derived indices as reliable biomarkers of cutaneous response to risankizumab.
MeSH
Blood, Lymphocytes, Biomarkers, Antibodies, Monoclonal, Therapeutics, Psoriasis