Anais Brasileiros de Dermatologia (Jan 2024)

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

  • Natália Ribeiro de Magalhães Alves,
  • Patrícia Shu Kurizky,
  • Licia Maria Henrique da Mota,
  • Cleandro Pires de Albuquerque,
  • Juliana Tomaz Esper,
  • Aridne Souza Costa Campos,
  • Vitoria Pereira Reis,
  • Henrique Metzker Ferro,
  • Natalia Gil-Jaramillo,
  • Joaquim Pedro Brito-de-Sousa,
  • Luana Cabral Leão Leal,
  • Otávio de Toledo Nóbrega,
  • Carla Nunes de Araújo,
  • Agenor de Castro Moreira dos Santos Júnior,
  • Gladys Aires Martins,
  • Olindo Assis Martins Filho,
  • Ciro Martins Gomes

DOI
https://doi.org/10.1016/j.abd.2023.03.002
Journal volume & issue
Vol. 99, no. 1
pp. 34 – 42

Abstract

Read online Read online

Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. 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: 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 inter-leukin (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: 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: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. 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.

Keywords