High density cholesterol level as predictor of clinical response to anti-TNF-alpha therapy in psoriatic patients

Abstract

Psoriasis is a common, chronic, inflammatory, and debilitating disease of the skin. Infliximab is a human/mouse chimeric anti-TNF-alpha antibody effective in the management of psoriasis. Availability of biomarkers for prediction of response, could optimize the therapeutic approach. The aim of this study was to identify predictors of clinical response to infliximab in psoriatic patients in the long-term treatment. Patients affected with psoriasis and suitable for treatment with infliximab were prospectively enrolled. Patients treated for a period longer than 96 weeks were included in the study and divided into high responders and low responders according to infliximab efficacy (PASI 90). A logistic regression analysis was used to explore independent association between high clinical response and possible biomarkers of prediction. A total of 112 patients were included for the analysis. Multiple regression analysis showed that high levels of HDL cholesterol and the short duration of psoriasis [OR 1.11 (CI 1.05-1.18) and OR 0.94 (CI 0.89-0.99)] predicted the most effective clinical response to infliximab. Our findings, which highlight a possible role for HDL cholesterol as clinical predictor for psoriasis treatment, are particularly noteworthy in the context of clinical strategies, but also suggest a possible role for lipid metabolism in aspects of psoriasis that deserves further investigation.