The role of inflammatory markers in assessing disease severity and response to treatment in patients with psoriasis treated with etanercept.

Abstract

BACKGROUND:

Psoriasis is a chronic, systemic, inflammatory disease. Inflammatory markers are used in clinical practice to detect acute inflammation, and as markers of treatment response. Etanercept blocks tumour necrosis factor (TNF)-α, which plays a central role in the psoriatic inflammation process.

AIM:

To reveal any possible association between disease severity [measured by Psoriasis Area and Severity Index (PASI)] and the inflammatory burden (measured by a group of inflammatory markers), before and after etanercept treatment.

METHODS:

In total, 41 patients with psoriasis vulgaris, eligible for biological treatment with etanercept, were enrolled in the study. A set of inflammatory markers was measured, including levels of white blood cells and neutrophils, fibrinogen, ferritin, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), haptoglobin, ceruloplasmin and α1-antitrypsin, before and after 12 weeks of etanercept 50 mg twice weekly.

RESULTS:

All markers were reduced after treatment (P < 0.001). PASI correlated with fibrinogen and hs-CRP. Of the 41 patients, 19 (46.3%) achieved reduction of 75% in PASI (PASI75). An increase in hs-CRP and ESR difference (values before minus values after treatment) was related to higher likelihood of achieving PASI75.

CONCLUSIONS:

Inflammatory markers, particularly hs-CRP and to a lesser extent, fibrinogen and ESR, can be used to assist in assessing disease severity and response to treatment in patients with psoriasis. A combination of selected inflammatory factors (which we term the Index of Psoriasis Inflammation) in combination with PASI might reflect inflammatory status in psoriasis more accurately than each one separately.

• Authors: A Kanelleas, C Liapi, A Katoulis, P Stavropoulos, G Avgerinou, S Georgala, T Economopoulos, N G Stavrianeas, A Katsambas
• Journal: Clinical and experimental dermatology (Clin Exp Dermatol) Vol. 36 Issue 8 Pg. 845-50 (Dec 2011) ISSN: 1365-2230 [Electronic] England
• PMID: 21790728 (Publication Type: Journal Article)
• Copyright: © The Author(s). CED © 2011 British Association of Dermatologists.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Biomarkers
• Immunoglobulin G
• Immunosuppressive Agents
• Receptors, Tumor Necrosis Factor
• Etanercept

Topics

• Adult
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Biomarkers (blood)
• Etanercept
• Female
• Humans
• Immunoglobulin G (therapeutic use)
• Immunosuppressive Agents (therapeutic use)
• Inflammation (blood)
• Male
• Middle Aged
• Psoriasis (blood, diagnosis, drug therapy)
• Receptors, Tumor Necrosis Factor (therapeutic use)
• Severity of Illness Index
• Young Adult