The effect of IL-17 and IL-23 ınhibitors on hematological ınflammatory parameters in patients with psoriasis vulgaris.

Background and objective: IL-17 and IL-23 inhibitors are widely used as biological agents in patients with psoriasis vulgaris to suppress inflammation and reduce disease severity. This study aimed to examine changes in inflammatory parameters, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic inflammation index (SII), platelet/hemoglobin ratio (PHR), and red cell distribution width/platelet ratio (RPR), as well as the Psoriasis Area and Severity Index (PASI), in psoriasis patients receiving biological therapy (IL-17 and IL-23 inhibitors).

Materials and methods: This retrospective study included 110 patients with psoriasis vulgaris treated with IL-23 (risankizumab, guselkumab or IL-17 inhibitors ( secukinumab, and ixekizumab). Disease severity was assessed using the PASI score. Hematological parameters (NLR, PLR, SII, PHR, and RPR) and PASI values of the patients were recorded and analyzed at baseline (month 0) and during treatment (month 6).

Results: A significant decrease was observed in NLR, SII, and PHR values during treatment. NLR decreased significantly from 2.43 ± 1.25 at baseline to 2.12 ± 0.81 at month 6 (p = 0.002). Both IL-17 and IL-23 groups significantly reduced NLR (p = 0.044, p = 0.029, respectively). SII decreased significantly from 695 ± 390 at baseline to 588 ± 288 at month 6 (p = 0.002). Both groups significantly reduced SII levels (p = 0.044, p = 0.018, respectively).PHR decreased significantly from 19.8 ± 6.60 at baseline to 19.2 ± 6.58 at month 6 (p = 0.033).PASI score significantly decreased during treatment (p < 0.001).

Conclusion: The significant reduction in NLR and SII levels in both the IL-17 and IL-23 groups suggests that these markers may be used together rather than separately in treatment follow-up. The significant decrease in PHR levels may indicate that IL-17 and IL-23 inhibitors contribute to reducing cardiovascular disease risk in patients with psoriasis vulgaris and promote a favorable long-term prognosis.