Evaluation of the serum creatinine to total bilirubin ratio in psoriasis patients treated with biological agents: Significant reduction following IL-17 inhibitor therapy.

Introduction: High serum creatinine to total bilirubin ratio has been associated with an increased risk of developing hypertension. We evaluated the effect of biological agents on serum creatinine to total bilirubin ratio in patients with psoriasis.

Methods: Serum creatinine and total bilirubin levels of patients were reviewed between June 2018 and October 2023.

Results: This study included 302 patients, 143 (47.4%) females and 159 (52.6%) males with a mean age of 49.46 ± 13.82 years. The creatinine to total bilirubin ratio was higher in males than in females (p = 0.028), and in patients with comorbidities compared to those without (p = 0.031). Six months after biological agent treatment, serum total bilirubin levels increased (p = 0.010), while the creatinine to total bilirubin ratio significantly decreased (p = 0.038) in all patients. Serum creatinine to total bilirubin ratio decreased (p = 0.031) in patients who received IL-17 inhibitors after 6 months. Among them, patients treated with ixekizumab showed a statistically significantly decrease in creatinine to total bilirubin ratio (p = 0.015).

Conclusion: The decrease in creatinine to total bilirubin ratio after 6 months of treatment was statistically significant only in patients treated with IL-17 inhibitors, particularly ixekizumab. Therefore, we suggest that IL-17 inhibitors may have a protective role against hypertension in patients with psoriasis.