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The role of inflammatory markers in assessing disease severity and response to treatment in patients with psoriasis treated with etanercept
Author(s) -
Kanelleas A.,
Liapi C.,
Katoulis A.,
Stavropoulos P.,
Avgerinou G.,
Georgala S.,
Economopoulos T.,
Stavrianeas N. G.,
Katsambas A.
Publication year - 2011
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.2011.04131.x
Subject(s) - etanercept , psoriasis , medicine , psoriasis area and severity index , fibrinogen , erythrocyte sedimentation rate , c reactive protein , gastroenterology , inflammation , immunology , psoriatic arthritis , haptoglobin , tumor necrosis factor alpha
Summary 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.