Frontiers in medicine · 2026
Association of IL-17 inhibitor therapy with glycemic, lipid profiles, and systemic inflammation in psoriasis patients with metabolic comorbidities: a retrospective cohort study.
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Zhang Xianzhe, Zhang Man, Nie Zhenhua, Xu Yan, Xu Haiyan, Li YunYun, Li Jun, Zhu Mengyuan, Li Junying
Аннотация
BACKGROUND: Moderate-to-severe plaque psoriasis frequently coexists with metabolic comorbidities, yet the impact of interleukin-17 (IL-17) inhibitors on metabolic parameters remains inadequately characterized. This study evaluated the effects of IL-17 inhibitor therapy on glycemic control, lipid profiles, uric acid, and novel systemic inflammatory indices in psoriasis patients with metabolic comorbidities.
OBJECTIVE: This 48-week single-center retrospective study included 30 patients with moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] ≥10 with ≥1 metabolic comorbidity) receiving IL-17 inhibitors (June 2023-December 2024). Fasting glucose, lipid profiles, uric acid, serum β2-microglobulin, urinary albumin-to-creatinine ratio (UACR), homocysteine, systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII) were assessed at baseline and weeks 12, 24, 36, and 48. The primary outcome was fasting glucose reduction ≥10% at week 48.
RESULTS: After 48 weeks of treatment, PASI score decreased from 18.6 ± 5.4 to 2.8 ± 1.2 (P < 0.001). Fasting glucose decreased from 6.2 ± 1.4 to 5.3 ± 0.9 mmol/L (P < 0.001), triglycerides from 2.1 ± 0.8 to 1.6 ± 0.5 mmol/L (P = 0.002), uric acid from 435 ± 52 to 378 ± 41 μmol/L (P < 0.001), and homocysteine from 14.2 ± 3.5 to 10.8 ± 2.6 μmol/L (P < 0.001). SIRI decreased from 1.85 ± 0.62 to 0.92 ± 0.31 (P < 0.001), and SII from 680 ± 145 to 420 ± 98 (P < 0.001). Multivariate analysis suggested that SIRI reduction may be an independent predictor of glycemic improvement [odds ratio (OR) = 2.68, 95% confidence interval (CI): 1.21-5.93, P = 0.015] in this cohort.
CONCLUSION: This study suggests that IL-17 inhibitor therapy is associated with improvements in glycemic control, triglycerides, uric acid, homocysteine, and systemic inflammation in psoriasis patients with metabolic comorbidities. Preliminary evidence indicates that SIRI may serve as a practical clinical indicator for assessing metabolic improvement, although prospective validation is required. However, given the observational design, small sample size, lack of a control group, and absence of systematic data on lifestyle factors and direct measures of insulin resistance, these findings should be interpreted as hypothesis-generating and do not establish causality. Confirmation in larger prospective controlled studies is needed before any clinical recommendations can be made.
OBJECTIVE: This 48-week single-center retrospective study included 30 patients with moderate-to-severe plaque psoriasis (Psoriasis Area and Severity Index [PASI] ≥10 with ≥1 metabolic comorbidity) receiving IL-17 inhibitors (June 2023-December 2024). Fasting glucose, lipid profiles, uric acid, serum β2-microglobulin, urinary albumin-to-creatinine ratio (UACR), homocysteine, systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII) were assessed at baseline and weeks 12, 24, 36, and 48. The primary outcome was fasting glucose reduction ≥10% at week 48.
RESULTS: After 48 weeks of treatment, PASI score decreased from 18.6 ± 5.4 to 2.8 ± 1.2 (P < 0.001). Fasting glucose decreased from 6.2 ± 1.4 to 5.3 ± 0.9 mmol/L (P < 0.001), triglycerides from 2.1 ± 0.8 to 1.6 ± 0.5 mmol/L (P = 0.002), uric acid from 435 ± 52 to 378 ± 41 μmol/L (P < 0.001), and homocysteine from 14.2 ± 3.5 to 10.8 ± 2.6 μmol/L (P < 0.001). SIRI decreased from 1.85 ± 0.62 to 0.92 ± 0.31 (P < 0.001), and SII from 680 ± 145 to 420 ± 98 (P < 0.001). Multivariate analysis suggested that SIRI reduction may be an independent predictor of glycemic improvement [odds ratio (OR) = 2.68, 95% confidence interval (CI): 1.21-5.93, P = 0.015] in this cohort.
CONCLUSION: This study suggests that IL-17 inhibitor therapy is associated with improvements in glycemic control, triglycerides, uric acid, homocysteine, and systemic inflammation in psoriasis patients with metabolic comorbidities. Preliminary evidence indicates that SIRI may serve as a practical clinical indicator for assessing metabolic improvement, although prospective validation is required. However, given the observational design, small sample size, lack of a control group, and absence of systematic data on lifestyle factors and direct measures of insulin resistance, these findings should be interpreted as hypothesis-generating and do not establish causality. Confirmation in larger prospective controlled studies is needed before any clinical recommendations can be made.