Clinical rheumatology · 2026
Evaluation of serum TWEAK levels and treatment response in psoriasis and psoriatic arthritis: a prospective comparative case-control study of adalimumab and methotrexate.
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Hegazy Eisa M, Sadek Eslam Abdelfattah, Ahmed Shimaa Saber
Аннотация
INTRODUCTION: Psoriasis vulgaris and psoriatic arthritis (PsA) are chronic immune-mediated diseases with systemic impact. Tumor necrosis factor (TNF)-related weak inducer of apoptosis (TWEAK) is a pro-inflammatory cytokine implicated in immune regulation and tissue remodeling, but its role in psoriatic disease remains incompletely understood.
METHODS: This prospective case-control study included 100 subjects: 30 psoriasis patients receiving adalimumab, 30 PsA patients receiving methotrexate, and 40 healthy controls. Serum TWEAK was measured by ELISA at baseline and after 24 weeks. PASI and DAPSA scores were evaluated at both visits.
RESULTS: Baseline TWEAK was higher in psoriasis (3.85 ± 0.62 ng/mL) and PsA patients (4.12 ± 0.71 ng/mL) than in controls (1.95 ± 0.54 ng/mL, p < 0.001). After 24 weeks, TWEAK decreased in both the adalimumab (2.21 ± 0.49 ng/mL) and methotrexate groups (2.67 ± 0.53 ng/mL, p < 0.001). Clinical improvement assessed by PASI and DAPSA paralleled this biochemical reduction, suggesting that TWEAK may serve as a biomarker of treatment response. TWEAK showed a stronger correlation with PASI after 24 weeks of treatment than with DAPSA.
CONCLUSION: Elevated TWEAK reflects psoriasis and PsA activity. Adalimumab and methotrexate reduce TWEAK alongside clinical improvement, supporting its potential as a biomarker for treatment monitoring. Key Points • Serum TWEAK levels were substantially elevated in psoriasis and psoriatic arthritis patients in comparison to controls. • TWEAK levels decreased following treatment with methotrexate and adalimumab. • Clinical improvement and disease activity scores were positively correlated with a decrease in TWEAK levels. • TWEAK may be a valuable biomarker for the monitoring of treatment response in psoriasis.
METHODS: This prospective case-control study included 100 subjects: 30 psoriasis patients receiving adalimumab, 30 PsA patients receiving methotrexate, and 40 healthy controls. Serum TWEAK was measured by ELISA at baseline and after 24 weeks. PASI and DAPSA scores were evaluated at both visits.
RESULTS: Baseline TWEAK was higher in psoriasis (3.85 ± 0.62 ng/mL) and PsA patients (4.12 ± 0.71 ng/mL) than in controls (1.95 ± 0.54 ng/mL, p < 0.001). After 24 weeks, TWEAK decreased in both the adalimumab (2.21 ± 0.49 ng/mL) and methotrexate groups (2.67 ± 0.53 ng/mL, p < 0.001). Clinical improvement assessed by PASI and DAPSA paralleled this biochemical reduction, suggesting that TWEAK may serve as a biomarker of treatment response. TWEAK showed a stronger correlation with PASI after 24 weeks of treatment than with DAPSA.
CONCLUSION: Elevated TWEAK reflects psoriasis and PsA activity. Adalimumab and methotrexate reduce TWEAK alongside clinical improvement, supporting its potential as a biomarker for treatment monitoring. Key Points • Serum TWEAK levels were substantially elevated in psoriasis and psoriatic arthritis patients in comparison to controls. • TWEAK levels decreased following treatment with methotrexate and adalimumab. • Clinical improvement and disease activity scores were positively correlated with a decrease in TWEAK levels. • TWEAK may be a valuable biomarker for the monitoring of treatment response in psoriasis.