Impact of IL-17A and IL-23p19 Inhibitors on Psychiatric Outcomes and Inflammation in Psoriasis.

BACKGROUND AND

OBJECTIVES

Psoriasis is a systemic inflammatory disease affecting skin and mental health. Biologic agents targeting IL-17A and IL-23p19 effectively treat skin symptoms, but their psychiatric and systemic anti-inflammatory effects remain unclear, especially in real-life settings. This study evaluated whether IL-17A and IL-23p19 inhibitors improve psychiatric symptoms, and whether these improvements are associated with reductions in inflammatory markers, independently of skin response.

PATIENTS AND

METHODS

In this multicenter prospective study, 235 psoriasis patients starting IL-17A and IL-23p19 inhibitors were assessed at baseline and six months. Assessments included CRP, NLR, HADS-A, HADS-D, and DLQI scores.

RESULTS

Treatment significantly improved skin, quality of life, and psychiatric scores (p < 0.001). CRP declined significantly and was independently correlated with reductions in HADS-A and HADS-D scores, even in patients without PASI90 response. IL-23p19 inhibitors produced greater reductions in CRP and NLR compared to IL-17A inhibitors, suggesting broader anti-inflammatory effects through upstream cytokine blockade.

CONCLUSIONS

IL-17A and IL-23p19 inhibitors improve both dermatological and psychiatric outcomes in psoriasis, potentially by reducing systemic inflammation. CRP may serve as a biomarker of psychiatric improvement, independent of skin response. Future studies with longer follow-up and non-biologic control groups are warranted. Integrating dermatological and psychiatric care may enhance outcomes in psoriasis patients.