A novel online calculator based on clinical features and hematological parameters to predict total skin clearance in patients with moderate to severe psoriasis
-
Published:2024-01-31
Issue:1
Volume:22
Page:
-
ISSN:1479-5876
-
Container-title:Journal of Translational Medicine
-
language:en
-
Short-container-title:J Transl Med
Author:
Jiang Yuxiong,Huang Dawei,Chen Qianyu,Yu Yingyuan,Hu Yifan,Wang Yu,Chen Rongfen,Yao Lingling,Zhong Xiaoyuan,Kong Luyang,Yu Qian,Lu Jiajing,Li Ying,Shi Yuling
Abstract
Abstract
Background
Treatment responses to biologic agents vary between patients with moderate to severe psoriasis; while some patients achieve total skin clearance (TSC), a proportion of patients may only experience partial improvement.
Objective
This study was designed to identify potential predictors for achieving TSC in psoriasis patients treated with IL-17 inhibitors. It also aimed to develop an easy-to-use calculator incorporating these factors by the nomogram to predict TSC response.
Methods
A total of 381 patients with psoriasis receiving ixekizumab were included in the development cohort and 229 psoriasis patients who initiated secukinumab treatment were included in the validation cohort. The study endpoint was achieving TSC after 12 weeks of IL-17 inhibitors treatment, defined as the 100% improvement in Psoriasis Area and Severity Index (PASI 100). Multivariate Cox regression analyses and LASSO analysis were performed to identify clinical predictors and blood predictors respectively.
Results
The following parameters were identified as predictive factors associated with TSC: previous biologic treatment, joint involvement, genital area affected, early response (PASI 60 at week 4), neutrophil counts and uric acid levels. The nomogram model incorporating these factors achieved good discrimination in the development cohort (AUC, 0.721; 95% CI 0.670–0.773) and validation cohort (AUC, 0.715; 95% CI 0.665–0.760). The calibration curves exhibited a satisfactory fit, indicating the accuracy of the model. Furthermore, the decision curve analysis confirmed the clinical utility of the nomogram, highlighting its favorable value for practical application. Web-based online calculator has been developed to enhance the efficiency of clinical applications.
Conclusions
This study developed a practical and clinically applicable nomogram model for the prediction of TSC in patients with moderate to severe psoriasis. The nomogram model demonstrated robust predictive performance and exhibited significant clinical utility.
Trial registration A multi-center clinical study of systemic treatment strategies for psoriasis in Chinese population;ChiCTR2000036186; Registered 31 August 2020; https://www.chictr.org.cn/showproj.html?proj=58256.
Funder
National Natural Science Foundation of China
Innovation Program of Shanghai Municipal Education Commission
Clinical Research Plan of SHDC
Program of Shanghai Academic Research Leader
the Fundamental Research Funds for the Central Universities
Publisher
Springer Science and Business Media LLC
Subject
General Biochemistry, Genetics and Molecular Biology,General Medicine
Reference34 articles.
1. Armstrong AW, Read C. Pathophysiology, clinical presentation, and treatment of psoriasis a review. JAMA J Am Med Assoc. 2020;323:1945–60.
2. Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet. 2021;397:1301–15.
3. Yu J, Zhao Q, Wang X, Zhou H, Hu J, Gu L, Hu Y, Zeng F, Zhao F, Yue C, et al. Pathogenesis, multi-omics research, and clinical treatment of psoriasis. J Autoimmun. 2022;133: 102916.
4. Jiang Y, Chen Y, Yu Q, Shi Y. Biologic and small-molecule therapies for moderate-to-severe psoriasis: focus on psoriasis comorbidities. BioDrugs. 2023;37:35–55.
5. Puig L. PASI90 response: the new standard in therapeutic efficacy for psoriasis. J Eur Acad Dermatol Venereol. 2015;29:645–8.