The Influence of Long Term Therapy with Adalimumab on Biomarkers of Systemic Inflammation in Psoriasis
Abstract
Patients with psoriasis are at increased risk of atherosclerosis, which is characterized by endothelial dysfunction associated with systemic inflammation. It appears that anti-tumor necrosis alpha treatment may reduce this risk.
The purpose of this study was to measure serum marker levels associated with systemic inflammation in patients with psoriasis compared to healthy subjects and to further evaluate the change in their levels after 3 months and 2 years of treatment with adalimumab. We investigated four biomarkers: highly sensitive C-reactive protein (hsCRP), oxidized low density lipoproteins (OxLDL), E-selectin and Interleukin 22 (IL-22).
These markers were determined in healthy volunteers and in 28 patients with moderate to severe psoriasis before and after 3 and 24 months of adalimumab treatment. Patients with psoriasis had elevated markers levels compared to controls.
After 3 months of treatment, E-selectin decreased significantly (p < 0.001), same as IL-22 (p < 0.001). HsCRP also decreased, but statistically insignificantly, OxLDLs were slightly higher than originally.
After 24 months, 17 patients were still treated with adalimumab. In these patients, HsCRP (p < 0.05), E-selectin (p < 0.001) and IL-22 (p < 0.001) were significantly reduced.
The OxLDL value remained elevated. A steady decrease in E-selectin, hsCRP and IL-22 after 24 months confirms that adalimumab suppresses systemic inflammation.