Real-World Effectiveness of Biologic Therapy in Patients with Psoriasis: Metabolic Comorbidities and Treatment Outcomes
Adelina F. Ghilencea, Daniel O. Costache, Constantin Căruntu, Cristian Scheau, Ilinca Savulescu-Fiedler, Ioana Dicu-Andreescu, Damian Cojocaru, Raluca S. CostacheAbstract
Introduction
Psoriasis is a chronic systemic inflammatory disease, frequently associated with metabolic comorbidities that may influence therapeutic outcomes. Real-world evidence on the effectiveness of biologic therapy in this complex clinical context remains limited.
Objectives
To assess the prevalence of comorbidities in patients with psoriasis receiving biologic therapy and to identify factors associated with treatment response.
Methods
A retrospective observational study including 121 patients with chronic plaque psoriasis. Demographic data, comorbidities, biologic treatment class, and PASI/DLQI evolution at baseline and at standardized 6 and 12 months assessments was analyzed, together with the latest available clinical assessment recorded in 2025 after variable treatment durations.
Results
Comorbidities were present in 84.3% of patients, most frequently hepatic steatosis (73.6%), obesity (45.5%), hypertension (41.3%), and diabetes (19%). A significant improvement in PASI and DLQI scores was observed at all follow-up points (p < 0.001). Complete skin clearance (PASI 100) was achieved by 18.1% of the patients at 6 months and by 44.6% at 12 months. In multivariable logistic regression analysis, lower PASI scores at six months were independently associated with a higher likelihood of achieving PASI 100 at one year.
Conclusions
Biologic therapy was associated with marked clinical and quality-of-life improvement. Although metabolic comorbidities were highly prevalent, no significant association between metabolic comorbidities and PASI 100 response at one year was identified in the analyses performed.