Dermal biomarkers can predict patient response to psoriasis biologics prior to drug exposure, according to a study published in the November issue of SKIN.

Jerry Bagel, M.D., from the Psoriasis Treatment Center of Central New Jersey in East Windsor, and colleagues enrolled patients into one of two observational studies in which dermal biomarker patches (DBPs) were applied prior to drug exposure, followed by clinical evaluations at 12 weeks after exposure. To assess clinical response, Psoriasis Area and Severity Index (PASI) measurements were performed at baseline and 12 weeks. Responders were classified as those who achieved a 75 percent or greater reduction in PASI scores (PASI75). The transcriptomes obtained from the DBPs were sequenced and analyzed to derive and/or validate classifiers for each biologic class. The studies included 242 psoriasis patients: 49.6, 33.2, and 14.7 percent treated with interleukin-23i (IL-23i), IL-17i, and tumor necrosis factor alpha inhibitor (TNFαi), respectively.

The researchers found that the predictive classifier for IL-23i was developed from the patients enrolled earlier and was validated independently from the latter enrolled patients. IL-17i and TNFαi predictive classifiers were developed from publicly available datasets and were validated independently using these data. Positive predictive values for IL-23i, IL-17i, and TNFαi were 93.1, 92.3, and 85.7 percent, respectively, in the independent validation. Overall, 99.5 percent of patients in the whole cohort were predicted to respond to one or more drug classes.

"This test could lead to improved patient outcomes while also translating into tremendous cost savings for health care systems," the authors write.

Several authors are employees of Mindera Health.

Abstract/Full Text