Biologics May Clear Psoriasis, But Not the Inflammation Behind It, Research Warns

While biological therapies have proven effective in managing the visible symptoms of psoriasis, according to the authors, the study raises concerns that such treatments may not fully address the systemic nature of the disease. Psoriasis is increasingly recognized not just as a skin condition but as a chronic inflammatory disorder linked to a higher risk of cardiovascular disease, liver dysfunction, and other metabolic issues. The findings emphasize the need for a broader treatment approach that targets skin lesions and the underlying inflammation driving these associated comorbidities.

The researchers acknowledged several limitations in their study. The relatively short follow-up period may not have captured the long-term effects of biologic therapy on systemic inflammation. Moreover, the absence of a control group limits the ability to assess how biological therapy influences CRP levels over time. The presence of MASLD was inferred using surrogate markers rather than imaging, and the long-term clinical consequences of systemic inflammation in psoriasis were not directly evaluated.

The researchers note that despite these limitations, the study provides valuable insights into the persistent inflammatory burden in psoriasis patients. The researchers call for more comprehensive treatment strategies that address visible and hidden inflammation, especially given the elevated cardiovascular risk in this patient population.

Future research is needed to better understand the mechanisms behind residual inflammation and to explore interventions that may mitigate its broader health impacts.

"These findings emphasize the importance of monitoring systemic health in psoriasis patients—even those who appear to be responding well to treatment—and could shape future guidelines in managing the condition holistically," the researchers concluded.

Reference:

Lecumberri, A., et al. (2025). Residual Inflammation in Patients with Psoriasis Treated with Biologic Therapy: Findings from 3 Prospective Observational Cohorts. Journal of Investigative Dermatology. doi.org/10.1016/j.jid.2025.03.014.