Vitamin D, CRP and BMI May Help Predict Biologic Response in Psoriasis, suggests study

A new study published in the journal of Clinical and Experimental Dermatology showed that regular evaluation of 25-hydroxyvitamin D [25(OH)D], C-reactive protein (CRP), and body mass index (BMI) could assist in creating predictive models to determine which psoriasis patients are more or less likely to benefit from biologic treatments.

Psoriasis is a persistent, immune-driven condition impacting more than 60 million individuals worldwide. Although biologic therapies have enhanced the management of moderate to severe cases, the variability in treatment response and the substantial costs underscore the necessity for predictive biomarkers to facilitate personalized treatment approaches. Consequently, this study was undertaken to assess whether serum 25-hydroxyvitamin D (25(OH)D), body mass index (BMI), and CRP serve as predictors of response to biologic therapy in patients with moderate to severe psoriasis.

This cross-sectional research conducted at Belfast City Hospital, in partnership with Ulster University, included 120 adults undergoing biologic treatment, categorized according to their Psoriasis Area and Severity Index (PASI) response. Serum 25(OH)D, BMI, and CRP levels were analyzed across different responder groups, and logistic regression was used to identify factors predicting the outcome.

Notable differences in BMI, CRP, and 25(OH)D levels were found among the groups (BMI p = 0.021; CRP p = 0.044; 25(OH)D p < 0.001). Super-Responders exhibited lower BMI and CRP alongside elevated 25(OH)D, while Frequent Switchers displayed increased BMI and CRP with decreased 25(OH)D.

Excellent Responders (PASI ≥90%) had greater 25(OH)D (60.3 nmol/L vs 30.3 nmol/L, p < 0.001) and lower BMI (27.7 kg/m2 vs 32.2 kg/m2, p = 0.013), with 25(OH)D independently predicting PASI ≥90% (OR = 1.032 per nmol/L, p < 0.001). For PASI ≥75%, 25(OH)D continued to be a significant predictor (OR = 1.016, p = 0.045).

CRP levels were elevated in Frequent Switchers (p = 0.009). Higher BMI decreased the likelihood of being a Super-Responder (OR = 0.891, p = 0.027), and increased CRP was linked to reduced biologic stability (OR = 0.864, p = 0.012).

Overall, regular monitoring of 25(OH)D and CRP levels, alongside assessment of BMI, could contribute to creating predictive models that determine which patients are more or less likely to benefit from biologic treatments. This initial study offers early valuable perspectives for tailored approaches to managing psoriasis.

Source:

Rahman, K. L., McKenna, K., Kearney, N., McCann, M., Rodriguez, E. P., Demirdijan, S. P., & Thompson, P. (2026). Vitamin D status and systemic inflammatory burden as a predictor of biologic treatment response in psoriasis -A pilot study in Northern Ireland. Clinical and Experimental Dermatology, (llag452). https://doi.org/10.1093/ced/llag452