Long-term efficacy and impact of netakimab on the cardiometabolic profile in patients with psoriasis

Abstract

Introduction. Psoriasis is associated with chronic systemic inflammation and an increased cardiometabolic risk. The role of IL-17A inhibition in modifying these processes in long-term real-world clinical practice requires further investigation.
Aim. To evaluate the long-term efficacy of netakimab and the dynamics of systemic inflammation markers and cardiometabolic profile parameters in patients with plaque psoriasis.
Materials and methods. A retrospective cohort study included 73 patients treated with netakimab for at least 3 years. The analysis included patients who continued therapy and maintained a clinical response (PASI > 75). Changes in PASI, C-reactive protein (CRP), HbA1c, and lipid profile were assessed before treatment initiation and after 3 years of therapy.
Results. Against the background of therapy, a pronounced decrease in disease activity was observed (mean PASI reduction 93.0%; range 75–100%), a reduction in systemic inflammation (CRP from 7.51 ± 3.64 to 5.71 ± 3.41 mg/L), improvement in carbohydrate metabolism (HbA1c from 6.24 ± 0.96% to 6.16 ± 0.94%), and favorable dynamics of lipid parameters (total cholesterol from 5.17 ± 0.45 to 4.78 ± 0.52 mmol/L; LDL cholesterol from 3.02 ± 0.36 to 2.70 ± 0.41 mmol/L; HDL cholesterol from 1.25 ± 0.17 before treatment to 1.36 ± 0.23 mmol/L during therapy). No negative clinically significant dynamics of laboratory parameters were identified; in some patients, the changes were minimal, which corresponds to the pronounced comorbidity burden of the studied group.
Conclusion. Long-term netakimab therapy in patients with a sustained clinical response was associated with control of psoriasis activity and improvement in several cardiometabolic parameters. When interpreting the results, the selective nature of the cohort, retrospective design, and possible influence of concomitant therapy adjustments should be considered.