Jiang Yuxiong, Liu Xiaoke, Ma Rui, Huang Dawei, Wang Yu, Zhong Xiaoyuan, Yao Lingling, Xu Shuang, Li Ying, Zhang Xilin, Lu Jiajing, Shi Yuling
Department of Dermatology, Tenth People's Hospital Affiliated to Tongji University, Tongji University School of Medicine, Shanghai, China.
Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University, Shanghai, 200443, China.
Am J Clin Dermatol. 2025 Mar;26(2):291-300. doi: 10.1007/s40257-025-00918-y. Epub 2025 Jan 22.
Family history (FH) of psoriasis has been implicated as a risk factor for developing psoriasis. However, whether FH also carries information on clinical presentation and treatment response to biological agents in patients with psoriasis remains unclear.
This prospective, multicenter observational study aimed to analyze the clinical presentation and efficacy differences between patients with psoriasis with and without a FH.
The SPEECH registry is an observational, multicenter, and prospective registry that has been collecting data on psoriasis treatment since November 2022. This study included adult patients diagnosed with moderate-to-severe plaque psoriasis initiating treatment with biologics, including guselkumab, secukinumab, ixekizumab, ustekinumab, and adalimumab. FH of psoriasis was identified through patient self-report in which a positive FH was defined as a first-degree relative having psoriasis. The primary outcome measures include 75% improvement in Psoriasis Area and Severity Index (PASI75) and the Physician's Global Assessment score of cleared/minimal (PGA 0/1) after 3 months of treatment. Logistic regression was employed to determine the adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the achievement of response in selected outcomes for patients with a FH compared with those without a FH.
The study included a total of 859 patients, of whom 22.9% had a FH of psoriasis. Patients with psoriasis who had a FH experienced an earlier onset of the disease and more severe anxiety symptoms than those without a FH. After 3 months of treatment, patients with psoriasis with a FH exhibited a higher likelihood of achieving PASI75 (aOR 1.60 [95% CI 1.02, 2.51]) and PGA 0/1 (aOR 1.54 [95% CI 1.03, 2.31]). Notably, these differences persisted after 6 months of treatment, confirming the sustained effectiveness of biologic treatments in patients with a positive FH. Further mediation analysis uncovered a significant indirect effect of FH on the treatment response to biologics through age of onset (p = 0.028), and the proportion mediated was 20.5%.
FH of psoriasis may affect the clinical course of patients and enhance their treatment response to biologics, highlighting the importance of FH assessment in optimizing treatment outcome and guiding clinical decision of biologic selection. Future studies on biologic treatment responses in psoriasis should consider family history as a significant confounding factor.
ChiCTR2000036186.
银屑病家族史（FH）被认为是银屑病发病的一个风险因素。然而，FH是否也携带有关银屑病患者临床表现和生物制剂治疗反应的信息仍不清楚。
这项前瞻性、多中心观察性研究旨在分析有和没有FH的银屑病患者之间的临床表现和疗效差异。
SPEECH注册研究是一项观察性、多中心、前瞻性注册研究，自2022年11月以来一直在收集银屑病治疗数据。本研究纳入了诊断为中度至重度斑块状银屑病并开始使用生物制剂治疗的成年患者，生物制剂包括古塞库单抗、司库奇尤单抗、依奇珠单抗、乌司奴单抗和阿达木单抗。通过患者自我报告确定银屑病的FH，其中阳性FH定义为有银屑病的一级亲属。主要结局指标包括治疗3个月后银屑病面积和严重程度指数改善75%（PASI75）以及医师整体评估为清除/最小（PGA 0/1）。采用逻辑回归确定有FH的患者与无FH的患者在选定结局中达到反应的调整优势比（aOR）和95%置信区间（CI）。
该研究共纳入859例患者，其中22.9%有银屑病FH。有FH的银屑病患者比无FH的患者发病更早且焦虑症状更严重。治疗3个月后，有FH的银屑病患者达到PASI75（aOR 1.60 [95% CI 1.02, 2.
