Serum C-reactive protein to albumin ratio as a novel inflammation biomarker in psoriasis patients treated with adalimumab, ustekinumab, infliximab, and secukinumab: a retrospective study

Aim To assess C-reactive protein to albumin ratio (CAR) before and after treatment with biological agents in patients with psoriasis to determine whether CAR can be used as an inflammation biomarker. Methods Medical records of patients with psoriasis treated with biological agents at the Department of Dermatology, Gazi University Hospital were retrospectively evaluated between June 2018 and August 2019. The patients were divided into four groups based on the type of treatment (adalimumab, ustekinumab, infliximab, secukinumab). CAR was evaluated before and three months after treatment. Results The study enrolled 157 patients with psoriasis vulgaris (91 male) aged between 18 and 85. CAR significantly decreased in all treatment groups (adalimumab group P< 0.001; ustekinumab P = 0.006; infliximab P=0.007; secukinumab P < 0.001). The most prominent decrease in CAR was observed in patients treated with secukinumab (median CAR before treatment 1.52 [1.01-3.04] and after treatment 0.84 [0.62-0.99]). Conclusion CAR may be a good indicator of systemic inflammation in psoriasis patients treated with biological agents.