{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:43:32Z","timestamp":1792017812148,"version":"4.4.0"},"reference-count":27,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Psoriasis is a chronic immune-mediated inflammatory disease associated with systemic inflammation and comorbidities such as cardiovascular disease and metabolic syndrome. Blood-derived inflammatory indices like neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV) have been proposed as biomarkers of systemic inflammation and disease severity. This retrospective and prospective observational study aimed to evaluate the long-term effects of guselkumab, an IL-23 inhibitor, on these indices in moderate-to-severe psoriasis. Methods: We analyzed 208 patients with moderate-to-severe psoriasis treated with guselkumab, with hematologic evaluations available for 208 patients at baseline, 208 at week 52, 129 at week 104, and 94 at week 156. Systemic inflammatory indices were calculated from routine annual blood tests. Patients were stratified by obesity, cardiovascular comorbidities, treatment response, and prior biologic therapy. Longitudinal changes were assessed using Friedman tests with Wilcoxon post hoc comparisons, and correlations between PASI and inflammatory indices were evaluated using Spearman\u2019s coefficients. Results: SIRI and PLR showed significant reductions at week 156 (p = 0.038 and p = 0.018, respectively), while MLR also decreased over time without reaching consistent significance. NLR and PIV showed minimal or inconsistent changes. Obese patients and those with cardiovascular disease had higher baseline SII and SIRI and less pronounced improvements. No significant differences were observed between super responders and others. Correlation between baseline PASI and most inflammatory markers was weak, except for a weak but significant correlation with PIV (\u03c1 = 0.119, p = 0.049). Conclusions: Guselkumab treatment is associated with long-term reduction in systemic inflammatory indices, particularly SIRI. The weak correlation of these markers with skin severity highlights a dissociation between cutaneous and systemic inflammation. SIRI and SII may serve as useful biomarkers to monitor systemic inflammation and guide comprehensive management in psoriasis patients.<\/jats:p>","DOI":"10.3390\/jcm15020439","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:09:36Z","timestamp":1767712176000},"page":"439","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Long-Term Impact of Guselkumab on Systemic Inflammation Indices in Moderate-to-Severe Psoriasis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3763-6922","authenticated-orcid":false,"given":"Edoardo","family":"Mortato","sequence":"first","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Marcelli","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agostino","family":"Panichelli","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3070-4071","authenticated-orcid":false,"given":"Marina","family":"Talamonti","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Fondazione Policlinico \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Gneo","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Marrapodi","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4691-9381","authenticated-orcid":false,"given":"Cosimo","family":"Di Raimondo","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Fondazione Policlinico \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8697-6896","authenticated-orcid":false,"given":"Luca","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"},{"name":"Dermatology Unit, Fondazione Policlinico \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3424-5175","authenticated-orcid":false,"given":"Marco","family":"Galluzzo","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"},{"name":"Dermatology Unit, Fondazione Policlinico \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tashiro, T., and Sawada, Y. (2022). Psoriasis and Systemic Inflammatory Disorders. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23084457"},{"key":"ref_2","first-page":"201","article-title":"Update Aetiopathogenesis and Treatment of Psoriasis: A Literature Review","volume":"4","author":"Chen","year":"2023","journal-title":"J. Dermatol. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"122991","DOI":"10.1016\/j.lfs.2024.122991","article-title":"Advances in psoriasis research: From pathogenesis to therapeutics","volume":"355","author":"Sugumaran","year":"2024","journal-title":"Life Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s12016-018-8702-3","article-title":"The Immunologic Role of IL-17 in Psoriasis and Psoriatic Arthritis Pathogenesis","volume":"55","author":"Blauvelt","year":"2018","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1111\/bjd.18245","article-title":"Management of psoriasis as a systemic disease: What is the evidence?","volume":"182","author":"Korman","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1111\/ijd.13699","article-title":"Adipokines, psoriasis, systemic inflammation, and endothelial dysfunction","volume":"56","author":"Lynch","year":"2017","journal-title":"Int. J. Dermatol."},{"key":"ref_7","first-page":"467","article-title":"Psoriasis as a Systemic Disease","volume":"121","author":"Mrowietz","year":"2024","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1038\/jid.2010.103","article-title":"Psoriasis and systemic inflammatory diseases: Potential mechanistic links between skin disease and comorbid conditions","volume":"130","author":"Davidovici","year":"2010","journal-title":"J. Investig. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Honma, M., and Nozaki, H. (2021). Molecular pathogenesis of psoriasis and biomarkers reflecting disease activity. J. Clin. Med., 10.","DOI":"10.3390\/jcm10153199"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ma, R., Cui, L., Cai, J., Yang, N., Wang, Y., Chen, Q., Chen, W., Peng, C., Qin, H., and Ding, Y. (2024). Association between systemic immune inflammation index, systemic inflammation response index and adult psoriasis: Evidence from NHANES. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1323174"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sugimoto, E., Matsuda, H., Shibata, S., Mizuno, Y., Koyama, A., Li, L., Taira, H., Ito, Y., Awaji, K., and Yamashita, T. (2023). Impact of Pretreatment Systemic Inflammatory Markers on Treatment Persistence with Biologics and Conventional Systemic Therapy: A Retrospective Study of Patients with Psoriasis Vulgaris and Psoriatic Arthritis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12083046"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E13230","DOI":"10.1111\/eci.13230","article-title":"Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease","volume":"50","author":"Yang","year":"2020","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1007\/s00403-024-02994-2","article-title":"Associations of novel complete blood count-derived inflammatory markers with psoriasis: A systematic review and meta-analysis","volume":"316","author":"Liu","year":"2024","journal-title":"Arch. Dermatol. Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Zhao, X., Li, J., and Li, X. (2024). Association between systemic immune-inflammation index and psoriasis: A population-based study. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1305701"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1111\/tmi.14052","article-title":"Assessing systemic inflammatory markers in psoriasis: A retrospective study","volume":"29","author":"Solak","year":"2024","journal-title":"Trop. Med. Int. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1002\/jvc2.70001","article-title":"The Systemic Immune-Inflammation Index and Its Association with Biologic Therapy Switching and Response in Psoriasis","volume":"4","author":"Murray","year":"2025","journal-title":"JEADV Clin. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e2024065","DOI":"10.5826\/dpc.1401a65","article-title":"Effect of Treatment With Biologic Agents on the Novel Inflammatory Biomarkers Systemic Immune Inflammation Index and Systemic Inflammation Response Index for Psoriasis","volume":"14","author":"Tamer","year":"2024","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1007\/s00403-024-03768-6","article-title":"Are IL-17 inhibitors superior to IL-23 inhibitors in reducing systemic inflammation in moderate-to-severe plaque psoriasis? A retrospective cohort study","volume":"317","year":"2025","journal-title":"Arch. Dermatol. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1159\/000545148","article-title":"Treatment of Plaque Psoriasis with Guselkumab Reduces Systemic Inflammatory Burden as Measured by Neutrophil\/Lymphocyte Ratio, Platelet\/Lymphocyte Ratio, and Monocyte\/Lymphocyte Ratio: A post hoc Analysis of Three Randomised Clinical Trials","volume":"241","author":"Kearney","year":"2025","journal-title":"Dermatology"},{"key":"ref_20","first-page":"474","article-title":"Neutrophil-to-lymphocyte ratio, past, present and future perspectives","volume":"122","author":"Zahorec","year":"2021","journal-title":"Bratisl. Lek. Listy"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00403-024-02823-6","article-title":"Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in psoriasis: A systematic review and meta-analysis","volume":"316","author":"Ye","year":"2024","journal-title":"Arch. Dermatol. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e14101","DOI":"10.1111\/ijcp.14101","article-title":"The utility of systemic-immune inflammation index for predicting the disease activation in patients with psoriasis","volume":"75","author":"Tanacan","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1361088","DOI":"10.3389\/fcvm.2024.1361088","article-title":"Associations between SII, SIRI, and cardiovascular disease in obese individuals: A nationwide cross-sectional analysis","volume":"11","author":"Liu","year":"2024","journal-title":"Front Cardiovasc. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"22300","DOI":"10.1038\/s41598-025-08121-z","article-title":"Association between novel inflammatory biomarkers SII, SIRI, and obesity in sedentary adults: NHANES 2007\u20132020","volume":"15","author":"Lin","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_25","first-page":"e20255733","article-title":"Therapeutic Modulation of Peripheral Blood Cells And Inflammatory Indices During 52 Weeks Of Risankizumab In Responder Patients with Moderate-to-Severe Psoriasis: Results From A Multicenter Prospective Study","volume":"15","author":"Rosi","year":"2025","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Dziedzic, E.A., G\u0105sior, J.S., Tuzimek, A., Paleczny, J., Junka, A., D\u0105browski, M., and Jankowski, P. (2022). Investigation of the Associations of Novel Inflammatory Biomarkers\u2014Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)\u2014With the Severity of Coronary Artery Disease and Acute Coronary Syndrome Occurrence. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23179553"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e1369","DOI":"10.1002\/iid3.1369","article-title":"Screening significance of systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) in coronary heart disease of symptomatic youth","volume":"12","author":"Wang","year":"2024","journal-title":"Immun. Inflamm. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/439\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:55:15Z","timestamp":1767714915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/439"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020439"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020439","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}