Long-Term Changes in Complete Blood Count-Derived Inflammatory Indices During Risankizumab Treatment for Psoriasis: A 208-Week Multicenter Real-World Study

Background/Objectives: Blood count-derived inflammatory indices have been proposed as accessible biomarkers of systemic inflammation in psoriasis, but their longitudinal behavior during selective interleukin-23 blockade remains uncertain. We evaluated these indices in psoriasis patients treated with risankizumab.

Methods

We conducted a multicenter retrospective real-world study (DERMIS), including adults with cutaneous psoriasis, with or without psoriatic arthritis, treated with risankizumab across 10 Italian centers, from national reimbursement up to 1 December 2025. Psoriasis Area and Severity Index (PASI) and complete blood count-derived indices-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI)-were assessed at baseline and at weeks 12, 24, 52, 104, 156, and 208. Analyses used available data and sensitivity cohorts with follow-up at weeks 52, 104, and 208.