Cell population data as predictive biomarkers for biologic therapy response in psoriasis

Biologic agents have significantly improved psoriasis treatment, but patient responses exhibit considerable heterogeneity, highlighting the urgent need for practical predictive biomarkers of therapeutic efficacy. This prospective cohort study enrolled 422 psoriasis patients and 150 healthy controls. Sixteen CPD parameters were measured using a hematology analyzer. We analyzed associations between baseline CPD and disease severity as well as inflammatory markers, assessed their predictive value for treatment response over 48 weeks of biologic therapy, and monitored early dynamic changes in CPD and their relationship with treatment response in 169 patients. All CPD parameters were significantly elevated in psoriasis patients compared to healthy controls (all <i>p</i> &lt; 0.001). Baseline mean lymphocyte volume (MN-V-LY) demonstrated sustained negative correlations with PASI improvement rates from weeks 4 to 48 (ρ = −0.278 to −0.449, all <i>p</i> &lt; 0.001). Early reduction in monocyte volume heterogeneity (SD-V-MO) was significantly associated with long-term efficacy (ρ = −0.355 to −0.546, all <i>p</i> &lt; 0.001). As simple, standardized hematological parameters, CPD show potential for clinical application in predicting biologic therapy response in psoriasis.