The clinical indicators predicting the efficacy of acitretin in the treatment of psoriasis

Abstract

Abstract To identify the related factors affecting the efficacy of acitretin treatment for psoriasis and the correlations between these factors, thereby guiding the use of acitretin in psoriasis patients.156 cases of hospitalized psoriasis patients who received conventional acitretin treatment from 2018–2022 were collected. Psoriasis Area and Severity Index (PASI) was used as an observation indicator for efficacy. Treatment efficacies were divided into four Grades according to PASI50, PASI75, and PASI90. The patients' basic information, clinical features, laboratory examinations and other factors were retrospectively analyzed for correlations. The ROC curve of Hs-CRP predicting PASI90 was drawn, and the logistic multivariate regression model of AST and efficacy was established. PASI score was positively correlated with acitretin efficacy (r = 0.410, p < 0.001). Aspartate aminotransferase (AST) was negatively correlated with acitretin efficacy (r=-0.160, P < 0.046). The pre-treatment serum parameters of white blood cell count (WBC), neutrophil count (NEU), neutrophil ratio (NEU-R), highly sensitive C-reactive protein (Hs-CRP) and albumin (Alb) were different in four efficacy Grades and had a very good correlation. In the ROC curve of PASI90 predicted by Hs-CRP, the area under the curve was 0.731, and the cutoff point was 18.65.Acitretin treatment showed significant efficacy for psoriasis. AST had the highest correlation with therapeutic response and was significant for predicting treatment efficacy. Hs-CRP was meaningful for predicting PASI90. Hs-CRP, NEU-R and Alb had some guiding value in predicting treatment response to acitretin.