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Associations between HLA-Cw1 and Systemic Treatment Response of Asian Psoriasis Patients

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Abstract

Introduction

Psoriasis is a chronic inflammatory disease with a strong genetic background, particularly the human leukocyte antigen (HLA). HLA-Cw6 has been shown to be the major disease susceptibility locus and affects the phenotypes and treatment response in psoriasis; however, the prevalence of HLA-Cw6 is far lower than HLA-Cw1 in some Asian countries.

Objectives

The aim of this study was to determine whether HLA-Cw1 predisposes psoriasis patients to different treatment responses of biologics and other systemic therapy.

Methods

This retrospective case-control study included 126 patients with moderate to severe plaque-type psoriasis who had been genotyped and treated in a special psoriasis clinic. HLA-Cw1-positive and -negative patients were compared.

Results

Our results showed that HLA-Cw1-negative patients were significantly more likely to respond (achieve Psoriasis Area and Severity Index [PASI] 75 after a 12- to 16-week treatment course) to biologics (including etanercept, adalimumab, ustekinumab, secukinumab, ixekizumab, and guselkumab; odds ratio [OR] 1.99, 95% confidence interval [CI] 1.17–3.44, p = 0.0122) and especially to ustekinumab (OR 3.27, 95% CI 1.03–11.30; p = 0.0496). An HLA-Cw1 allele dose effect was also found. The results remained after multivariate logistic regression analysis. HLA-Cw1-negative patients also showed significantly greater improvement of PASI in ustekinumab and biologics (p = 0.0044 and p = 0.0064, respectively), with other biologics showing non-significant trends. HLA-Cw1 status did not affect the treatment responses of non-biologic systemic treatment, including phototherapy.

Conclusion

There is an association between HLA-Cw1 and treatment response to biologics, but not to non-biologics, in our Asian population of patients with moderate to severe psoriasis; however, the exact mechanism and role of HLA-Cw1 remain to be investigated.

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Authors and Affiliations

  1. National Taiwan University Hospital, No. 7 Chung San South Road, Taipei, Taiwan

    Shin-Shin Ho & Tsen-Fang Tsai

  2. Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    Tsen-Fang Tsai

Authors
  1. Shin-Shin Ho
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Corresponding author

Correspondence to Tsen-Fang Tsai.

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Funding

No sources of funding were received to assist in the preparation of this article.

Conflicts of interest/competing interests

Shin-Shin Ho has no conflicts of interest that are directly relevant to the contents of this article. Tsen-Fang Tsai has conducted clinical trials or received honoraria for serving as a consultant for Abbvie, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Galderma, Janssen-Cilag, Merck Sharp & Dohme, Novartis International AG, Pfzer Inc., and UCB Pharma.

Ethics approval

This study has been approved by the local Institutional Review Board (20190412RINC, 200712123R).

Consent to participate and for publication

All patients provided written informed consent.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

Authors’ contributions

All authors contributed to the study conception and design. The literature search and data analysis were performed by Shin-Shin Ho and Tsen-Fang Tsai. The first draft of the manuscript was written by Shin-Shin Ho and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Ho, SS., Tsai, TF. Associations between HLA-Cw1 and Systemic Treatment Response of Asian Psoriasis Patients. Mol Diagn Ther 26, 541–549 (2022). https://doi.org/10.1007/s40291-022-00603-4

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  • DOI: https://doi.org/10.1007/s40291-022-00603-4

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