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Blood test tracking treatment response diverges sharply between IL-17/IL-23 inhibitors and older therapies, new 12-month study finds
PHILADELPHIA - PennZone -- A routine blood test already used to flag general inflammation may also help doctors track how well psoriasis patients are responding to their biologic medication, according to new research published in the Journal of Personalized Medicine.
The study followed 210 adults with psoriasis over 12 months, comparing how a marker called the Systemic Immune Inflammation Index (SII) changed across four treatment types: cyclosporine, anti-TNF biologics, anti-IL-17 biologics, and anti-IL-23 biologics. SII dropped significantly in patients on IL-17 and IL-23 inhibitors, while it climbed in patients on cyclosporine and anti-TNF therapy, even when skin symptoms improved similarly across groups.
Roohid Parast, a translational scientist at Johnson & Johnson Innovative Medicine who works on IL-23 pathway biology and biomarker analysis in inflammatory disease, said the finding reflects a broader shift in how the field measures treatment success.
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"For years the standard was watching skin clearance and calling it done. This study adds to a growing body of evidence that a drug can look effective on the surface while the underlying inflammatory signature tells a different story depending on which pathway it targets. A marker like SII gives clinicians another data point beyond PASI scores, and it's inexpensive enough to check at almost any visit."
Parast said this kind of biomarker-informed monitoring fits the broader move toward precision medicine in dermatology and rheumatology, where treatment decisions increasingly weigh systemic inflammatory burden rather than skin appearance alone. He pointed to his own work on pharmacodynamic biomarkers in IL-23 inhibitor trials, published earlier this year in JCI Insight, as part of the same trend toward objective inflammatory markers guiding biologic therapy in psoriasis and psoriatic arthritis.
Study authors caution that prospective trials are still needed before SII becomes part of routine clinical decision-making, but the retrospective data builds the case for blood-based monitoring tools in psoriatic disease.
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About Roohid Parast
Roohid Parast is a translational scientist at Johnson & Johnson Innovative Medicine in Spring House, Pennsylvania, focused on IL-23 pathway biology and pharmacodynamic biomarker analysis across inflammatory diseases including psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis. He holds a BS in Biochemistry from Temple University and is a co-author on a 2025 JCI Insight publication on pharmacodynamic biomarkers of icotrokinra in psoriasis patients. He is also an ACSM-certified personal trainer who trains in MMA, boxing, and Brazilian Jiu-Jitsu at Underground Kings MMA in Newtown, Pennsylvania.
http://Roohidparast.github.io
Source: Trovato E, et al. Systemic Immune-Inflammation Index (SII) as a Predictive Biomarker of Therapeutic Response in Psoriasis. J Pers Med. 2026. DOI: 10.3390/jpm16060323 (https://doi.org/10.3390/jpm16060323)
The study followed 210 adults with psoriasis over 12 months, comparing how a marker called the Systemic Immune Inflammation Index (SII) changed across four treatment types: cyclosporine, anti-TNF biologics, anti-IL-17 biologics, and anti-IL-23 biologics. SII dropped significantly in patients on IL-17 and IL-23 inhibitors, while it climbed in patients on cyclosporine and anti-TNF therapy, even when skin symptoms improved similarly across groups.
Roohid Parast, a translational scientist at Johnson & Johnson Innovative Medicine who works on IL-23 pathway biology and biomarker analysis in inflammatory disease, said the finding reflects a broader shift in how the field measures treatment success.
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"For years the standard was watching skin clearance and calling it done. This study adds to a growing body of evidence that a drug can look effective on the surface while the underlying inflammatory signature tells a different story depending on which pathway it targets. A marker like SII gives clinicians another data point beyond PASI scores, and it's inexpensive enough to check at almost any visit."
Parast said this kind of biomarker-informed monitoring fits the broader move toward precision medicine in dermatology and rheumatology, where treatment decisions increasingly weigh systemic inflammatory burden rather than skin appearance alone. He pointed to his own work on pharmacodynamic biomarkers in IL-23 inhibitor trials, published earlier this year in JCI Insight, as part of the same trend toward objective inflammatory markers guiding biologic therapy in psoriasis and psoriatic arthritis.
Study authors caution that prospective trials are still needed before SII becomes part of routine clinical decision-making, but the retrospective data builds the case for blood-based monitoring tools in psoriatic disease.
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About Roohid Parast
Roohid Parast is a translational scientist at Johnson & Johnson Innovative Medicine in Spring House, Pennsylvania, focused on IL-23 pathway biology and pharmacodynamic biomarker analysis across inflammatory diseases including psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis. He holds a BS in Biochemistry from Temple University and is a co-author on a 2025 JCI Insight publication on pharmacodynamic biomarkers of icotrokinra in psoriasis patients. He is also an ACSM-certified personal trainer who trains in MMA, boxing, and Brazilian Jiu-Jitsu at Underground Kings MMA in Newtown, Pennsylvania.
http://Roohidparast.github.io
Source: Trovato E, et al. Systemic Immune-Inflammation Index (SII) as a Predictive Biomarker of Therapeutic Response in Psoriasis. J Pers Med. 2026. DOI: 10.3390/jpm16060323 (https://doi.org/10.3390/jpm16060323)
Media Contact
rparast@eagles.phila.gov
rparast@eagles.phila.gov
Source: Roohid Parast Science & Fitness
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