Improved Sleep Quality in Psoriasis Patients Under Biologicals: A Prospective Observational Study

Area of Science:

• Dermatology
• Immunology
• Sleep Medicine

Background:

• Sleep disorders are a significant but often overlooked aspect of psoriasis morbidity.
• Biologic therapies targeting IL-17 and IL-23 show potential for improving sleep quality by mitigating systemic inflammation and associated symptoms in psoriasis patients.

Purpose of the Study:

• To investigate the association between moderate-to-severe psoriasis and impaired sleep quality.
• To evaluate the efficacy of IL-17 and IL-23 inhibitors in improving sleep disorders over a 16-week treatment period.

Main Methods:

• A prospective, observational cohort study included patients with moderate-to-severe psoriasis receiving IL-17 or IL-23 inhibitors.
• Evaluated Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), pruritus, pain, and Pittsburgh Sleep Quality Index (PSQI) at baseline, week 4, and week 16.

Main Results:

• Seventy patients presented with moderate sleep impairment at baseline (mean PSQI 7.57), with pruritus and pain strongly correlating with poor sleep.
• Both IL-17 and IL-23 inhibitors significantly improved PASI, DLQI, pruritus, pain, and PSQI scores by week 16.
• IL-23 inhibitors showed earlier improvement in PSQI at week 4 compared to IL-17 inhibitors, which demonstrated significant improvement by week 16.

Conclusions:

• Biologic therapy effectively enhances sleep quality in psoriasis patients, primarily through symptom alleviation.
• While both IL-17 and IL-23 inhibitors are effective, IL-23 blockade may provide a more rapid onset of sleep benefits.
• Sleep quality improvement can be considered a meaningful outcome measure in the management of psoriasis.