Mustafa ÜRÜN, Musa Can GÜZELBABA, Yıldız Gürsel ÜRÜN
Turkish Journal of Dermatology - 2026;20(2):64-71
Aim: Biologic treatments have become important for optimal disease control in patients with moderate to severe plaque psoriasis. The term "super response" is used to describe a faster and more sustained response to biologic treatment. This study aimed to determine the characteristics of non-super-responder (NSR) and super-responder (SR) patients with psoriasis receiving interleukin (IL)-17 or IL-23 inhibitors. Materials and Methods: Patients with plaque psoriasis who were treated with IL-17 or IL-23 inhibitors between 2020 and 2024 were retrospectively analyzed. A super response was defined as a psoriasis area and severity index (PASI) 100 response at week 16 that was maintained through week 28. The patients were divided into the NSR and SR groups and compared in terms of sociodemographic characteristics, clinical findings, biological treatments, and lipid profiles. Results: A total of 200 patients were included in the study; 96 (48%) were SRs. The frequency of super response was significantly higher among patients with an initial PASI score of >= 10 (P = 0.041). Compared with the SR group, the NSR group was more likely to have a history of biologic therapy (P = 0.002). Continued use of the same biological agent was more frequent among SRs (P = 0.019). In the multivariate logistic regression analysis, prior biologic therapy was independently associated with a lower likelihood of achieving a super response [odds ratio (OR) = 0.30; 95% confidence interval (CI): 0.15-0.61; P = 0.001]. Additionally, low high-density lipoprotein (HDL) levels were identified as independent negative predictors of super response (OR = 0.44; 95% CI: 0.24-0.81; P = 0.008). Conclusion: Prior biologic therapy and HDL level were identified as the most important factors associated with super response.
