HLA-Cw6 status predicts efficacy of biologic treatments in psoriasis patients

Over the past decade, biologic therapies have been developed to treat auto-inflammatory conditions such as psoriasis. They have the advantage of better target specificity than traditional systemics such as methotrexate and cyclosporine and therefore significantly reduce side-effects and toxicity associated with wide spread systemic treatments. It has been suggested that the efficacy of biologics used in the treatment of psoriasis may be related with HLA-Cw6 status.Using HLA-Cw6 as a biomarker would therefore provide an advantage in the selection of a biologic agent for successful treatment based on a patient’s genetic makeup and thus allowing us to use HLA-Cw6 to individualize therapy for patients with moderate-to-severe psoriasis.In the present study, the HLA-Cw6 status was determined for psoriasis patients previously treated with etanercept, adalimumab, efalizumab, infliximab or ustekinumab.The success or failure rates of the biologic treatments were compared for patients with and without the HLA-Cw6 allele.The HLA-Cw6 status was significantly associated to the treatment outcomes for biologics efalizumab (no longer on the market), infliximab and ustekinumab; but not etanercept or adalimumab.These results support the use of HLA-Cw6 status as a biomarker for biologic treatment in moderate-to-severe psoriasis patients.