Twelve-month changes in lipid-derived cardiovascular risk indices among patients with psoriasis receiving biologic therapy: a multicenter real-world retrospective cohort study

BACKGROUND: Biologic agents have transformed moderate-to-severe psoriasis treatment, but their real-world effect on lipid-derived cardiovascular risk markers remains unclear. RESEARCH DESIGN AND METHODS: This multicenter retrospective cohort included 113 adults with moderate-to-severe plaque psoriasis treated with a biologic for 12 months in routine practice. Patients with chronic systemic disease or confounding concomitant medication were excluded; psoriatic arthritis was retained as a covariate. Six lipid-derived indices, including the atherogenic index of plasma (AIP), were calculated at baseline and month 12. The primary outcome was the 12-month change in AIP; drug- and class-level comparisons and multivariable regression were exploratory. RESULTS: = 0.016; bootstrap 95% CI 0.014 to 0.120); the other five indices remained stable. Baseline AIP, smoking, and psoriatic arthritis were independently associated with this change. Treatment subgroups were small and unbalanced, so drug- and class-level findings are hypothesis-generating. CONCLUSIONS: Lipid-derived indices changed selectively rather than uniformly. Given its modest magnitude and the absence of psoriasis-specific thresholds, the AIP increase is better read as a dynamic shift in the triglyceride/high-density lipoprotein cholesterol axis than as worsening cardiovascular risk.