Impact of IL‐17A and IL‐23p19 Inhibitors on Psychiatric Outcomes and Inflammation in Psoriasis

BACKGROUND AND OBJECTIVES: Psoriasis is a systemic inflammatory disease affecting skin and mental health. Biologic agents targeting IL-17A and IL-23p19 effectively treat skin symptoms, but their psychiatric and systemic anti-inflammatory effects remain unclear, especially in real-life settings. This study evaluated whether IL-17A and IL-23p19 inhibitors improve psychiatric symptoms, and whether these improvements are associated with reductions in inflammatory markers, independently of skin response. PATIENTS AND METHODS: In this multicenter prospective study, 235 psoriasis patients starting IL-17A and IL-23p19 inhibitors were assessed at baseline and six months. Assessments included CRP, NLR, HADS-A, HADS-D, and DLQI scores. RESULTS: Treatment significantly improved skin, quality of life, and psychiatric scores (p < 0.001). CRP declined significantly and was independently correlated with reductions in HADS-A and HADS-D scores, even in patients without PASI90 response. IL-23p19 inhibitors produced greater reductions in CRP and NLR compared to IL-17A inhibitors, suggesting broader anti-inflammatory effects through upstream cytokine blockade. CONCLUSIONS: IL-17A and IL-23p19 inhibitors improve both dermatological and psychiatric outcomes in psoriasis, potentially by reducing systemic inflammation. CRP may serve as a biomarker of psychiatric improvement, independent of skin response. Future studies with longer follow-up and non-biologic control groups are warranted. Integrating dermatological and psychiatric care may enhance outcomes in psoriasis patients.