Real-World Effectiveness of Biologic Therapy in Patients with Psoriasis: Metabolic Comorbidities and Treatment Outcomes.

INTRODUCTION: Psoriasis is a chronic systemic inflammatory disease, frequently associated with metabolic comorbidities that may influence therapeutic outcomes. Real-world evidence on the effectiveness of biologic therapy in this complex clinical context remains limited. OBJECTIVES: To assess the prevalence of comorbidities in patients with psoriasis receiving biologic therapy and to identify factors associated with treatment response. METHODS: A retrospective observational study including 121 patients with chronic plaque psoriasis. Demographic data, comorbidities, biologic treatment class, and PASI/DLQI evolution at baseline and at standardized 6 and 12 months assessments was analyzed, together with the latest available clinical assessment recorded in 2025 after variable treatment durations. RESULTS: Comorbidities were present in 84.3% of patients, most frequently hepatic steatosis (73.6%), obesity (45.5%), hypertension (41.3%), and diabetes (19%). A significant improvement in PASI and DLQI scores was observed at all follow-up points (p < 0.001). Complete skin clearance (PASI 100) was achieved by 18.1% of the patients at 6 months and by 44.6% at 12 months. In multivariable logistic regression analysis, lower PASI scores at six months were independently associated with a higher likelihood of achieving PASI 100 at one year. CONCLUSIONS: Biologic therapy was associated with marked clinical and quality-of-life improvement. Although metabolic comorbidities were highly prevalent, no significant association between metabolic comorbidities and PASI 100 response at one year was identified in the analyses performed.