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Older age, higher BMI, and comorbidities are associated with lower clearance rates in psoriasis patientsFactors Like Age and BMI Impact Psoriasis Treatment Success
Journal of the European Academy of Dermatology and Venereology : JEADVPublished September 1, 2026Study authors: Mao Xuerui, Meng Shuo, Wu Panyu, Cao Lei, Wang LeiPubMed ↗DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Note that older age, higher BMI, and comorbidities are associated with lower rates of skin clearance in psoriasis.
This meta-analysis evaluates the factors influencing clinical response to biologic therapies in a population of 13,902 patients with psoriasis. The study specifically investigates predictors of complete skin clearance to help clinicians identify patients who may face greater challenges in achieving clear skin.
Key findings indicate that several factors are associated with a lower likelihood of achieving clearance. Specifically, older age (OR 0.99, 95% CI 0.98-0.99, p < 0.001), higher body mass index (OR 0.94, 95% CI 0.92-0.97, p < 0.001), and the presence of comorbidities (OR 0.75, 95% CI 0.63-0.9, p = 0.002) were negative predictors of clearance. Additionally, the involvement of special areas was a negative predictor (OR 0.71, 95% CI 0.56-0.89, p = 0.003). Conversely, a positive family history was a positive predictor of clearance (OR 1.42, 95% CI 1.18-1.71, p < 0.001).
These findings suggest that age, BMI, and comorbidities can facilitate phenotype-based risk stratification to guide treatment selection. However, because the data are derived from observational and clinical records, these associations do not imply a direct causal link. The results should be used to inform clinical expectations rather than as guaranteed outcomes.
How this fits prior evidence
This meta-analysis extends the understanding of psoriasis management by identifying specific patient characteristics that predict response to biologics. While previous evidence highlighted the efficacy of the IL-17 axis and the role of GDF15 as a potential biomarker for patient stratification, this study provides specific clinical predictors such as age, BMI, and comorbidities to further refine how clinicians might stratify patients for treatment selection.
Researchers analyzed data from over 13,000 patients with psoriasis to see what factors influence how well they respond to biologic treatments. The study looked specifically at the likelihood of achieving complete skin clearance, which is a major goal for many patients.
The findings showed that certain factors were linked to a lower chance of achieving clear skin. These included being older, having a higher body mass index, having other health conditions, and having psoriasis in special areas of the body. On the other hand, having a positive family history of the condition was linked to a better chance of clear skin.
Because this was a meta-analysis of existing data, these results show links rather than direct causes. These findings can help doctors better understand which patients might need more intensive support. Patients should talk to their doctors to see how these specific factors might affect their own treatment plans.
What this means for you:
Factors like age, BMI, and other health conditions can influence how well psoriasis responds to biologic treatments.
Common questions
How do factors like age and weight affect psoriasis treatment?
The study found that both older age and a higher body mass index were linked to a lower chance of achieving complete skin clearance. These results suggest that these factors may help doctors better predict how a patient might respond to biologic therapies.
Does having other health conditions affect treatment success?
Yes, the data showed that having comorbidities and involvement of special areas on the body were linked to a lower likelihood of clear skin. These findings help doctors identify patients who may need specific treatment plans.
Does family history play a role in how well the medicine works?
The study found that a positive family history was linked to a higher chance of achieving complete skin clearance. While this is a positive predictor, it is just one of several factors that can influence treatment outcomes.
BACKGROUND: Biologic therapies have revolutionized psoriasis management, yet inter-individual response varies significantly and reliable predictors of complete skin clearance remain unclear.
OBJECTIVES: This study aimed to identify prognostic predictors of biologic efficacy in patients with psoriasis through a systematic review and meta-analysis.
METHODS: We systematically searched four databases (from their inception to January 28, 2026). Studies were screened and data extracted per predefined criteria; quality was assessed using the Newcastle-Ottawa Scale (NOS), and analyses were performed in Stata 15.0.
RESULTS: Thirty studies (n = 13,902) were included. Negative predictors of clearance included older age (odds ratio [OR] 0.99, 95% CI 0.98-0.99, p < 0.001), higher body mass index (OR 0.94, 95% CI 0.92-0.97, p < 0.001), comorbidities (OR 0.75, 95% CI 0.63-0.9, p = 0.002), and involvement of special areas (OR 0.71, 95% CI 0.56-0.89, p = 0.003). Conversely, a positive family history (OR 1.42, 95% CI 1.18-1.71, p < 0.001) emerged as a significant predictor associated with better outcomes. No significant associations were observed for other analysed variables.
CONCLUSIONS: Older age, higher comorbidity burden, obesity, and special-site involvement are associated with poorer biologic response in psoriasis, whereas family history is associated with better outcomes. These readily available baseline factors facilitate phenotype-based risk stratification and may guide treatment selection in clinical practice.
