Survivin as a Promising Biomarker for Patients Under IL17 RA Inhibitor Therapy: A Single‐Center, Pilot Study

Background Tissue and blood survivin overexpression has been associated with psoriasis. Objectives To evaluate the effect of brodalumab therapy on survivin expression in blood samples and tissue biopsies. Methods Peripheral blood samples and skin biopsies were obtained from 16 psoriatic patients and 16 healthy controls. Clinical scores (Psoriasis Area and Severity Index [PASI] and Dermatology Life Quality Index [DLQI]) were recorded at 0, 3, and 12 months. Serum and tissue survivin expression were examined using an enzyme‐linked immunosorbent assay (ELISA) method. Results Brodalumab produced a remarkable clinical response at 3 and 12 months compared to baseline (median PASI score change: −10.6 [ Q 1– Q 3: −11.4, −8.1], p < 0.001 and −12.3 [ Q 1– Q 3: −14.8, −11.0], p < 0.001, respectively, and mean DLQI score reduction: 13.1 ± 3.1, p < 0.001 and 15.1 ± 2.5, p < 0.001, respectively). A significant reduction in tissue survivin was found in psoriatic skin at 12 months ( p = 0.046). The median difference in tissue survivin between the two groups at baseline was also statistically significant ( p < 0.001), showing higher levels in the psoriasis group. Similarly, the mean difference between tissue survivin levels at baseline and 12 months was statistically significant ( p < 0.001, 95% CI of 0.034 [0.022, 0.047]). At 12 months, serum survivin decreased significantly compared to baseline, in the psoriasis group ( p = 0.004, 95% CI 11.2 [4.2, 18.1]). A moderate to strong negative correlation was found between the change in serum survivin levels and the change in DLQI at 3 months ( p = 0.020). Conclusions Our study provides the first evidence that serum and tissue survivin may serve as a potential biomarker in patients treated with brodalumab treatment.