This might be because the increase in BMI was associated with increased skin inflammation, elevated leptin, and reduced adiponectin, which was further linked with increased progression of psoriasis, thus leading to a lower treatment response to vunakizumab (Baran et al., 2015; Kaushik et al., 2023; Barr et al., 2022; Guo et al., 2022). Here, LEP is linked to psoriasis.