Psoriasis, metabolic syndrome and cardiovascular risk factors. A population‐based study

Fernández‐Armenteros, Josep Manel; Gómez‐Arbonés, X.; Buti‐Soler, M.; Betriu-Bars, A.; Sanmartin-Novell, V.; Bravo, Marta Ortega; Martínez-Alonso, Montse; Garí, Eloi; Portero-Otı́n, Manel; Santamaria‐Babí, Luis F.; Casanova-Seuma, J.M.

doi:10.1111/jdv.15159

Cited by 114 publications

(113 citation statements)

References 30 publications

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“…Psoriasis is a systemic, immunometabolic, and still untreatable disease affecting 2%-4% of the general population worldwide. This disease was considered as a solely dermatological condition, while recent studies have linked psoriasis to many comorbidities namely obesity, cardiometabolic events, diabetes mellitus type 2 (DM type 2), lipid disturbances, and liver dysfunctions [1][2][3]. Further investigations have highlighted a higher risk of hypertension, metabolic syndrome (MS), or DM in association with the severity of psoriasis [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Krahel

Baran

Kamiński

et al. 2020

JCM

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Background: Proprotein convertase subtilisin/kexin type 9 (PCSK9) exerts an important role in inflammatory processes, lipids homeostasis, and cardiometabolic disorders that are closely associated with psoriasis. The aim of the study was to analyze the clinical and diagnostic value of serum PCSK9 concentrations and their connections with disease severity, inflammation, metabolic syndrome, and impact of systemic therapies in psoriatic patients. The study enrolled thirty-five patients with active plaque-type psoriasis and eighteen healthy volunteers served as controls. Blood samples were obtained before and after 12 weeks of treatment with methotrexate or acitretin. Serum PCSK9 concentrations were measured by the ELISA (Enzyme-Linked Immunosorbent Assay) commercial kits. Morphological and biochemical parameters were assayed using routine laboratory techniques. Psoriatic patients showed significantly elevated levels of PCSK9 compared to controls (p < 0.01), mostly in patients with a mild and moderate course of psoriasis. PCSK9 concentrations correlated positively with BMI and triglyceride levels (p < 0.05). Interestingly, PCSK9 had a strong negative correlation with low-density lipoprotein levels and total cholesterol (p < 0.05). Three months of monotherapy with methotrexate significantly reduced PCSK9 level (p < 0.05), on the contrary, the acitretin group showed a further increase of PCSK9 levels (p < 0.05). PCSK9 seems to be a novel marker of psoriasis and a putative explanation of lipid disturbances, which are common in patients with psoriasis and are vital for the further developing of metabolic syndrome. Methotrexate should be considered as a treatment of choice in patients with an elevated PCSK9 concentration.

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Section: Introductionmentioning

confidence: 99%

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Krahel

Baran

Kamiński

et al. 2020

JCM

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“…Psoriasis is a chronic, immune-mediated disease affecting 2-4% of general population. Numerous data have confirmed not only skin, but systemic involvement and significant co-occurrence with different diseases including hypertension, obesity, metabolic syndrome (MS), diabetes mellitus (DM), cardiometabolic diseases (CMD), and liver or bowel diseases (Farley, 2011, Fernández-Armenteros, 2018. Multifactorial interplay between psoriasis and obesity mainly genetic basis, chronic inflammation, or adipokines increases the risk of heart failure and other CMD leading to a higher mortality rate in psoriatics (Ahlehoff, 2011;Hu, 2017;Imai, 2015).…”

Section: Introductionmentioning

confidence: 99%

Adipocyte Fatty Acid‐Binding Protein as a Novel Marker of Psoriasis and Clinical Response to Acitretin

Baran

Kiluk

Świderska

et al. 2019

Lipids

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Psoriasis is a systemic disease associated with metabolic syndrome and cardiometabolic diseases. Adipocyte fatty acid‐binding protein (A‐FABP, FABP4) is a relevant mediator of lipid metabolism and several comorbidities development. Aim of the study was to explore the possible role of FABP4 in psoriasis and assess its relationship with disease activity, inflammation or metabolic disturbances, and impact of systemic treatment. Fasting blood samples were obtained from 33 patients with active plaque‐type psoriasis before and after 12 weeks of therapy and from 11 healthy volunteers. Serum FABP4 concentrations were analyzed by the enzyme‐linked immunosorbent assay (ELISA) and statistically analyzed for their correlations with clinical outcomes and the treatment introduced. Serum FABP4 levels were significantly increased in psoriatics compared to controls (p = 0.03). No relationship between the protein and psoriasis severity expressed through psoriasis area and severity index (PASI) was noted (p = 0.57). FABP4 did not correlate with CRP (p = 0.41), lipid profile, and body mass index (BMI) nor the glucose level or liver enzyme activity. FABP4 significantly correlated with morphotic blood elements. After total therapy, FABP4 did not statistically change (p = 0.07), but significantly decreased after administering acitretin (p = 0.03). FABP4 is a potential marker of psoriasis and clinical outcome after therapy with acitretin. Adipocyte‐type FABP may be related to hematological disorders or obesity‐mediated comorbidities in psoriasis.

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“…Psoriasis is the most common immune-mediated disease in the United States (US), with a prevalence of 1-3% (1), and is associated with psoriatic arthritis (PsA), other autoimmune diseases such as inflammatory bowel disease, non-melanoma skin cancer, and depression (2,3). Compared with the general population, psoriasis patients have higher rates of metabolic syndrome and its component comorbidities: obesity, hypertension, dyslipidemia, and hyperglycemia/insulin resistance (3)(4)(5)(6). Metabolic syndrome is associated with increased cardiovascular mortality, and, similar to psoriasis, incurs a substantial economic burden to society (3,7,8).…”

Section: Introductionmentioning

confidence: 99%

“…The association between psoriasis and metabolic syndrome is likely due to genetic and environmental factors (5). The concept of metabolic syndrome was first proposed to identify a group of interrelated conditions with a shared pathophysiology (6).…”

Section: Introductionmentioning

confidence: 99%

Real-world treatment patterns and healthcare costs of biologics and apremilast among patients with moderate-to-severe plaque psoriasis by metabolic condition status

Feldman

Zhang

Martínez

et al. 2019

Journal of Dermatological Treatment

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Objectives: To compare treatment patterns and costs among psoriasis patients with and without metabolic conditions newly initiating a biologic or apremilast. Methods: Adult patients included had !1 prescription for secukinumab, adalimumab, ustekinumab, etanercept, or apremilast between 01/01/2015 and 08/31/2018 (date of first prescription was index date) and no index drug use in the 12-months pre-index, and continuous enrollment in the 12-month pre-index and 24-month post-index periods. Patients were divided into mutually exclusive treatment cohorts and stratified by their pre-index metabolic condition status. Treatment patterns (adherence, non-persistence, switching, discontinuation, use of combination therapy, and re-initiation) and healthcare costs were compared. Results: Overall, 7773 patients were included; 47.5-56.7% had a metabolic condition. Except for the apremilast group, patients with metabolic conditions had higher discontinuation (secukinumab: 50.6% vs. 43.7%; adalimumab Ã : 53.9% vs. 48.7%; ustekinumab Ã : 41.9% vs. 35.1%; etanercept: 42.8% vs. 41.2%; apremilast: 43.1% vs. 46.1%) and switching (secukinumab: 48.1% vs. 41.2%; adalimumab Ã : 47.8% vs. 41.9%; ustekinumab Ã : 34.5% vs. 25.3%; etanercept Ã : 53.6% vs. 51.5%; apremilast: 45.8% vs. 44.6%) than patients without (Ã p < .05). Patients with metabolic conditions incurred significantly higher costs. Conclusion: Many psoriasis patients initiating biologics or apremilast had metabolic conditions. These patients had higher discontinuation and switching, and significantly higher healthcare costs.

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Psoriasis, metabolic syndrome and cardiovascular risk factors. A population‐based study

Cited by 114 publications

References 30 publications

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Methotrexate Decreases the Level of PCSK9—A Novel Indicator of the Risk of Proatherogenic Lipid Profile in Psoriasis. The Preliminary Data

Adipocyte Fatty Acid‐Binding Protein as a Novel Marker of Psoriasis and Clinical Response to Acitretin

Real-world treatment patterns and healthcare costs of biologics and apremilast among patients with moderate-to-severe plaque psoriasis by metabolic condition status

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