Evaluation of risk factors for body weight increment in psoriatic patients on infliximab: a multicentre, cross‐sectional study

Abstract

Severe weight increment is frequent on IFX treatment, mainly in men, and patients with severe psoriasis. Dietary follow-up or simultaneous use of methotrexate could limit this weight increment.

Anti-tumour necrosis factor-α treatment and weight gain in psoriasis: the ‘pudgy blanching’ conundrum

“…TNF‐α blockade may lead to an increase in leptinaemia 14 and a return to true baseline weight in the absence of inflammation 6 . The association between weight gain and baseline levels of biomarkers of inflammation (such as IL‐6), which has been found in some studies, 7,8,10,11 is consistent with this hypothesis.…”

“…Up to one‐fourth of patients may experience a 4–10‐kg weight gain, 2 and 32% of patients on etanercept and 25% on adalimumab had an increase in weight of more than 10% in a 48‐week evaluation 3 . According to one study, the percentage change in body weight associated with infliximab treatment of psoriasis is larger in patients with normal weight at baseline than in their overweight/obese counterparts, 5 but this finding has not been confirmed 1,6 . Normal weight participants in recent open prospective studies showed a greater increase in fat mass than lean mass compared with obese participants, 7 and weight changes correlated with fat mass gain in patients with psoriasis and with fat and lean mass gain in patients with psoriatic arthritis 8…”

“…A recently published multicentric French study included 191 patients who had received infliximab for at least 1 year 6 . Nearly 50% of them suffered from weight gain (> 2% above baseline); their mean weight change was 7·8%, and in 10% the weight increment was 10% or more 6 .…”

“…A recently published multicentric French study included 191 patients who had received infliximab for at least 1 year 6 . Nearly 50% of them suffered from weight gain (> 2% above baseline); their mean weight change was 7·8%, and in 10% the weight increment was 10% or more 6 . Male sex, psoriasis severity and low baseline BMI were associated with greater weight increment on univariate analysis, whereas dietary management during infliximab treatment and simultaneous methotrexate intake provided protection against weight gain on multivariate analysis 6 …”

Weight change in patients with psoriasis using tumour necrosis factor‐α inhibitors

“…A retrospective study revealed a 4·8 ± 5‐kg ( P = 0·005) weight increase in 16 patients after 3 years of follow‐up . A cross‐sectional prospective multicentre study reported a 1·6‐kg increase over a 1‐year period where 48·2% of patients experienced a weight increment . Two studies over a treatment period of 24 weeks found a weight gain of 2·5 ± 3·3 kg ( P = 0·004) in 40 patients, and a 2‐kg increase in 81 patients …”