Impact of Body Mass Index on the Efficacy of Biological Therapies in Patients with Psoriasis: A Real-World Study

Pirrò, Federico; Caldarola, Giacomo; Chiricozzi, Andrea; Burlando, Martina; Mariani, Marco; Parodi, Aurora; Peris, Ketty; Simone, Clara De

doi:10.1007/s40261-021-01080-z

Cited by 46 publications

(46 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[16][17][18] High weight does not seem to compromise the response to brodalumab, 19 the role of the weight in the response to ixekizumab shows contradictory results in the current literature. 18,20 In our study obesity proved to be a negative predictor of response to risankizumab in some of the outcomes analyzed: in the achievement of PASI 100 at week 28, reached by 22% of obese patients versus 58% of non-obese patients (p = 0.007), and in the mean PASI at 28 weeks 1.7 vs. 0.9 (p = 0.006). Other significant differences were seen in the attainment of PASI 100 at week 40 and PASI <3 at week 40.…”

Section: Discussionmentioning

confidence: 57%

Risankizumab shows high efficacy and maintenance in improvement of response until week 52

Mastorino

Susca

Megna

et al. 2022

Dermatologic Therapy

View full text Add to dashboard Cite

Risankizumab has been recently approved for moderate‐to‐severe plaque psoriasis; however, real‐life studies are scarce. Analysis of possible predictor factors of treatment response are limited to body mass index (BMI) and previous biologic experience. Our objectives were to evaluate the effectiveness and safety of Risankizumab and to investigate on possible predictor factors response. We retrospectively analyzed 166 patients from two centers in Italy who undergone Risankizumab for psoriasis. The proportion of patients achieving a 100%, 90%, 75% of improvement in Psoriasis Area Severity Index (PASI) and PASI <3 were collected at weeks 16, 28, 40, and 52. Study population was analyzed in subgroups to investigate possible predictors of response to Risankizumab since week 40. At the time of analysis 165, 103, 30, and 11 patients had completed 16, 28, 40, and 52 weeks of treatment, respectively. The mean PASI score decreased from 12.5 ± 5.1 at baseline to 1.9 ± 2.4 at week 16. Similar reductions were observed when considering PASI <3, PASI 75, PASI 90, and PASI 100. Previous biologics failure, different smoking habits, obesity, and joint involvement resulted in a lower response to risankizumab. In particular, significant differences in mean PASI at any time‐points was observed between psoriatic arthritis (PSA) and non‐PSA patients: 2.7 versus 1.7 (p = 0.036), 1.9 versus 0.4 (p = 0.006), and 4.1 versus 0.5 (p = 0.016) at 16, 28, and 40 weeks, respectively. No difference in response to risankizumab occurred in the case of involvement of difficult‐to‐treat areas. In this population, Risankizumab was effective and safe. Smoking habits, joint involvement, obese status, and previous biologic experience may negatively affect treatment response, while difficult body sites involvement have minor impact.

show abstract

Section: Discussionmentioning

confidence: 57%

Risankizumab shows high efficacy and maintenance in improvement of response until week 52

Mastorino

Susca

Megna

et al. 2022

Dermatologic Therapy

View full text Add to dashboard Cite

show abstract

“…The IL-17A inhibitor secukinumab demonstrated an inverse association of LDA and BMI in PsA after 6 months of treatment, perhaps due to greater serum IL-17 levels in patients with BMI ≥25 versus <25 kg/m 2 43. However, in PsO, a real-world study of secukinumab and the IL-17 inhibitor ixekizumab showed lower rates of skin response at 12 and 24 weeks and at 24 weeks, respectively, among patients with BMI ≥30 versus <30 kg/m 2 44. In the current post-hoc study, guselkumab Q4W and Q8W effect at week 24 was maintained through week 52 regardless of sex and obese versus non-obese status, supporting the potential benefits of guselkumab in treating these patient subgroups.…”

Section: Discussionmentioning

confidence: 98%

Sustained and improved guselkumab response in patients with active psoriatic arthritis regardless of baseline demographic and disease characteristics: pooled results through week 52 of two phase III, randomised, placebo-controlled studies

et al. 2022

View full text Add to dashboard Cite

ObjectivesTo evaluate the efficacy through 52 weeks of guselkumab, an interleukin 23-p19 subunit inhibitor, in subgroups of pooled psoriatic arthritis (PsA) patients from the DISCOVER-1 and DISCOVER-2 trials defined by baseline patient characteristics.MethodsAdults with active PsA despite standard therapies were enrolled in DISCOVER-1 (≥3 swollen and ≥3 tender joints, C reactive protein (CRP) level ≥0.3 mg/dL) and DISCOVER-2 (≥5 swollen and ≥5 tender joints, CRP ≥0.6 mg/dL, biological-naïve). Randomised patients received 100 mg guselkumab at weeks 0, 4, and then every 4 or 8 weeks (Q4W/Q8W) or placebo. Guselkumab effects on joint (ACR20/50/70), skin (IGA 0/1, IGA 0), patient-reported outcome (Health Assessment Questionnaire Disability Index/Functional Assessment of Chronic Illness Therapy-Fatigue) and disease severity (minimal disease activity/PsA Disease Activity Score low disease activity) endpoints were evaluated by patient sex, body mass index, PsA duration, swollen/tender joint counts, CRP level, percent body surface area with psoriasis, Psoriasis Area and Severity Index score, and conventional synthetic disease-modifying antirheumatic drug use at baseline.ResultsBaseline patients characteristics in DISCOVER-1 (N=381) and DISCOVER-2 (N=739) were well balanced across randomised groups. At week 24, 62% (232/373) and 60% (225/375), respectively, of guselkumab Q4W-treated and Q8W-treated patients pooled across DISCOVER-1 and DISCOVER-2 achieved the primary endpoint of ACR20 response versus 29% (109/372) of placebo-treated patients. Guselkumab treatment effect at week 24 was observed across patient subgroups. Within each patient subgroup, response rates across all disease domains were sustained or increased at week 52 with both guselkumab regimens.ConclusionsGuselkumab Q4W and Q8W resulted in robust and sustained improvements in PsA signs and symptoms consistently in subgroups of patients defined by diverse baseline characteristics.Trial registration numbersNCT03162796, NCT03158285.

show abstract

“…Their 7-year retrospective study showed that, compared to infliximab (where mean BMI increased from 24.7 to 25.7 kg/m 2 after 7 months), treatment with secukinumab maintained mean BMI levels to a constant value of 25.2. Based on their findings, it is therefore suggested that secukinumab exerts a neutral effect on body weight and could therefore constitute a more advantageous alternative for obese patients undergoing TNFI therapy [35]. In the same manner, results from a 12-week phase 3 clinical trial (UNCOVER-1, UNCOVER-2, and UNCOVER-3) measuring for cardiovascular and other parameters showed that ixekizumab had a neutral effect on both cardiovascular-related variables and body mass, as no weight gain was observed in patients receiving ixekizumab therapy at 12-week follow-up treatment [36].…”

Section: Il-17a Inhibitors and Bmimentioning

confidence: 99%

Body Mass Index Influence for the Personalization of the Monoclonal Antibodies Therapy for Psoriasis

Anghel

Nițușcă

Cristodor

2021

Life

View full text Add to dashboard Cite

Psoriasis is a chronic inflammatory, autoimmune-mediated disease that affects millions of individuals worldwide. Advances in treatment with biological agents represented by monoclonal antibodies, such as TNF-α inhibitors (TNFI), IL-17A and IL-12/23 antagonists have not only benefited from outstanding clinical efficacy with lower side effects compared to conventional systemic therapy, but also raised the standards towards therapeutic success, fact reflected in the greater Psoriasis Area and Severity Index (PASI) response rates. However, due to their relatively recent introduction in clinical practice, and despite their proven superior efficacy, further research is needed for monitoring the eventual changes in treatment-induced parameters, especially of metabolic origin. In this respect, initial reports stress on one particular comorbidity associated with psoriasis-obesity-which seems to be not only a risk and result of the disease, but also an adverse effect of long-term therapy with some biologics. The consequent drug-induced increase in body mass index (BMI) of patients suffering from psoriasis undergoing biological treatment appears to contribute to the progression of the disease, promote drug discontinuation and reduce overall clinical efficacy of monoclonal antibodies. Therefore, we review herein the impact of body weight (BMI) increase on the biological treatment of psoriasis, to further investigate on its relationship with the disease and aid on the management of treatment schemes that take into account individual characteristics of patients, such as body mass, for a more efficient and personalized therapy approach.

show abstract

Impact of Body Mass Index on the Efficacy of Biological Therapies in Patients with Psoriasis: A Real-World Study

Cited by 46 publications

References 53 publications

Risankizumab shows high efficacy and maintenance in improvement of response until week 52

Risankizumab shows high efficacy and maintenance in improvement of response until week 52

Sustained and improved guselkumab response in patients with active psoriatic arthritis regardless of baseline demographic and disease characteristics: pooled results through week 52 of two phase III, randomised, placebo-controlled studies

Body Mass Index Influence for the Personalization of the Monoclonal Antibodies Therapy for Psoriasis

Contact Info

Product

Resources

About