Metabolic Syndrome and psoriatic arthritis: considerations for the clinician

Caso, Francesco; Chimenti, Maria Sole; Navarini, Luca; Ruscitti, Piero; Peluso, Rosario; Girolimetto, Nicolò; Puente, Antonio Del; Giacomelli, Roberto; Scarpa, Raffaele; Costa, Luisa

doi:10.1080/1744666x.2020.1740593

Cited by 23 publications

(29 citation statements)

References 181 publications

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“…MetS is a cluster of classic cardiovascular (CV) risk factors identified as a strong predictor of CV disease, stroke, and type 2 diabetes. MetS was strongly associated with a lower probability of achieving MDA in PsA patients in therapy with TNFi, and different studies have reported a higher prevalence of MetS in PsA patients compared to other rheumatic diseases [35]. Our cohort of patients, in line with previous findings, suggests that MetS may be a negative predictor factor for achieving MDA not only in patients undergoing TNFi therapy, but also for SEC.…”

Section: Discussionsupporting

confidence: 89%

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

Chimenti

Fonti

Conigliaro

et al. 2020

Expert Opinion on Biological Therapy

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Background: Secukinumab (SEC) is effective for ankylosing spondylitis (AS) and psoriatic arthritis (PsA) in randomized trials, but real-life data are lacking. Research design and methods: Real-life, prospective observational study on 169 consecutive outpatients at baseline (T0) and at 6 (T6) and 12 months (T12) after starting SEC (39 AS, 23%; 130 PsA, 77%). Results: Significant improvement was seen at T6 and T12 for all clinical variables, including TJC, SJC, ESR, CRP, DAPSA, ASDAS-CRP, and BASDAI, as well as in patient-reported outcomes like VAS-pain. By multivariable regression analysis, in AS patients high BASDAI at T0 correlated with diagnostic delay (R 2 = 0.4; p = 0.009) and peripheral joint involvement (R 2 = 0.4; p = 0.04). During follow-up, reduction of BASDAI positively correlated with high ESR (R 2 = 0.65; p = 0.04). ASDAS-CRP at T0 positively correlated with high ESR (R 2 = 0.34; p = 0.004). Reduction of ASDAS-CRP from T0 to T6 correlated with current smoking status (R 2 = 0.42; p = 0.003). In PsA patients, reduction of DAPSA score from T0 to T12 is negatively correlated with the presence of metabolic syndrome (R 2 = 0.41; p = 0.0025). SEC was well tolerated; 10 patients discontinued treatment for non-severe adverse events. Conclusions: Secukinumab is effective and safe in patients with AS and PsA in a real-life setting.

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Section: Discussionsupporting

confidence: 89%

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

Chimenti

Fonti

Conigliaro

et al. 2020

Expert Opinion on Biological Therapy

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“…Within the spectrum of extra-articular manifestations, MetS stands out. Over the years, the diagnostic criterion for MetS, a cluster of coexistent hypertension, obesity, insulin resistance, and dyslipidemia, has undergone changes, each of which posing per se cardiovascular risk ( 27 ) Joint inflammation and MetS share common signaling pathways, which result in cardiovascular disease ( 3 , 28 ). Atherosclerosis, MetS, and PsA show a common pattern of T-cell activation.…”

Section: Pathogenesis Of Psoriatic Arthritismentioning

confidence: 99%

“…Psoriasis is a chronic inflammatory disease mainly compromising skin with systemic involvement associated with various comorbidities ( 1 ). With 6% to 40% percent of psoriatic patients experiencing psoriatic arthritis (PsA) ( 2 ), it equally affects men and women, starting usually at the age of 40 ( 3 ). The first signs appear on the skin usually 10 years before arthritis is diagnosed ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…Although the etiopathogenesis of PsA is multifactorial and not entirely known, there is an interaction between genetic susceptibility factors, mainly human leukocyte antigens (HLA) B27, together with other HLA-B loci and the HLA-Cw * 0602 allele) and environmental triggers (such as mechanical stress, dysbiosis, trauma, smoking, or infection), leading to dysregulation of immunoinflammatory pathways and the development of the disease ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

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Adipokines, Cardiovascular Risk, and Therapeutic Management in Obesity and Psoriatic Arthritis

et al. 2021

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Psoriatic arthritis is a chronic inflammatory disease with skin and joint pathology as the dominant characteristics. Scientific evidence supports its systemic nature and relevant relationship with obesity, metabolic syndrome, and associated conditions. Metabolic syndrome and obesity share common signaling pathways with joint inflammation, reinforcing the idea that adipose tissue is a major contributor to disease development and severity. The adipose tissue is not a mere energy store but also an endocrine organ participating in the immune response. In the search for the best therapeutic strategy for a patient, we should appraise the adipose tissue as an endocrine and immune organ responsible for mild chronic inflammation. Today, our challenge is not only to achieve disease remission but to control the associated comorbidities as well. In light of the high prevalence of obesity in psoriatic arthritis patients and the importance of the adipose tissue in the development of chronic inflammation, we aimed to identify the most relevant articles in this regard published in English until June 2020 using the PubMed database. Search terms included psoriatic arthritis, in combination with metabolic syndrome, obesity, adipokines, cardiovascular disease, and treatment. This review summarizes the current evidence regarding the role of adipose tissue as an adipokine-secreting endocrine organ, discussing its influence on disease development and severity, and ultimately in meeting successful disease management.

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“…16,17 PsA is characterized by a general inflammatory state responsible for associated comorbidities and systemic manifestations, including cardiovascular (CV) disease, diabetes mellitus II (DM), obesity, metabolic syndrome (MetS), uveitis, inflammatory bowel disease (IBD), liver inflammation, osteoporosis, emotional, and psychological symptoms. 18, More than half of patients with PsA have at least one comorbidity. 21 The prevalence of clinical features and comorbidities are summarized in Table 1.…”

Section: Clinical Manifestations and Comorbiditiesmentioning

confidence: 99%

<p>An Update for the Clinician on Biologics for the Treatment of Psoriatic Arthritis</p>

Chimenti¹,

D’Antonio²,

Conigliaro³

et al. 2020

BTT

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Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy typically associated with psoriasis (PsO). The pathogenesis is strictly related to the association among the presence of genetic risk alleles and innate and acquired immune response with dramatic consequences on bone remodeling. Clinically, PsA patients may present heterogenicity of articular and periarticular manifestations that may be associated with the presence of comorbidities making treatment decision challenging in patients management. The identification of patient-targeted therapies is still a critical issue. Actually, several biological and synthetic drugs are promising in terms of efficacy and safety profile. National and international treatment recommendations support clinicians in the decision of the best treatment, although they may have limits basically related to updates and different outcomes included in the clinical studies evaluated. The aim of this narrative review is therefore to give guidance for clinicians for PsA patients treatment. For this purpose, we evaluated evidence on biological therapies efficacy used for PsA treatment. Specifically, we reviewed data on biological therapies, Janus kinases (JAK) inhibitors, and drugs with a new mechanism of action that are part of the treatment pipeline. The concept of "switching" and "swapping" is also described, as well as data concerning special populations such as pregnant women and elderly patients.

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Metabolic Syndrome and psoriatic arthritis: considerations for the clinician

Cited by 23 publications

References 181 publications

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

One-year effectiveness, retention rate, and safety of secukinumab in ankylosing spondylitis and psoriatic arthritis: a real-life multicenter study

Adipokines, Cardiovascular Risk, and Therapeutic Management in Obesity and Psoriatic Arthritis

<p>An Update for the Clinician on Biologics for the Treatment of Psoriatic Arthritis</p>

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