Metabolic syndrome in <scp>M</scp>oroccan patients with psoriasis

Meziane, Mariame; Kelati, Awatef; Najdi, Adil; Berraho, A; Nejjari, Chakib; Mernissi, F.Z.

doi:10.1111/ijd.12623

Cited by 28 publications

(18 citation statements)

References 25 publications

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“…In contrast, we could not confirm this correlation in our study. In comparison with data from the literature, we partly recorded lower rates of comorbid diseases in our series [35][36][37] . An explanation for the lower rates detected may be that 64.8% of the patients received Fumaderm ® as a first-line therapy, which means that the patients were in comparatively early stages of the disease.…”

Section: Discussionsupporting

confidence: 68%

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Lymphopenia and CD4+/CD8+ Cell Reduction under Fumaric Acid Esters

Sondermann

Rompoti²,

Leister³

et al. 2017

Dermatology

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Background: Fumaric acid esters (FAEs) are a broadly used therapy option for patients suffering from moderate-to-severe plaque psoriasis. Various studies in psoriasis have already shown peripheral blood lymphopenia during oral FAE therapy. Smaller studies also documented a reduction of CD4+ and CD8+ cell counts. Up to now, there are few case reports on opportunistic infections under FAE therapy - all of them associated with lymphopenia. Objective: To examine the influence of FAEs on white blood cells with special regard to leukocytes, lymphocytes, and CD4+ and CD8+ cells during psoriasis therapy. Patients and Methods: A cohort of 105 patients with diagnosed moderate-to-severe chronic plaque psoriasis was enrolled in this single-centre observational trial. For a cohort of 36 patients, T-cell subset analyses were performed. Results: Of the total, 65 patients were male (61.9%) and 40 (38.1%) female; the mean age was 43.3 years (range 16-73 years). The median lymphocyte count was significantly reduced by about 35.8% after the first 6 months of therapy. When assessing the lymphocyte count nadir over the whole period observed, 46.7% of the patients developed lymphopenia. Severe lymphopenia (<500/µL) was documented in 11.4% of the patients. The CD4+ and CD8+ cell counts were significantly reduced by about 30.2 and 45.3%, respectively. Conclusion: To the best of our knowledge this is the largest clinical investigation analysing prospectively CD4+ and CD8+ cell counts in psoriasis patients receiving FAEs. We suggest periodic monitoring of absolute lymphocyte counts as well as the establishment of the determination of T-cell subsets prior to and during therapy.

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Section: Discussionsupporting

confidence: 68%

“…An explanation for the lower rates detected may be that 64.8% of the patients received Fumaderm ® as a first-line therapy, which means that the patients were in comparatively early stages of the disease. It is well known that the rate of comorbidity increases with severity of psoriasis [36,37] .…”

Section: Discussionmentioning

confidence: 99%

Lymphopenia and CD4+/CD8+ Cell Reduction under Fumaric Acid Esters

Sondermann

Rompoti²,

Leister³

et al. 2017

Dermatology

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“…Whereas, the opposite situation was noted when comparing the diabetic and nondiabetic patients. Observations conducted by two independent research teams indicate that systemic diseases concurrent with psoriasis contribute to more intensified psoriatic symptoms (Itani, Arabi, Harb, Hmazeh, & Kibbi, ; Meziane et al, ). It may result from the disproportion between the number of patients with Diabetes 2 when compared with the number of patients without it.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas, the opposite situation was noted when comparing the diabetic and nondiabetic patients. Observations conducted by two independent research teams indicate that systemic diseases concurrent with psoriasis contribute to more intensified psoriatic symptoms (Itani, Arabi, Harb, Hmazeh, & Kibbi, 2016;Meziane et al, 2016 Gisondi, Del Giglio, and Di Francesco (2008) states that in the group of obese psoriatic patients treated using CsA, reduced body weight (through the use of a low-calorie diet) improves response to the medicine.…”

Section: Discussionmentioning

confidence: 99%

The impact of diabetes and metabolic syndromes to the effectiveness of cyclosporine a pharmacotherapy in psoriatic patients

Michalska-Bańkowska

Grabarek

Wcisło‐Dziadecka

et al. 2019

Dermatologic Therapy

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Metabolic diseases concurrent with psoriasis may considerably affect the intensity of its symptoms and therapy efficacy. Cyclosporine A (CsA) is one of the medicines used in conventional therapy of psoriasis. The aim of the study was to determine whether Diabetes 2 and metabolic syndromes influence the efficacy of the CsA therapy in psoriatic patients. The sample group was composed of 32 patients with diagnosed moderate to severe forms of psoriasis vulgaris. The group was divided into subgroups, with regard to concurrently occurring Diabetes 2 and metabolic syndromes. The subgroups were composed of as follows: with diabetes—7 patients, without diabetes—25, with metabolic syndrome—15, without concurrent metabolic syndrome—17, with a metabolic syndrome without diabetes—8 and with both a metabolic syndrome and diabetes—7 patients. The efficacy of therapy was evaluated in each subgroup on the basis of the following scales: PASI, BSA, DLQI on the day of therapy commencing, after 42 and 84 days of the CsA therapy. The statistical analysis was performed with the use of STATISICA 12 (Cracow, Poland; p < .05). The following tests were used: The ANOVA Friedeman test, the posthoc test for ANOVA Friedeman test, the Mann–Whitney U test. We observed clinical improvement measured with PASI BSA scales in each subgroup. The patients themselves also reported improved comfort in their lives, which is confirmed by the lower score in the DLQI scale after 42 and 84 days of the pharmacotherapy. Differences in the values of each scale in a given subgroup turned to be statistically significant. The biggest differences occur after the first 42 days of therapy and they last in the later period of observations. We did not determine any statistically significant differences as a response to treatment in the subgroups subject to comparison. Diabetes and a metabolic syndrome concurrent with psoriasis vulgaris do not affect the efficacy of CsA therapy, which indicates no necessity to modify the standard dosage of the medicine and therapy regime.

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“…Many of these studies were looking for biomarkers of disease – for example, TNF-α, IL-6, IL-8, IL-17A, soluble TNF receptors-1, and lipocalin 2 5,6. Meziane et al reported that abdominal obesity and dyslipidemia were metabolic factors significantly related to psoriasis, and hypertension, diabetes, increased levels of triglycerides, and high-density lipoprotein cholesterol were associated with the severity of psoriasis in Moroccan patients with psoriasis 7. However, so far there has been no specific research into detailed systemic abnormalities in psoriatic patients.…”

Section: Introductionmentioning

confidence: 99%

Systemic abnormalities of psoriatic patients: a retrospective study

Yin

et al. 2016

CCID

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BackgroundPsoriasis is a chronic immune-mediated inflammatory disease related to the metabolic syndrome, cardiovascular disease, and other comorbidities. However, so far there has been no specific research concerning systemic abnormalities in psoriatic patients.ObjectiveA retrospective study was conducted focusing on the detailed systemic abnormalities in psoriatic patients.MethodsPsoriatic inpatients data was collected from July 2009 to September 2015. The inclusion criteria were first-time hospitalization and without administration of systemic drug therapy or exposure to phototherapy for psoriasis for at least 1 month. Detailed systemic indexes were mainly evaluated.ResultsThe abnormality rates of blood routine examination, urine examination, blood biochemical examination and chest X-ray of 43 psoriatic patients were significantly higher than those of 44 non-psoriasis controls, and psoriasis patients significantly had higher absolute values of leukocytes and neutrophils, and significantly lower values of lymphocytes. Compared with psoriasis vulgaris, erythrodermic psoriasis had significantly higher abnormality rates of blood biochemical examination and serum electrolyte analysis. Erythrodermic psoriasis had significantly higher absolute values of blood leukocytes, neutrophils, and lower serum calcium compared with those of psoriasis vulgaris. The neutrophil-to-lymphocyte ratio of controls was significantly lower than that of psoriatic patients, and neutrophil-to-lymphocyte ratio of erythrodermic psoriasis was significantly higher in comparison with psoriasis vulgaris.ConclusionThis study is the first report in relation to a detailed assessment of systemic abnormalities in psoriatic patients prior to onset of systemic treatment. The systemic condition of psoriatic patients should be observed by clinicians before systemic therapy.

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Metabolic syndrome in Moroccan patients with psoriasis

Abstract: Metabolic syndrome is an important comorbidity in patients with psoriasis, and vigilance and enhanced screening may be important in this population, especially patients with severe disease.

Cited by 28 publications

References 25 publications

Lymphopenia and CD4+/CD8+ Cell Reduction under Fumaric Acid Esters

Lymphopenia and CD4+/CD8+ Cell Reduction under Fumaric Acid Esters

The impact of diabetes and metabolic syndromes to the effectiveness of cyclosporine a pharmacotherapy in psoriatic patients

Systemic abnormalities of psoriatic patients: a retrospective study

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