Prospective assessment of body weight and body composition changes in patients with psoriasis receiving anti-TNF-α treatment

Abstract

Tumor necrosis factor (TNF)-a is a pro-inflammatory cytokine associated with psoriasis pathogenesis. Anti-TNF-a therapies are effective in psoriasis. A significant weight gain has been reported in patients treated with anti-TNF-a agents. The aim of the present study was to evaluate the body composition changes in psoriatic patients receiving anti-TNF-a therapies according with disease phenotype. Forty patients affected with psoriasis were followed up for 24 weeks and divided into two groups: psoriasis vulgaris (PsO) and psoriatic arthritis (PsA). Anthropometric, blood biochemical, body composition parameters, resting metabolic rate, and disease activity indexes were measured at baseline and at week 24. After 24 weeks of anti-TNF-a administration, the disease activity indexes and concentration of inflammatory markers were significantly decreased. Seventy-five percent of PsO and 60% of PsA patients had an increase in body weight. Weight changes correlated with fat mass gain in the PsO group, and with fat and lean mass gain in the PsA group. In the present study, we demonstrated that a blockage of TNF-a bioactivity is related with fat and lean mass gain in both PsO and PsA subjects. The anti-TNF-a therapies could play a key role in the cross talk between adipose tissue and skeletal muscle, mediated by the reduction of TNF-a and interleukin-6 production.

Crosstalk between skin inflammation and adipose tissue-derived products: pathogenic evidence linking psoriasis to increased adiposity

“…This evidence may, at least partially, give reason of (i) the enhanced TNF-α levels detected in obese subjects, with putative protective function; (ii) the body weight increase observed in psoriatic patients undergoing treatment with TNF-α inhibitors or other antipsoriatic agents decreasing TNF-α expression levels [56,[70][71][72]. However, data on TNF-α role in increased adiposity are controversial as it may also contribute to obesity counteracting insulin receptor activity and inhibiting glucose transporter (GLUT)-4, with a consequent enhancement of insulin levels that stimulates the hunger center [68].…”

The impact of obesity on psoriasis

“…Wiąże się to z zablokowaniem działania TNF-α, który ma właściwości prokachektyczne (dawna nazwa tej cytokiny to kachektyna). Tego efektu nie obserwuje się u pacjentów leczonych przewlekle metotreksatem [30,31]. Ostatnio opublikowano ciekawą pracę, w której analizowano wpływ terapii ustekinumabem na masę ciała u 11 pacjentów.…”

Systemic therapy of psoriasis in diabetic patients

“…A body weight gain could occur in patients treated with TNF-α antagonists [47,48]. Weight changes are induced mainly by fat mass gain in patients with psoriasis receiving TNF-alpha antagonists [47].…”

“…Weight changes are induced mainly by fat mass gain in patients with psoriasis receiving TNF-alpha antagonists [47]. Ustekinumab is not associated with weight gain in patients with chronic plaque psoriasis [49].…”