The effect of weight reduction on treatment outcomes in obese patients with psoriasis on biologic therapy: a randomized controlled prospective trial

Al-Mutairi, Nawaf; Nour, Tarek

doi:10.1517/14712598.2014.900541

Cited by 120 publications

(128 citation statements)

References 45 publications

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“…There are potential reasons to explain why drug discontinuation due to ineffectiveness is higher in obese patients, such as lower blood drug levels, higher body surface area or an increase in proinflammatory cytokines from adipose tissue, which are thought to interfere with drug therapy . One randomized controlled trial showed that weight reduction in patients yielded improved Psoriasis Area and Severity Index scores . Moreover, a retrospective cohort study demonstrated that obesity was independently associated with biologic treatment failure in biologic‐treated patients with ulcerative colitis .…”

Section: Discussionmentioning

confidence: 99%

Factors predicting persistence of biologic drugs in psoriasis: a systematic review and meta‐analysis

et al. 2019

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Summary Background Long‐term therapy for psoriasis is impaired by gradual loss of effectiveness and treatment discontinuation. Identifying factors that affect biologic drug survival may help in treatment optimization. Objectives To identify factors that predicted biologic drug persistence or discontinuation in a real‐life setting. Methods We identified studies of biologic persistence in psoriasis through a comprehensive, systematic literature search using predefined search criteria. Studies were screened by title and abstract then further by full‐text review. Hazard ratio (HR) data were extracted for all available predictive factors (HRs > 1 denoted biologic discontinuation, and HRs < 1 denoted biologic persistence). A meta‐analysis of HRs (random‐effects model) was used to assess any predictive factor included in at least two studies. Results Sixteen cohort studies were included in the review, with a total of 32 194 patients. A meta‐analysis was performed on 13 studies (n = 29 802): nine for female sex (n = 28 090), six for obesity (n = 9311) and six for psoriatic arthritis (n = 24 444). Obesity and female sex predicted treatment discontinuation, with HRs of 1.21 [95% confidence interval (CI) 1.10–1.32, I2 = 0%] and 1.22 (95% CI 1.07–1.38, I2 = 84%), respectively. Concomitant psoriatic arthritis predicted biologic persistence (HR 0.83, 95% CI 0.80–0.86, I2 = 0%). Female sex predicted biologic discontinuation due to side‐effects, with a pooled HR of 2.16 (95% CI 1.39–3.35, I2 = 67%). Other reported predictive factors (smoking, metabolic syndrome, biologic naivety, age, Dermatology Life Quality Index, dyslipidaemia, high socioeconomic status and concomitant methotrexate) were insufficiently reported for meta‐analysis. Conclusions Our meta‐analysis demonstrates that female sex and obesity predict biologic discontinuation, and concomitant psoriatic arthritis predicts biologic survival. What's already known about this topic? Ineffectiveness is the main factor that causes drug discontinuation during long‐term treatment of psoriasis. It is unclear which factors and comorbidities impact drug persistence. What does this study add? Female sex and obesity predict biologic discontinuation due to ineffectiveness and adverse events. Concomitant psoriatic arthritis is associated with improved drug persistence.

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Section: Discussionmentioning

confidence: 99%

Factors predicting persistence of biologic drugs in psoriasis: a systematic review and meta‐analysis

et al. 2019

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“…Indeed, a recently performed randomized controlled trial showed a positive effect of a diet–exercise combination over an information‐only strategy on psoriasis severity in patients with psoriasis who were being treated with systemic agents such as biologics . In another randomized trial, psoriasis severity was significantly lower in the diet group than in the control group at 24 weeks of biological treatment …”

Section: Discussionmentioning

confidence: 99%

Body mass index predicts discontinuation due to ineffectiveness and female sex predicts discontinuation due to side-effects in patients with psoriasis treated with adalimumab, etanercept or ustekinumab in daily practice: a prospective, comparative, long-t

Zweegers¹,

Reek²,

Kerkhof³

et al. 2016

Br J Dermatol

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“…Importantly, weight loss may improve response to biologic therapy as suggested by a single RCT evaluating the effect of weight reduction by diet modification on treatment efficacy among obese psoriasis patients on adalimumab, etanercept, infliximab, or ustekinumab. 35 Another similarly designed RCT also found improved response to treatment with low-dose cyclosporine among obese psoriasis patients randomized to a low-calorie versus normal diet. 36 While weight has not been found to have an effect on response to treatment with methotrexate, one single center study suggests that obese psoriasis patients are more likely to experience loss of response to methotrexate than non-obese patients.…”

Section: Cardiometabolic Diseasementioning

confidence: 97%

Psoriasis and comorbid diseases

Takeshita

Grewal

Langan

et al. 2017

Journal of the American Academy of Dermatology

195

114

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As summarized in Part I of this continuing medical education article, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel diseases, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis. The clinical implications of the comorbid diseases that are associated with psoriasis and recommendations for clinical management are reviewed in this section.

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The effect of weight reduction on treatment outcomes in obese patients with psoriasis on biologic therapy: a randomized controlled prospective trial

Abstract: Body weight reduction in obese patients on biologics may increase the efficacy of the drug.

Cited by 120 publications

References 45 publications

Factors predicting persistence of biologic drugs in psoriasis: a systematic review and meta‐analysis

Factors predicting persistence of biologic drugs in psoriasis: a systematic review and meta‐analysis

Body mass index predicts discontinuation due to ineffectiveness and female sex predicts discontinuation due to side-effects in patients with psoriasis treated with adalimumab, etanercept or ustekinumab in daily practice: a prospective, comparative, long-t

Psoriasis and comorbid diseases

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