Body mass does not affect the remission of psoriatic arthritis patients on anti-TNF-α therapy

Iannone, Florenzo; Fanizzi, Rosalinda; Scioscia, Crescenzio; Anelli, Maria Grazia; Lapadula, Giovanni

doi:10.3109/03009742.2012.715186

Cited by 31 publications

(34 citation statements)

References 13 publications

(12 reference statements)

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“…Interestingly, a significant difference was also found in eight studies [17–19, 29–33] in which researchers reported data on overweight patients and showed a significantly lower prevalence of MDA achievement in the 1579 overweight patients (297 with PsA and 1282 with RA) than in the 1794 normal-weight subjects (OR 0.867, 95% CI 0.757–0.994, p = 0.041, I 2 = 64%, p = 0.007) (Fig. 2).…”

Section: Resultsmentioning

confidence: 57%

“…All the included studies stratified the study population according to the presence of obesity. In addition, eight studies [17–19, 29–33] also reported data on overweight patients.…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Table 2, 10 of the 17 studies [18, 25–29, 31–34] included in our meta-analysis enrolled patients with RA, whereas the remaining 7 [7, 15–17, 19, 24, 30] examined patients with PsA. Overall, the studies on patients with RA comprised a total of 3849 patients, including 1122 obese subjects compared and 2727 normal-weight control subjects.…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, immune-mediated inflammation may act synergistically with obesity-mediated inflammatory status and may influence disease activity in rheumatic diseases [13, 15, 16]. Some studies [17] suggested that obese patients with rheumatic diseases exhibit a lower rate of low disease activity achievement during treatment with antirheumatic drugs. However, these results were challenged and not confirmed by other studies [18, 19].…”

Section: Introductionmentioning

confidence: 99%

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Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis

et al. 2016

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BackgroundIn this study, we evaluated the impact of obesity and/or overweight on the achievement of minimal disease activity (MDA) in patients with psoriatic arthritis (PsA) and patients with rheumatoid arthritis (RA) receiving an anti-rheumatic treatment. Obesity can be considered a low-grade, chronic systemic inflammatory disease and some studies suggested that obese patients with rheumatic diseases exhibit a lower rate of low disease activity achievement during treatment with anti-rheumatic drugs.MethodsA systematic search was performed in major electronic databases (PubMed, Web of Science, Scopus, Embase) to identify studies reporting MDA achievement in obese and/or overweight patients with RA or PsA and in normal-weight RA or PsA control subjects. Results were expressed as Odds Ratios (ORs) with pertinent 95% Confidence Intervals (95%CIs).ResultsWe included 17 studies (10 on RA and 7 on PsA) comprising a total of 6693 patients (1562 with PsA and 5131 with RA) in the analysis. The MDA achievement rate was significantly lower in obese patients than in normal-weight subjects (OR 0.447, 95% CI 0.346–0.577, p < 0.001, I 2 = 62.6%, p < 0.001). Similarly, overweight patients showed a significantly lower prevalence of MDA achievement than normal-weight subjects (OR 0.867, 95% CI 0.757–0.994, p = 0.041, I 2 = 64%, p = 0.007). Interestingly, the effect of obesity on MDA was confirmed when we separately analyzed data on patients with RA and patients with PsA. In contrast, when we evaluated the effect of overweight, our results were confirmed for PsA but not for RA. A meta-regression analysis showed that follow-up duration, age, male sex, and treatment duration are covariates significantly affecting the effect of obesity/overweight on MDA achievement.ConclusionsThe results of our meta-analysis suggest that obesity and overweight reduce the chances to achieve MDA in patients with rheumatic diseases receiving treatment with traditional or biologic disease-modifying antirheumatic drugs.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-016-1194-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 57%

“…All the included studies stratified the study population according to the presence of obesity. In addition, eight studies [17–19, 29–33] also reported data on overweight patients.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis

et al. 2016

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“…In addition to being a risk factor for PsA, obesity may also adversely impact the efficacy of tumour necrosis factor (TNF) inhibitors in decreasing disease activity in PsA, although the evidence is inconclusive (17,18). A potential mechanism for these hypothesized effects of obesity is the release of adipokines (including TNF) by fat cells (19).…”

Section: Risk Factorsmentioning

confidence: 99%

Current Concepts in Psoriatic Arthritis: Pathogenesis and Management

Vlam¹,

Gottlieb²,

Mease³

2014

Acta Derm Venerol

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Psoriatic arthritis occurs in a subset of psoriasis patients and is therefore commonly encountered in dermatology practice. Although its exact pathogenesis is unknown, psoriatic arthritis is thought to share common mechanisms with psoriatic skin symptoms. Innate and adaptive immune responses are abnormally activated in psoriasis and may acquire the ability to attack peripheral joints and other sites following an environmental trigger (e.g. mechanical stress, trauma, infection) in genetically susceptible patients. The increased cardiovascular risk inherent in psoriasis appears further enhanced in psoriatic arthritis, likely reflecting the overall burden of systemic inflammation contributing to atherogenic processes. Basic research and clinical trials have suggested that tumour necrosis factor is important in psoriatic arthritis pathophysiology, and accumulating evidence suggests that Th17 cells and interleukin-17A may also be important. Basic research and clinical trials inform our understanding of psoriatic arthritis pathophysiology and, in turn, help dermatologists to make better treatment decisions.

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Impact of obesity on the efficacy of ustekinumab in Japanese patients with psoriasis: a retrospective cohort study of 111 patients

et al. 2014

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Obesity is thought to be involved in the pathogenesis of psoriasis, although its impact on the therapeutic response to systemic treatments remains unclear. The aim of this study was to examine the association of body mass index (BMI) with the efficacy of ustekinumab in Japanese patients with psoriasis. Clinical data from a cohort of 111 Japanese patients treated with ustekinumab 45 mg between July 2011 and March 2014 were retrospectively evaluated. The measured outcome was improvement in the psoriasis area and severity index (PASI) score at week 16. Patients with BMI ≥ 25 and BMI < 25 had comparable rates of ≥50 and 75 % improvement in PASI (PASI-50 and PASI-75, respectively), whereas patients with BMI ≥ 25 had significantly lower PASI-90 and PASI-100 response rates. Patients with BMI ≥ 25 also showed significantly lower percent reduction in PASI than those with BMI < 25 at week 16 (85 vs. 74 %, P < 0.004). BMI was negatively correlated with percent reduction in PASI, whereas body weight was not. These results show that a higher BMI, but not body weight, is associated with lower effectiveness of ustekinumab for psoriasis. BMI ≥ 25 could therefore be a negative predictor of achieving PASI-90 and PASI-100 in patients with psoriasis when starting ustekinumab.

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Body mass does not affect the remission of psoriatic arthritis patients on anti-TNF-α therapy

Abstract: In our retrospective analysis, disease activity and clinical response to anti-TNF-α therapy in PsA do not seem to be affected by BMI. Further prospective studies are needed to confirm these preliminary results.

Cited by 31 publications

References 13 publications

Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis

Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis

Current Concepts in Psoriatic Arthritis: Pathogenesis and Management

Impact of obesity on the efficacy of ustekinumab in Japanese patients with psoriasis: a retrospective cohort study of 111 patients

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