Changes in metabolic parameters in psoriatic patients treated with secukinumab

Abstract

Background: Psoriasis is associated with cardiovascular disease and metabolic syndrome but the effects of interleukin (IL)-17A inhibitor treatment on metabolic parameters are unknown. This study aimed to determine the effects of secukinumab on metabolic parameters based on the disease activity and treatment response in patients with psoriasis. Methods: In this retrospective study, we included 99 patients with moderate to severe psoriasis, who received IL-17 inhibitor (secukinumab) treatment for 24 weeks between January 2016 and February 2020. The disease activity [Psoriasis Area and Severity Index (PASI)] and metabolic parameters at baseline and after 12 or 24 weeks of treatment were collected. Results: The PASI improved with a significant reduction of high-sensitivity C-reactive protein (hs-CRP) at weeks 12 and 24 respectively. However, body weight and body mass index were significantly increased at week 12 and 24 of treatment. Triglycerides level and atherogenic index of plasma were significantly higher in week 24 in PASI-90 non-responders. The baseline hs-CRP level and PASI-90 non-response correlated with elevated triglyceride levels. Conclusion: Our results suggest that obesity and hypertriglyceridemia still existed in patients despite the improved disease activity after secukinumab treatment. Higher baseline hs-CRP level and PASI-90 non-response were predictors for elevated triglyceride levels after treatment. Therefore, patient education, regular screening of the lipid profile, and weight control are recommended during the treatment of secukinumab.

Depression and Obesity in Patients With Psoriasis and Psoriatic Arthritis: Is IL-17-Mediated Immune Dysregulation the Connecting Link?

“…However, a recent study failed no correlation between body mass index and IL-17 expression in 95 patients with depression ( 85 ) and secukinumab-induced skin remission in patients with Ps does not reduce body weight after 12 or 24 weeks of treatment ( 86 ). A phase 4 randomized, multi-centre, open label, parallel group, active comparator-controlled study with a duration of 28 weeks and a 28 week extension phase (MEDABOLYX, NCT03440736) recruits patients in an attempt to assess whether secukinumab with lifestyle intervention can improve both skin symptomatology and cardiometabolic status compared to secukinumab alone.…”

Anti-Interleukin-17 Therapy of Severe Psoriatic Patients Results in an Improvement of Serum Lipid and Inflammatory Parameters’ Levels, but Has No Effect on Body Composition Parameters

“…In the case of the baseline HDLcholesterol levels, values higher than ours were only found in the UNCOVER studies. The highest baseline LDL-cholesterol values were measured in our study compared to the others [31][32][33][34]. Moreover, 60% of our study population was obese.…”

“…In the secukinumab group, significant changes were not observed in the parameters, and in the methotrexate group, a significant increase was observed in liver enzymes [32]. In a retrospective study, Wang et al examined the effect of secukinumab on 99 psoriatic patients during a 24-week treatment and found that hs-CRP was significantly reduced, while body weight and BMI were significantly increased at week 24 [33]. In the UNCOVER studies, significant changes were not observed in body weight or serum lipid and glucose parameters after 60 weeks [34].…”

Biologic Treatment in Combination with Lifestyle Intervention in Moderate to Severe Plaque Psoriasis and Concomitant Metabolic Syndrome: Rationale and Methodology of the METABOLyx Randomized Controlled Clinical Trial

“…Secukinumab is shown to reduce systemic inflammation as measured by hsCRP [ 33 ] and was also found to potentially reduce cardiovascular risk, as assessed by flow-medicated dilation, a measure of endothelial function [ 37 ]. However, a study of treatment with secukinumab showed that hypertriglyceridemia was still present in patients despite improved psoriatic disease activity after secukinumab treatment [ 38 ].…”

“…These previous analyses suggest that treating skin inflammation alone is not sufficient in psoriasis patients with concomitant metabolic syndrome. A treatment approach focused solely on the skin does not address obesity and metabolic factors as significant sources of systemic inflammation, with clinical consequences including high levels of systemic inflammation, lower treatment efficacy for the skin, higher chance of relapse, and higher cardiometabolic risk [ 33 , 34 , 38 ]. The evidence indicates an opportunity for a holistic treatment strategy for psoriasis patients with metabolic comorbidities, one that addresses skin and joint manifestations, but that also targets metabolic diseases and the inflammation associated with them.…”