THU0330 Obesity in psoriatic arthritis: comparative prevalence with skin psoriasis and associated factors

Abstract

BackgroundObesity (BMI ≥30 kg/m2) is a common cardiovascular risk factor in psoriatic disease1. Although the prevalence of obesity is high, the factors associated with it in psoriatic arthritis (PsA) are poorly understood.ObjectivesWe aimed to evaluate the prevalence and obesity-associated factors in patients with PsA.MethodsRetrospective cross-sectional study that included 205 consecutive patients with PsA according to CASPAR criteria. The prevalence of obesity was compared with that of 310 patients with skin psoriasis of similar age (±3 years). The factors associated with obesity were first analysed by a conditional logistic regression. The significant factors in this first model were then introduced in a multivariate model using a backward step approach (p-values<0.05 were considered significant).ResultsOne-hundred twelve men and 94 women were included, with a mean age of 53±13 years. Obesity was more prevalent among psoriatics (36.5%) compared to PsA patients (24%), OR 1.6 (1.1–2.3), p<0.05. The factors associated with obesity in the univariate analysis (p<0.05) were: onset of psoriasis >40 years (OR 2.4), onset of arthritis >40 years (OR 2.1), PsA family history (OR 3.1), polyarticular presentation (OR 1.9), axial presentation (OR 2.5), polyarticular evolution (OR 2.4), axial evolution (OR 4.2), diabetes (OR 3.6), HBP (OR 3.9), and dyslipidemia (OR 3.5). After correcting for age, sex, disease duration and other confounders, independent associations with obesity found in the multivariate model (p<0.05) were: PsA family history (OR 3.6, IC95%: 1.1–14.4), axial evolution (OR 4.4, IC95%: 1.0–22.4) and dyslipidemia (OR 3.5, IC95%: 1.5–8.6).ConclusionsObesity was more common among our patients with cutaneous psoriasis than in those with arthritis. The model that best explains obesity in this PsA series combines genetic factors (PsA family history), together with factors specific to the metabolic syndrome (dyslipidemia), with others owned to arthritis (axial evolution).Reference[1] Husni ME. Comorbidities in psoriatic arthritis. Rheum Dis Clin North Am2015;41:677–98.Disclosure of InterestNone declared

Secukinumab efficacy in patients with PsA is not dependent on patients’ body mass index

“…PsA is a chronic inflammatory arthritis burdened by a series of metabolic comorbidities. Among them, obesity is very common in PsA, with a prevalence of 27%, as confirmed by a recent Spanish work 2. Obesity in PsA has been associated with higher disease activity and a worse effectiveness of biologic treatment in PsA.…”

“…As far as we are concerned, these are the first data about clinical response to secukinumab in obese patients with PsA. Obesity has been shown to promote the expansion of IL-17-producing T cells in adipose and peripheral tissues 6. In addition, in patients affected by metabolic syndrome, the levels of IL-17R expression in the liver or muscles are correlated with insulin resistance 6.…”

“…Obesity has been shown to promote the expansion of IL-17-producing T cells in adipose and peripheral tissues 6. In addition, in patients affected by metabolic syndrome, the levels of IL-17R expression in the liver or muscles are correlated with insulin resistance 6. Our results support the relevance of IL-17 in driving systemic inflammation in obese patients with PsA, also providing evidence that obese patients may have a better response to secukinumab compared with non-obese patients.…”

The Impact of Comorbidity on Patient-Reported Outcomes in Psoriatic Arthritis: A Systematic Literature Review

“…In summary, there is sufficient evidence demonstrating the high prevalence of comorbidity [2,4,5] in patients with PsA and its impact on outcome measures, treatment response and clinical decision-making [6,[9][10][11][12][13]. A number of studies have also highlighted that comorbidity clearly impairs function and quality of life in PsA patients.…”

“…It has been reported that more than half of patients with PsA have at least one comorbidity [2,3]. The most prevalent comorbidities associated with PsA are cardiovascular disease, metabolic syndrome, depression and anxiety, osteoporosis, ophthalmic, liver, kidney and inflammatory bowel disease [2,4,5].…”