Effects of biologic drug therapy on body weight, appetite, and blood lipid profile in patients with psoriasis

Abstract

Obesity and dyslipidemia are frequently observed in patients with psoriasis. This study aimed to evaluate the effects of biological therapy on body weight (BW), body mass index (BMI), appetite, and blood lipid profiles in patients with psoriasis. A total of 83 patients receiving biologic therapy (n=44) [anti-tumor necrosis factor alpha (anti-TNFα) (n=5), interleukin (IL)-12/23 inhibitor (n=13), IL-17 inhibitor (n=20), and IL-23 inhibitor (n=6)] and conventional therapy (n=39) [methotrexate (MTX) (n=25) and acitretin (n=14)] were included in the study. The patient’s baseline and current BW, BMI, waist circumference, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), plasma triglyceride values, and Psoriasis Area and Severity Index (PASI) were retrospectively screened. Appetite was assessed with the Simplified Nutritional Appetite Questionnaire (SNAQ). The mean BW percent change values were found to increase by 2.40±2.30 kg, 2.38±4.13 kg, and 0.40±3.47 kg in patients taking anti-TNFα, IL-12/23 inhibitor, and IL-17 inhibitor agents, respectively, decrease by -0.60±0.89 kg in those receiving an IL-23 inhibitor; increase by 0.52±3.40 kg and 1.38±2.79 kg in those receiving MTX and acitretin, respectively. The triglyceride percent change rates increased with MTX (27.46±52.87 mg/dl) (p=0.029). Anti-TNFα and ixekizumab increased HDL percent change rates (21.44±20.99 mg/dl and 24.4±35.40 mg/dl, respectively) (p=0.044 and p=0.005). Although the SNAQ scores were similar in patients using conventional and biological drugs, a negative correlation was observed between the SNAQ scores and the PASI change (p=0.049, r=-0.221). In addition, an increase in BMI had a negative correlation with the PASI change (p=0.01, r=-0.282). Anti-TNFα and IL-12-23 inhibitors increased BW. While MTX increased triglyceride levels, anti-TNFα and ixekizumab increased HDL levels. In the treatment of psoriasis, the presence of obesity and blood lipid profiles should be considered in the selection of the appropriate treatment for each patient.