Psoriasis Treatment Response: It’s Relation to Comorbid Obesity and Diabetes

Psoriasis is a skin disease that is associated with comorbid systemic metabolic issues. That is why this study in the Journal of the American Academy of Dermatologyassessed the possible association of comorbid obesity, history of diabetes, hypertension, and hyperlipidemia with response to biologic treatment at 6 months among patients in the CorEvitas' Psoriasis Registry.

There were 2,924 patients included in the data set. These patients were starting biologic therapy of tumor necrosis factor inhibitors [TNFi], interleukin [IL]-17i, IL-12/23i, or IL-23i for psoriasis with baseline and 6-month follow-up visits available for inclusion. Logistic regressions resulted in adjusted odd ratios (OR) and 95% confidence intervals (CI) for achievement of response in select outcomes for those with obesity and history of diabetes, hypertension, and hyperlipidemia relative to those without each, the article explained.

It was found obesity decreased the odds of achieving Psoriasis Area and Severity Index (PASI)75 (OR, 0.75; 95% CI, 0.64-0.88) and PASI90 (OR, 0.70; 95% CI, 0.59-0.81) by 25%-30%. A history of diabetes reduced odds of achieving PASI75 by 31% (OR, 0.69; 95% CI, 0.56-0.85) and PASI90 by 21% (OR, 0.79; 95% CI, 0.63-0.98).

Also, obesity was associated with lower response to TNFi and IL-17i classes and diabetes was associated with poorer outcomes when on IL-17i therapy and hypertension, to a lesser extent, when on the TNFi class. No significant associations were found in the hyperlipidemia group. Thought the study was limited by only examining short-term effectiveness and small sample sizes, affecting the power to detect differences.

“Assessment of comorbid disease burden is important for improved likelihoods of achieving treatment response with biologics,” the authors concluded.

Reference:

Enos CW, Ramos VL, McLean RR, et al. Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: A prospective analysis in Corrona Psoriasis Registry. Journal of the American Academy of Dermatology. 2022;86(1):68-76. doi:10.1016/j.jaad.2021.06.883