Anti-tumour necrosis factor-alpha therapy increases body weight in patients with chronic plaque psoriasis: a retrospective cohort study.
BACKGROUND Chronic plaque psoriasis is associated with overweight or obesity. Anti-tumour necrosis factor-alpha (anti-TNF-alpha) treatments are now frequently used in psoriasis management. TNF-alpha is deeply involved in body weight homeostasis, which may be affected by TNF-alpha-targeted therapy.


OBJECTIVE
To investigate whether anti-TNF-alpha treatments is associated with changes in body weight in patients with chronic plaque psoriasis.


METHODS
We performed a retrospective controlled analysis comparing the variations in body weight and body mass index (BMI) in three closed cohorts of psoriatic patients during a 6-month treatment with etanercept (N = 58), infliximab (N = 40) or methotrexate (N = 43).


RESULTS
We observed a body weight increment of 1.5 +/- 2.7 kg (mean +/- SD; P = 0.0002) and 2.5 +/- 3.3 kg (P = 0.004) in patients treated with etanercept and infliximab, respectively. In contrast, a non-significant change (0.6 +/- 1.4 kg; P = 0.4) was measured in patients treated with methotrexate. The BMI increased with 0.5 +/- 0.5 (P = 0.01) and 0.8 +/- 1 (P = 0.003) points in patients treated with etanercept and infliximab, respectively, whereas it did not change (< 0.2 +/- 0.5; P = 0.06) in patients treated with methotrexate. About one fourth of patients experienced a 4- to 10-kg weight gain. Differences in body weight variations among patients treated with anti-TNF-alpha therapies and methotrexate were statistically significant (P = 0.0005). We could not identify clinical parameters predicting this phenomenon.


CONCLUSIONS
Patients with psoriasis treated with long-term anti-TNF-alpha therapies may manifest a body weight gain. This effect should be taken into account in the global approach to patients with psoriasis.
Gisondi
P
P
Section of Dermatology, Department of Biomedical and Surgical Science, University of Verona, Verona, Italy. paolo.gisondi@univr.it
Cotena
C
C
Tessari
G
G
Girolomoni
G
G
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000494:pharmacology* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015992:Body Mass Index; D002908:Chronic Disease; D015331:Cohort Studies; D000068800:Etanercept; D005260:Female; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects* / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000503:physiopathology*; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012189:Retrospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D015430:Weight Gain / Q000187:drug effects*
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept; D008727:Methotrexate