Impact of body mass index and obesity on clinical response to systemic treatment for psoriasis. Evidence from the Psocare project.
OBJECTIVE
Our aim was to assess the role of the body mass index (BMI) in the clinical response to systemic treatment for psoriasis.


METHODS
A nationwide cohort study of patients receiving a new systemic treatment for plaque psoriasis at reference centres in Italy was conducted. Information was gathered through a web-based electronic form. Patients being maintained on the same medication and with data available at 8 and 16 weeks by March 31, 2007, were eligible. The outcome was a reduction in the Psoriasis Area Severity Index (PASI) of at least 75% at follow-up compared to baseline (PASI-75).


RESULTS
Out of 8,072 patients enrolled, 2,368 were eligible and analysable at 8 weeks and 2,042 at 16 weeks. PASI-75 was achieved by 819 patients (34.5%) at 8 weeks and 1,034 (50.6%) at 16 weeks. The proportion steadily decreased with increased values of BMI. Compared to normal weight (BMI = 20-24) the adjusted odds ratio for achieving PASI-75 in obese patients was 0.73 (95% CI = 0.58-0.93) at 8 weeks and 0.62 (95% CI = 0.49-0.79) at 16 weeks. The impact of the BMI did not show remarkable variations according to the drug prescribed at entry.


CONCLUSIONS
The BMI affects the early clinical response to systemic treatment for psoriasis.
Naldi
Luigi
L
GISED Study Centre, Ospedali Riuniti, Bergamo, Italy. luigi.naldi@gised.it
Addis
Antonio
A
Chimenti
Sergio
S
Giannetti
Alberto
A
Picardo
Mauro
M
Tomino
Carlo
C
Maccarone
Mara
M
Chatenoud
Liliane
L
Bertuccio
Paola
P
Caggese
Eugenia
E
Cuscito
Rosanna
R
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020407:Internet; D007558:Italy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome