title: Impact of body mass index on retention rates of anti-TNF-alfa drugs in daily practice for psoriasis.
abstract: BACKGROUND
  Psoriasis is a chronic inflammatory skin disease which often requires life-long treatment.
  
  
  OBJECTIVE
  Our objective was to assess the role of the body mass index (BMI) on the retention rates of anti-TNF-alfa therapies in patients with moderate to severe plaque psoriasis.
  
  
  METHODS
  Retrospective observational study of psoriasis patients included in local databases of three public Italian hospitals. All patients, who received anti-TNF-alfa treatment in referral centers, were included. Only patients with at least 1-year follow-up were considered eligible. The outcome was the conservation of the treatment at 1 and 2 years of follow-up.
  
  
  RESULTS
  194 patients were enrolled. 307 treatment courses with a minimum follow-up of 12 months and 263 with a follow-up of 24 months were analyzed. The proportion of patients receiving the same treatment at months 12 and 24 was 67.43% and 42.21%, respectively. The proportion steadily decreased with increased values of BMI.
  
  
  CONCLUSIONS
  The overall efficacy of TNF-alfa inhibitors diminishes with time. The BMI affects the long-term survival rate of anti-TNF-alfa in psoriatic patients. A high BMI can be considered a potential predictor of drug discontinuation.
authors.affiliation: Operative Units of Dermatology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. vito.dilernia@asmn.re.it
authors.forename: Vito
authors.initials: V
authors.lastname: Di Lernia
authors.forename: Laura
authors.initials: L
authors.lastname: Tasin
authors.forename: Riccardo
authors.initials: R
authors.lastname: Pellicano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zumiani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Albertini
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D028761:Withholding Treatment
chemical_list: D003879:Dermatologic Agents; D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha