title: Ustekinumab does not increase body mass index in patients with chronic plaque psoriasis: a prospective cohort study.
abstract: BACKGROUND
  Chronic plaque psoriasis is frequently associated with metabolic disorders including obesity. Antitumour necrosis factor α treatments can induce body-weight increase in patients with psoriasis. Information on the effect of ustekinumab on body weight is not available.
  
  
  OBJECTIVE
  To investigate whether therapy with ustekinumab is associated with changes in body mass index (BMI) in patients with chronic plaque psoriasis.
  
  
  METHODS
  A prospective, multicentre study comparing the changes in BMI in two closed cohorts of patients with psoriasis during 7-month treatment with ustekinumab (n = 79) or infliximab (n = 83).
  
  
  RESULTS
  Patients treated for 7 months with infliximab showed a significant (P < 0.001) increase in mean BMI (2.1 ± 4.5%) and body weight (2.5 ± 3.3 kg) compared with patients treated with ustekinumab (0.1 ± 3.3%; 0.6 ± 1.1 kg). Some 45% of patients treated with infliximab had a BMI increase > 2%, compared with only 11% of those receiving ustekinumab (P = 0.01). In the multivariate analysis, all other clinical parameters predicted the BMI increase, except for the use of infliximab. At month 7, 96% of patients treated with infliximab and 82% of patients treated with ustekinumab achieved at least a 50% improvement from their baseline psoriasis area and severity index (PASI 50), and 69% of the infliximab group compared with 58% of the ustekinumab group achieved at least PASI 75. There was no difference in the proportion of PASI 50 and PASI 75 responders between the two groups.
  
  
  CONCLUSIONS
  In contrast to infliximab, ustekinumab does not increase BMI in patients with chronic plaque psoriasis. This difference could be taken into account in the selection of biologics when treating patients with psoriasis.
authors: Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy. paolo.gisondi@univr.it
authors: P
authors: P
authors: Gisondi
authors: A
authors: A
authors: Conti
authors: G
authors: G
authors: Galdo
authors: S
authors: S
authors: Piaserico
authors: C
authors: C
authors: De Simone
authors: G
authors: G
authors: Girolomoni
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D001688:Biological Products / Q000009:adverse effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D015331:Cohort Studies; D003879:Dermatologic Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy*; D016896:Treatment Outcome; D000069549:Ustekinumab; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D003879:Dermatologic Agents; D000069285:Infliximab; D000069549:Ustekinumab