title: Body mass index in patients with moderate-to-severe psoriasis in Spain and its impact as an independent risk factor for therapy withdrawal: results of the Biobadaderm Registry.
abstract: BACKGROUND
  There are few data on the prevalence of obesity in the general psoriasis population and on the real impact of obesity on the management of psoriasis patients in the clinical setting.
  
  
  OBJECTIVE
  To evaluate the prevalence of overweight and obesity in patients with moderate-to-severe psoriasis compared to the general population and to assess the relationship between Body Mass Index (BMI) and the risk of discontinuing treatment.
  
  
  METHODS
  Patients registered on Biobadaderm, a prospective registry, were grouped according the different categories of BMI and compared to the general Spanish population. Drug survival was analysed considering only drug withdrawal due to lack of effectiveness, remission and adverse events.
  
  
  RESULTS
  A total of 1162 moderate-to-severe psoriasis patients on systemic conventional or biological treatment were recruited. The prevalence of obesity was found to be significantly higher in psoriasis patients than in the general Spanish population (P < 0.001). In multivariate analysis a 5-unit increase in BMI, similar to a change in BMI category from normal weight to overweight and from overweight to obesity, was associated with a 12% increased risk of discontinuing therapy due to lack of effectiveness (HR 1.12, 95% CI: 1.01-1.24) and with a 17% increased risk of having an adverse event (HR 1.17, 95% CI: 1.02-1.36), both independently of the drug used.
  
  
  CONCLUSIONS
  Patients with moderate-to-severe psoriasis had a higher prevalence of obesity than the general population. Increased BMI was associated with an increased risk of treatment discontinuation due to lack of effectiveness and a higher risk of adverse events.
authors.affiliation: Hospital Universitari Germans Trías i Pujol, Badalona, Universitat Autònoma de Barcelona, Barcelona.
authors.forename: J M
authors.initials: JM
authors.lastname: Carrascosa
authors.forename: M
authors.initials: M
authors.lastname: Vilavella
authors.forename: I
authors.initials: I
authors.lastname: Garcia-Doval
authors.forename: G
authors.initials: G
authors.lastname: Carretero
authors.forename: F
authors.initials: F
authors.lastname: Vanaclocha
authors.forename: E
authors.initials: E
authors.lastname: Daudén
authors.forename: F J
authors.initials: FJ
authors.lastname: Gómez-García
authors.forename: E
authors.initials: E
authors.lastname: Herrera-Ceballos
authors.forename: P
authors.initials: P
authors.lastname: De la Cueva Dobao
authors.forename: I
authors.initials: I
authors.lastname: Belinchón
authors.forename: J L
authors.initials: JL
authors.lastname: Sánchez-Carazo
authors.forename: M
authors.initials: M
authors.lastname: Alsina
authors.forename: J L
authors.initials: JL
authors.lastname: López-Estebaranz
authors.forename: M
authors.initials: M
authors.lastname: Ferrán
authors.forename: F
authors.initials: F
authors.lastname: Peral
authors.forename: R
authors.initials: R
authors.lastname: Torrado
authors.forename: R
authors.initials: R
authors.lastname: Rivera
authors.forename: R
authors.initials: R
authors.lastname: Jiménez-Puya
authors.forename: M V
authors.initials: MV
authors.lastname: Mendiola
authors.forename: C
authors.initials: C
authors.lastname: Ferrándiz
mesh_terms: D001688:Biological Products / Q000009:adverse effects* / Q000627:therapeutic use*; D015992:Body Mass Index; D015897:Comorbidity; D006801:Humans; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000453:epidemiology*; D050177:Overweight / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy* / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D001688:Biological Products