TNF Inhibitors Linked to Higher Weight, BMI in Psoriasis Patients

By Anne Harding

August 20, 2019

NEW YORK (Reuters Health) - Biologic therapies - particularly tumor necrosis factor inhibitors (TNFi) - are associated with increases in body weight (BW) and BMI in psoriasis patients, according to a new systematic review.

"However, based on current limited evidence, there were no similar changes in BW and BMI in the use of biologics targeting interleukin (IL)-12/23 and IL-17, i.e. ustekinumab and secukinumab," Dr. Ching-Chi Chi and Dr. Ming-Ying Wu of Chang Gung Memorial Hospital in Taoyuan, Taiwan, two of the study's authors, told Reuters Health in a joint email.

"Obesity is prevalent among psoriasis patients and has been considered as an independent risk factor for occurrence and worsening of psoriasis by promoting systemic inflammation," Dr. Chi, Dr. Wu and their colleagues write in the Journal of the American Academy of Dermatology, online August 7.

The researchers reviewed six studies including 862 patients with psoriasis. Average BW and BMI were significantly higher in patients on TNFi compared with those on conventional therapy (mean difference 1.40 kg and 0.39 kg/m2, respectively).

Neither ustekinumab nor secukinumab was significantly associated with BW or BMI, but only one of the studies included secukinumab.

"The potential effects of TNFi treatments on BW may be considered in the care of overweight and obese psoriasis patients," Dr. Chi and Dr. Wu said. They noted that anti-IL biologics are as effective as or more effective than TNFi for treating psoriasis.

"We lacked data for long-term follow-up and treatment response and are unsure whether these observed weight changes were clinically significant," they added. "However, one previous study has shown an increase in the risk for diabetes mellitus by 7.3% for every kilogram of BW gain. Still, further research is warranted."

Dr. Chi has received speaking fees from AbbVie Taiwan, Janssen Taiwan, Novartis Taiwan and Pfizer Taiwan.


J Am Acad Dermatol 2019.