Effect of Etanercept on Insulin Sensitivity in Nine Patients with Psoriasis

• Published in: International journal of immunopathology and pharmacology Vol. 20; no. 4; pp. 731 - 736
• Main Authors: Marra, M., Campanati, A., Testa, R., Sirolla, C., Bonfigli, A.R., Franceschi, C., Marchegiani, F., Offidani, A.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2007
• Subjects: Adult; Blood Glucose - metabolism; Etanercept; Female; Homeostasis - drug effects; Humans; Immunoglobulin G - therapeutic use; Insulin - blood; Insulin Resistance - physiology; Interleukin-6 - blood; Keratolytic Agents - therapeutic use; Lipid Metabolism - drug effects; Lipids - blood; Male; Middle Aged; Psoriasis - drug therapy; Psoriasis - metabolism; Psoriasis - psychology; Quality of Life; Receptors, Tumor Necrosis Factor - therapeutic use; Etanercept; inflammation; insulin resistance
• ISSN: 0394-6320; 2058-7384
• DOI: 10.1177/039463200702000408

Metabolic syndrome is associated to chronic low grade inflammation, characterized by increased levels of inflammatory cytokines, such as Tumor Necrosis Factor-α (TNF-α) and Interleukin-6 (IL-6). In particular, TNF-α causes a decrease in the insulin-stimulated kinases related to the early phases of the insulin cascade, thereby leading to insulin resistance. Etanercept is a human fusion protein used in the treatment of psoriasis and inflammatory arthritis. It blocks inflammatory response by interfering in the binding of TNF-α to its receptors. The aim of this case report study is to verify the effect of Etanercept on insulin sensitivity, lipid profile and inflammatory status in psoriatic patients. Nine psoriatic patients with stable, active, plaque type psoriasis were enrolled and treated with Etanercept for 24 weeks. We found an improvement in the metabolic assessment with a significant reduction of insulin plasma levels. In particular, this treatment allows to maintain their euglycemic state with lower insulin plasma levels, as confirmed by the improved Homeostasis Model Assessment (HOMA) index. We conclude that Etanercept, probably acting on inflammation, improves insulin sensitivity in psoriatic subjects.