Impact of Body Mass Index and Obesity on Clinical Response to Systemic Treatment for Psoriasis : Evidence from the Psocare Project

• Published in: Dermatology (Basel) Vol. 217; no. 4; pp. 365 - 373
• Main Authors: NALDI, Luigi, ADDIS, Antonio, CUSCITO, Rosanna, CHIMENTI, Sergio, GIANNETTI, Alberto, PICARDO, Mauro, TOMINO, Carlo, MACCARONE, Mara, CHATENOUD, Liliane, BERTUCCIO, Paola, CAGGESE, Eugenia
• Format: Journal Article
• Language: English
• Published: Basel Karger 2008
• Subjects: Adult; Biological and medical sciences; Body Mass Index; Cohort Studies; Dermatology; Epidemiology; Female; General aspects; Humans; Internet; Italy; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - complications; Psoriasis - complications; Psoriasis - drug therapy; Psoriasis. Parapsoriasis. Lichen; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Life; Severity of Illness Index; Treatment Outcome; Italy; Obesity; Skin disease; Prognosis; Psoriasis; Dermatology; Prognosis, psoriasis; Nutrition disorder; Epidemiology, psoriasis; Systemic route; Systemic; Epidemiology; Systemic therapy; Body mass index; Project; Treatment; Disseminated; Nutritional status
• ISSN: 1018-8665; 1421-9832
• DOI: 10.1159/000156599

Our aim was to assess the role of the body mass index (BMI) in the clinical response to systemic treatment for psoriasis. A nationwide cohort study of patients receiving a new systemic treatment for plaque psoriasis at reference centres in Italy was conducted. Information was gathered through a web-based electronic form. Patients being maintained on the same medication and with data available at 8 and 16 weeks by March 31, 2007, were eligible. The outcome was a reduction in the Psoriasis Area Severity Index (PASI) of at least 75% at follow-up compared to baseline (PASI-75). Out of 8,072 patients enrolled, 2,368 were eligible and analysable at 8 weeks and 2,042 at 16 weeks. PASI-75 was achieved by 819 patients (34.5%) at 8 weeks and 1,034 (50.6%) at 16 weeks. The proportion steadily decreased with increased values of BMI. Compared to normal weight (BMI = 20-24) the adjusted odds ratio for achieving PASI-75 in obese patients was 0.73 (95% CI = 0.58-0.93) at 8 weeks and 0.62 (95% CI = 0.49-0.79) at 16 weeks. The impact of the BMI did not show remarkable variations according to the drug prescribed at entry. The BMI affects the early clinical response to systemic treatment for psoriasis.