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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2017 Apr 19
Copyright © 2017 EDIZIONI MINERVA MEDICA
Effects of TNF-α inhibitors in patients with psoriasis and metabolic syndrome: a preliminary study
Giulia MERLO 1, Emanuele COZZANI 1 ✉, Martina BURLANDO 1, Stefano CALVIERI 2, Concetta POTENZA 3, Luca STINGENI 4, Giorgio FILOSA 5, Monica PAU 6, Marco SIMONACCI 7, Marzia CAPRONI 8, Aurora PARODI 1
1 Di.S.Sal. Section of Dermatology, University of Genoa, IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy; 2 Dermatology Clinic, Department of Internal Medicine and Medical Specialties, University of Rome, Rome, Italy; 3 UOC of Dermatology “Daniele Innocenzi”, Faculty of Medicine and Surgery, University of Rome “Sapienza”, Polo Pontino, A.Fiorini Hospital, Terracina, Italy; 4 Section of Clinical, Allergological and Venereological Dermatology, Department of Medicine, University of Perugia, Perugia, Italy; 5 Dermatology Unit, Carlo Urbani Hospital, Jesi, Italy; 6 Dermatology Department, University of Cagliari, Cagliari, Italy; 7 Division of Dermatology, Macerata; 8 Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
BACKGROUND: Psoriasis is an inflammatory disease, that is increasingly being considered as a systemic disorder. Among associated comorbidities, metabolic syndrome plays an important role. The effects of biological therapies on metabolic syndrome is controversial.
METHODS: Thirty-one psoriatic patients with metabolic syndrome, eligible to treatment with anti-TNFα agents, were enrolled. Metabolic parameters were measured during 4 subsequent visits, one every 40 to 60 days. PASI, BSA and DLQI assessed the severity of psoriasis and the impact on quality of life.
RESULTS: We include 31 patients, 18 treated with etanercept and 13 with adalimumab. Metabolic parameters evaluated at V4 in both groups showed different trends in the blood glucose values: a slight decrease in adalimumab group, an increase in etanercept group, with an almost significant comparison test (p=0.073). Similarly, the lipid profile revealed an opposing trend, with an increase in triglycerides in adalimumab patients, and a decrease in the other group, without statistically significant differences. No statistically significant difference was recorded in HDL cholesterol. An improvement in systolic and diastolic pressure was appreciated in both groups, although not significantly. The waist circumference slightly decreased in both groups. PASI 75 score was reached in 60% of the patients. In addition, BSA and DLQI improved.
CONCLUSIONS: Our study showed a slight improvement of metabolic parameters, at times with a trend toward significance. Additional long-term studies and a larger number of patients are needed to more clearly define the association between psoriasis and cardiovascular disease and understand the effect of biological therapies on metabolic parameters.
KEY WORDS: Psoriasis - Metabolic syndrome - Biologic therapies