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Giornale Italiano di Dermatologia e Venereologia 2020 February;155(1):14-8

DOI: 10.23736/S0392-0488.17.05621-8


language: English

Effects of TNFα 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 Section of Dermatology, Department of Health Sciences, San Martino University Hospital IRCCS, University of Genoa, Genoa, Italy; 2 Department of Internal Medicine and Medical Specialties, Clinic of Dermatology, University of Rome, Rome, Italy; 3 Daniele Innocenzi Unit of Dermatology, Faculty of Medicine and Surgery, A. Fiorini Hospital, Sapienza University, Rome, Italy; 4 Section of Clinical, Allergological and Venereological Dermatology, Department of Medicine, University of Perugia, Perugia, Italy; 5 Unit of Dermatology, Carlo Urbani Hospital, Jesi, Ancona, Italy; 6 Department of Dermatology, University of Cagliari, Cagliari, Italy; 7 Division of Dermatology, Macerata, Italy; 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; Biological therapies

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