Impact of Body Mass Index and Obesity on Clinical Response to Systemic Treatment for Psoriasis
Evidence from the Psocare ProjectNaldi L. · Addis A. · Chimenti S. · Giannetti A. · Picardo M. · Tomino C. · Maccarone M. · Chatenoud L. · Bertuccio P. · Caggese E. · Cuscito R.
aGISED Study Centre, Ospedali Riuniti, Bergamo; bUnit of Analytic Epidemiology, Mario Negri Institute for Pharmacological Research, Milan; cDepartment of Dermatology, Modena and Reggio Emilia University, Modena; dItalian Drug Agency (AIFA), eSan Gallicano-IFO Institute, Rome, fDepartment of Dermatology, Tor Vergata University, Rome, and gItalian Psoriatic Patient Association (ADIPSO), Rome, Italy
Objective: Our aim was to assess the role of the body mass index (BMI) in the clinical response to systemic treatment for psoriasis. Methods: 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). Results: 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. Conclusion: The BMI affects the early clinical response to systemic treatment for psoriasis.
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