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Clin Rheumatol. 2019 Sep;38(9):2355-2362. doi: 10.1007/s10067-019-04663-6. Epub 2019 Jun 28.

Psoriatic arthritis and obesity: the role of anti-IL-12/IL-23 treatment.

Author information

1
Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Naples, Italy. lv.costa@libero.it.
2
Rheumatology unit, Department of Medicine DIMED, University of Padova, Padova, Italy.
3
Rheumatology Unit, A.O.U. Policlinico Vittorio Emanuele, Catania, Italy.
4
Clinica Medica 3, Center for the Study and Integrated Management of Obesity, Department of Medicine - DIMED, Padova University-Hospital, Padova, Italy.
5
Rheumatology Unit, Department of Emergency and Organs Transplantation (DETO), University of Bari, Bari, Italy.
6
Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Naples, Italy.

Abstract

Patients with psoriatic arthritis (PsA) have an increased prevalence of obesity, but mechanisms underlying this association remain unknown and it is unclear if obesity is the cause or effect of PsA. For PsA patients, comorbid obesity may influence their clinical response to systemic treatment, and especially targeted immunomodulators such as anti-tumor necrosis factor (TNF)α. Weight gain has also been associated with anti-TNFα treatment. Consequently, modification of the therapeutic approach may be needed for patients with an inadequate response to TNFα inhibitors. In recent years, interleukin (IL)-12/IL-23 inhibitors have entered clinical practice as a new class of drug for the treatment of PsA, with some data suggesting a lower effect of body weight on their effectiveness. Recent findings demonstrate effective and sustained responses in patients with PsA to ustekinumab, an IL-12/IL-23 inhibitor. This narrative review critically discusses the link between PsA, obesity, and response to therapy. The current role of ustekinumab in this setting is also discussed.

KEYWORDS:

Biological therapy; Interleukin inhibitor; MDA in PsA; Obesity; Psoriatic arthritis; Therapeutic response

PMID:
31264033
DOI:
10.1007/s10067-019-04663-6

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