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Current Obesity Reports

Erschienen in:

16.05.2020 | Metabolism (M Dalamaga, Section Editor)

Deciphering the Association Between Psoriasis and Obesity: Current Evidence and Treatment Considerations

verfasst von: Kyriaki Paroutoglou, Evangelia Papadavid, Gerasimos Socrates Christodoulatos, Maria Dalamaga

Erschienen in: Current Obesity Reports | Ausgabe 3/2020

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Abstract

Purpose of Review

Obesity and psoriasis represent chronic inflammatory states that are interconnected in a vicious cycle, sharing also a degree of synergy. In this review, we aim to decipher the various lines of evidence supporting the bidirectional association between psoriasis and obesity highlighting their pathophysiologic connections as well as we attempt to strategize a therapeutic holistic approach for obese psoriatic patients.

Recent Findings

Recent meta-analyses have shown that (1) genetically higher BMI increased the odds of psoriasis occurrence; (2) obesity is associated with higher incidence and prevalence of psoriasis as well as psoriasis severity; (3) obesity is associated with lower efficacy to anti-TNF agents and may predict biologic treatment discontinuation; and (4) weight loss through diet and physical exercise may improve pre-existing psoriasis and prevent from de novo psoriasis. Methotrexate, acitretin, and cyclosporine could worsen hypertension, liver steatosis, and dyslipidemia. Since infliximab and ustekinumab are weight adjusted, they may be ideal drugs to treat obese psoriatic patients. IL-17 inhibitors are very effective independently from body weight; however, they tend to present better clearance rates in normal weight patients. There is a paucity on weight data regarding the efficacious IL-23 inhibitors. Apremilast may induce weight loss as an adverse effect presenting also some beneficial metabolic actions. Finally, simvastatin and some antidiabetic drugs could decrease psoriasis severity.

Summary

More mechanistic, observational studies and well-conducted RCTs are necessary to decipher the enigmatic link between psoriasis and obesity, and to provide evidence-based specific guidelines for the screening and management of obese psoriatic patients.

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Titel: Deciphering the Association Between Psoriasis and Obesity: Current Evidence and Treatment Considerations
verfasst von: Kyriaki Paroutoglou
Evangelia Papadavid
Gerasimos Socrates Christodoulatos
Maria Dalamaga
Publikationsdatum: 16.05.2020
Verlag: Springer US
Erschienen in: Current Obesity Reports / Ausgabe 3/2020
Elektronische ISSN: 2162-4968
DOI: https://doi.org/10.1007/s13679-020-00380-3

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