TNFα inhibitor treatment tied to increase in body weight, BMI in psoriasis patients

Treatment with tumour necrosis factor-alpha (TNFα) inhibitor may likely lead to an increase in body weight and body mass index (BMI) in patients with psoriasis, whereas treatment with anti-interleukin (IL)-12/23 and IL-17 biologics does not, results of a recent systematic review and meta-analysis have shown.

“Previous studies have suggested that biologic therapy for psoriasis might relate to body weight gain,” the investigators noted.

This systematic review and network meta-analysis was carried out to assess the changes in body weight and BMI in patients with psoriasis treated with biologics. The databases of Medline, Embase and Cochrane Central Register of Controlled Trials were searched for relevant studies on 1 March 2019. The risk of bias was evaluated using the Newcastle-Ottawa scale.

Six studies including a combined total of 862 psoriasis patients met the eligibility criteria. Treatment with TNFα inhibitors appeared to result in a significant increase in body weight (mean difference, 1.40 kg, 95 percent confidence interval [CI], 0.88–1.93 kg) and in BMI (mean difference, 0.39 kg/m², 95 percent CI, 0.24–0.54 kg/m²) as compared with conventional systemic therapies.

On the other hand, patients treated with anti-IL-12/23 or anti-IL-17 biologics did not show a significant increase in their body weight or BMI.

“This association should be considered before initiating biologics for overweight and obese patients,” the investigators said.

This study had certain limitations. For instance, only one study had findings on body weight and BMI for patients treated with anti-IL-17 biologic.