Infliximab Treatment Improves Psoriasis Severity, Quality of Life Regardless of BMI

Adult patients with moderate to severe plaque psoriasis who are treated with infliximab report reduced disease activity and improved health-related quality of life through 1 year of therapy, independent of their body mass index (BMI) and waist circumference (WC), according to the results of a multicenter, prospective, observational study conducted in Greece and recently published in the Journal of the European Academy of Dermatology and Venereology.

The investigators sought to examine the association of BMI and WC with disease severity, to identify patient characteristics related to the attainment of response, and to evaluate the effect of infliximab therapy on health-related quality of life in adults with moderate to severe plaque psoriasis.

All participants had initiated treatment with originator infliximab within 2 weeks before study enrollment. Postenrollment visits took place at 14±4 weeks, 30±4 weeks, and 54±4 weeks after treatment onset.

A total of 136 eligible patients with a median BMI of 29.6 kg/m² and a median WC of 107.0 cm at enrollment were recruited by 21 dermatology hospital/private offices throughout Greece between October 2012 and June 2014. The mean patient age was 48.6 years, and 62.5% of the participants were men. All the patients had received prior psoriasis therapy; 62.5% of the participants were biologic-naive. At baseline, mean Psoriasis Area Severity Index (PASI) and Dermatology Quality of Life Index (DLQI) scores were 23.4±13.6 and 15.0±8.3, respectively.

There was a low, positive, statistically significant correlation between WC at study enrollment and baseline PASI (P <.001). “Over a median of 48.4 weeks of infliximab treatment, 89.3% of the per protocol set achieved a PASI 75 response (ie, ≥75% reduction in PASI score from baseline),” the investigators reported.

PASI 75 attainment rates at 14, 30, and 54 weeks were 66.4%, 74.8%, and 76.6%, respectively. The clinically meaningful DLQI improvement (ie, ≥5-point decrease) rates were 68.9%, 75.7%, and 69.8%, respectively. Attainment of improvements in PASI 75 response and DLQI scores was not affected by a patient’s BMI category or abdominal obesity.

The investigators concluded that the current study offers real-world evidence of the clinical benefits of infliximab therapy in adults with moderate to severe plaque psoriasis. The sustained benefits of infliximab were not shown to be associated with baseline BMI or WC, thus supporting use of the agent in this population regardless of the presence of high BMI values or abdominal obesity at treatment onset.

Reference

Petridis A, Panagakis P, Moustou E, et al. A multicenter, prospective, observational study examining the impact of risk factors, such as BMI and waist circumference, on quality of life improvement and clinical response in moderate-to-severe plaque-type psoriasis patients treated with infliximab in routine care settings of Greece [published online January 22, 2018]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.14802