First-Line Biologic Therapy and Obesity in Moderate-to-Severe Psoriasis: Results from the Prospective Multicenter Cohort Psobioteq - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Dermatology Année : 2021

First-Line Biologic Therapy and Obesity in Moderate-to-Severe Psoriasis: Results from the Prospective Multicenter Cohort Psobioteq

Manuelle Viguier
  • Fonction : Auteur
  • PersonId : 971338
Carle F Paul
Marie-Aleth Richard

Résumé

Background - Obesity is associated with an increased risk of psoriasis. Objective - In this study, we examined whether body mass index (BMI) is taken into account when choosing first-line biologic therapy for psoriasis. Methods - In this cohort study, we compared obese (BMI ≥30 kg/m2) and non-obese patients for the first-line biologic therapy prescribed, its survival, reasons for discontinuation, therapy optimization, co-prescription of methotrexate and factors associated with long drug survival. Results - A total of 931 patients were included: 594 (64%) were male, median age was 46 years (interquartile range 36-56). The most-prescribed biologic agents as first-line treatment were adalimumab (ADA; 42.7%), ustekinumab (UST; 29.9%) and etanercept (ETA; 22.9%); only frequency of infliximab (IFX) prescription differed between groups. Drug survival was significantly shorter for obese than non-obese patients (p < 2.10-4) and was worse for obese than non-obese patients for UST (p = 0.009) and ETA (p = 0.02), with no difference for ADA (p = 0.11). The main reason for discontinuation was primary inefficacy (62%), which was more frequent in obese than non-obese patients. The cumulative incidence of optimization did not significantly differ between the groups, except for ADA (SHR 1.91, 95% CI [1.23-2.96], p = 0.005). On multivariate analysis, risk of discontinuation was associated with only ETA as first-line biologic therapy (HR 1.51, 95% CI 1.04-2.19). Conclusion - This study highlighted the lack of difference in prescription of first-line biologic treatment, except for IFX, between obese and non-obese patients presenting moderate-to-severe psoriasis. Drug survival in obese patients is shorter, mainly because of inefficacy, than in non-obese patients. This highlights the need for targeted pharmacological studies in obese individuals to find optimal administration schemes.
Fichier non déposé

Dates et versions

hal-03156232 , version 1 (02-03-2021)

Identifiants

Citer

Florence Assan, Florence Tubach, Hugo Arlegui, Manuelle Viguier, Marie Beylot-Barry, et al.. First-Line Biologic Therapy and Obesity in Moderate-to-Severe Psoriasis: Results from the Prospective Multicenter Cohort Psobioteq. Dermatology, 2021, 237 (3), pp.338-346. ⟨10.1159/000513398⟩. ⟨hal-03156232⟩
74 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More