Comorbid obesity and history of diabetes are independently associated with poorer treatment response to biologics at 6 months: A prospective analysis in Corrona Psoriasis Registry

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:86

Article

Enos, Clinton W.¹  Ramos, Vanessa L.¹  McLean, Robert R.²  Lin, Tin-Chi²  Foster, Nicole²  Dube, Blessing²  Van Voorhees, Abby S.¹ 

[1] Eastern Virginia Med Sch, Dept Dermatol, 721 Fairfax Ave,Suite 200,Andrews Hall, Norfolk, VA 23507 USA

[2] CorEvitas LLC, Waltham, MA USA

关键词: biologics;    biologic therapy;    comorbid disease;    metabolic disease;    outcomes;    psoriasis;    psoriatic disease;    treatment response;   

DOI  :  10.1016/j.jaad.2021.06.883

来源: Elsevier

【 摘 要 】

Background: Psoriasis is associated with comorbid systemic metabolic disease. Objective: To assess possible associations of comorbid obesity, history of diabetes, hypertension, and hyperlipidemia with response to biologic treatment at 6 months among patients in CorEvitas' Psoriasis Registry. Methods: Participants included 2924 patients initiating biologic therapy (tumour necrosis factor inhibitors [TNFi], interleukin [IL]-17i, IL-12/23i, or IL-23i) with baseline and 6-month follow-up visits available. Logistic regressions resulted in adjusted odd ratios (OR) and 95% confidence intervals (CI) for achievement of response in select outcomes for those with obesity and history of diabetes, hypertension, and hyperlipidemia relative to those without each. Results: Overall, obesity reduced by 25% to 30% odds of achieving PASI75 (OR, 0.75; 95% CI, 0.64-0.88) and PASI90 (OR, 0.70; 95% CI, 0.59-0.81). History of diabetes reduced odds of achieving PASI75 by 31% (OR, 0.69; 95% CI, 0.56-0.85) and PASI90 by 21% (OR, 0.79; 95% CI, 0.63-0.98). Obesity was associated with lower response to TNFi and IL-17i classes. Independent of obesity, diabetes was associated with poorer outcomes when on IL-17i therapy and hypertension, to a lesser extent, when on the TNFi class. No significant associations were found in the hyperlipidemia group. Limitations: The study assessed only short-term effectiveness and small sample sizes limited the power to detect differences. Conclusion: Assessment of comorbid disease burden is important for improved likelihoods of achieving treatment response with biologics.

【 授权许可】

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