Articles

Changes in Body Mass Index and Lipid Profile in Psoriatic Patients After Treatment With Standard Protocol of Infliximab

Abstract

Psoriasis is a chronic and inflammatory dermatologic disease. Psoriasis may predispose to cardiovascular disease and diabetes. However, the role of tumor necrosis factor (TNF) inhibitor in mediating this risk is controversial. Regarding frequent use of infliximab in psoriasis, and the hypothesis that anti TNF-α treatment may increase Body Mass Index (BMI) and alter lipid profile in these patients, the aim of this study was to assess changes in BMI and Lipid Profile and level of leptin in Psoriatic Patients under Treatment of Standard Protocol of Infliximab in a 24 week period. This study was accomplished as a before-after study. Twenty-seven psoriatic patients were included, and standard infliximab therapy was applied. All patients underwent 3 times of blood collection and in each session; LDL, HDL, Total Cholesterol, Triglycerides, Leptin, and PASI score were measured at the start of the study and at the 12th and 24th week of follow-up. Twenty-five patients consisted of 18 (72%) male and 7 (28%) female subjects were evaluated. The mean age of the patients was 36.91±13.31 years. PASI score demonstrated significant decrease after 24 weeks; however, BMI and HDL and leptin showed a significant increase during treatment. Significant negative correlation was seen between Leptin and PASI score changes (r=0.331, P=0.042). HDL and BMI had the most correlations with leptin (positive correlation) and PASI score (negative correlation). Results demonstrated a dramatic decrease in PASI, increase in BMI and HDL and increased in leptin; somewhat correlated to each other. These results suggest that patients taking infliximab should take more care of their weight and lipid profile, while on treatment.

- Bowcock AM. Genetic locus for psoriasis identified. Ann Med. Apr 1995;27(2):183-6.

- Krueger JG, Bowcock A. Psoriasis pathophysiology: current concepts of pathogenesis. Ann Rheum Dis. Mar 2005;64 Suppl 2:ii30-6.

- Gelfand JM, Stern RS, Nijsten T, Feldman SR, Thomas J, Kist J, et al. The prevalence of psoriasis in African Americans: results from a population-based study. J Am Acad Dermatol. Jan 2005;52(1):23-6.

- de Korte J, Sprangers MA, Mombers FM, et al. Quality of life in patients with psoriasis: a systematic literature review. J Investig Dermatol Symp Proc. Mar 2004;9(2):140-7.

- Krueger GG, Feldman SR, Camisa C, Duvic M, Elder JT, Gottlieb AB, et al. Two considerations for patients with psoriasis and their clinicians: what defines mild, moderate, and severe psoriasis? What constitutes a clinically significant improvement when treating psoriasis?. J Am Acad Dermatol. 2000;43:281-5.

- Kurd SK, Troxel AB, Crits-Christoph P, Gelfand JM. The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol. Aug 2010;146(8):891-5.

- Mason AR, Mason J, Cork M, Dooley G, Edwards G. Topical treatments for chronic plaque psoriasis. Cochrane Database Syst Rev. Apr 15 2009;CD005028.

- Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. May 2008;58(5):826-50.

- Hotamisligil GS, Arner P, Caro JF et al. Increased adipose tissue expression of tumor necrosis factoralpha in human obesity and insulin resistance. The Journal of Clinical Investigation 1995; 95: 2409–2415.

- Kern PA, Ranganathan S, Li C et al. Adipose tissue tumor necrosis factor and interleukin-6 expression in human obesity and insulin resistance. American Journal of Physiology Endocrinology and Metabolism 2001; 280: E745–E751.

- An WS, Kim SE, Kim KH, Bae HR, Rha SH. Associations between oxidized LDL to LDL ratio, HDL and vascular calcification in the feet of hemodialysis patients. J Korean Med Sci. 2009 Jan;24 Suppl:S115-20.

-Balogh Z, Fóris G, Kosztáczky B, Paragh G Jr, Seres I, Zsíros E, Kónya G, Paragh G. Peptides. The concentration dependent biphasic effect of leptin on endogenous cholesterol synthesis in human monocytes. 2007 Oct;28(10):2081-3.

- Magiera M, Kopec-Medrek M, Widuchowska M, Kotulska A, Dziewit T, Ziaja D, Kucharz EJ, Logiewa-Bazger B, Mazur W. Serum ghrelin in female patients with rheumatoid arthritis during treatment with infliximab. Rheumatol Int. 2013 Jun;33(6):1611-3.

- Nishio S, Yamamoto T, Kaneko K, Tanaka-Matsumoto N, Muraoka S, Kaburaki M, Kusunoki Y, Takagi K, Kawai S.Pharmacokinetic study and Fcgamma receptor gene analysis in two patients with rheumatoid arthritis controlled by low-dose infliximab. Mod Rheumatol. 2009;19(3):329-33.

- Gonzalez-Gay MA, Gonzalez-Juanatey C, Miranda-Filloy JA, Martin J, Garcia-Unzueta MT, Llorca J. Response to Infliximab therapy increases body fat mass in early rheumatoid arthritis independently of changes in disease activity and levels of leptin and adiponectin: a randomized study over 21 months'. Arthritis Res Ther. 2011 Apr 27;13(2):404.

- Tokarczyk-Knapik A1, Nowicki M, Wyroślak J. [The relation between plasma leptin concentration and body fat mass in patients with rheumatoid arthritis]. Pol Arch Med Wewn. 2002 Aug;108(2):761-7. [Article in Polish]

- Pollono EN, Lopez-Olivo MA, Lopez JA, Suarez-Almazor ME. A systematic review of the effect of TNF-alpha antagonists on lipid profiles in patients with rheumatoid arthritis. Clin Rheumatol. 2010 Sep;29(9):947-55

- Castro KR, Aikawa NE, Saad CG, Moraes JC, Medeiros AC, Mota LM, Silva CA, Bonfá E, Carvalho JF. Infliximab induces increase in triglyceride levels in psoriatic arthritis patients. Clin Dev Immunol. 2011;2011:352686.

- Cauza E, Cauza K, Hanusch-Enserer U, Etemad M, Dunky A, Kostner K. Intravenous anti TNF-alpha antibody therapy leads to elevated triglyceride and reduced HDL-cholesterol levels in patients with rheumatoid and psoriatic arthritis. Wien Klin Wochenschr. 2002 Dec 30;114(23-24):1004-7.

- Gisondi P, Cotena C, Tessari G, Girolomoni G. Anti-tumour necrosis factor-alpha therapy increases body weight in patients with chronic plaque psoriasis: a retrospective cohort study. J Eur Acad Dermatol Venereol. 2008 Mar;22(3):341-4.

- Briot K, Gossec L, Kolta S, Dougados M, Roux C. Prospective assessment of body weight, body composition, and bone density changes in patients with spondyloarthropathy receiving anti-tumor necrosis factor-alpha treatment. J Rheumatol. 2008;35:855–861.

- Nakahigashi M, Yamamoto T. Increases in body mass index during infliximab therapy in patients with Crohn's disease: an open label prospective study. Cytokine. 2011 Nov;56(2):531-5.

- Yen FT1, Deckelbaum RJ, Mann CJ, Marcel YL, Milne RW, Tall AR. Inhibition of cholesteryl ester transfer protein activity by monoclonal antibody. Effects on cholesteryl ester formation and neutral lipid mass transfer in human plasma. J Clin Invest. 1989 Jun;83(6):2018-24.

- U. Mrowietz and colleagues, Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011 Jan; 303(1): 1–10.

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IssueVol 54, No 9 (2016) QRcode
SectionArticles
Keywords
Body mass index Lipid profile Psoriasis Infliximab

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How to Cite
1.
Ehsani AH, Mortazavi H, Balighi K, Hosseini MS, Azizpour A, Hejazi SP, Goodarzi A, Darvari SB. Changes in Body Mass Index and Lipid Profile in Psoriatic Patients After Treatment With Standard Protocol of Infliximab. Acta Med Iran. 2016;54(9):570-575.