Affiliation:
1. Saint Petersburg State University; Dermatovenerologic Dispensary No. 10 – Clinic of Dermatology and Venereology
2. Saint Petersburg State University; City Dermatovenerologic Dispensary
3. Saint Petersburg State University; International Medical Center ‘Sogaz’
4. Saint Petersburg State University
5. Saint Petersburg State University, Saint Petersburg
Abstract
In recent years, comorbidity in psoriasis has been actively studied, one of the most significant of which is obesity. Obesity is a risk factor for dermatosis in susceptible individuals, which can affect the effectiveness of therapy for the disease, including genetically engineered biological drugs.The aim of the study. To study the effectiveness of therapy with an interleukin‑17 inhibitor (iskekizumab) and the dynamics of lipid parameters in patients with psoriasis and overweight and obesity.Material and methods. A retrospective study of 25 patients diagnosed with psoriasis vulgaris was carried out. Inclusion criteria were PASI more than 12 points, BSA more than 10% and sPGA more than 3 points, age over 18 years. Anthropomeric parameters and lipid profile data were studied. All patients received iksekizumab treatment according to the standard regimen. Evaluation of the effectiveness of therapy was carried out according to the dynamics of PASI indicators, as well as the frequency of patients achieving the response PASI 75, PASI 90 and PASI 100.Results. Obesity and overweight were diagnosed in 13 patients who made up the main observation group. The comparison group included 12 nonobese patients. Patients in the observation groups did not differ in sex and severity of psoriasis. In patients of the main group, hypertriglyceridemia was significantly more often diagnosed (55.6%; 95% CI: 33.7–75.4; in its absence in the comparison group; p = 0.0200), as well as other comorbidity – hypertension and metabolic syndrome (p = 0.0016 and p = 0.0052, respectively). On the background of therapy, skin rashes were resolved in patients of both observation groups. By the seventh week of therapy, there was a significant decrease in PASI, sPGA and BSA, by the 36th week, the rash was completely resolved in all patients (p < 0.001). There were no significant differences between the groups in the dynamics of clinical indicators of the severity of the disease. Body mass index did not change statistically significantly over the observation period in patients of both groups (p = 0.6690). Changes in lipid profile for all parameters were statistically insignificant. There were no significant differences in the frequency of achieving PASI of 75, 90 and 100% between the groups.
Subject
Materials Chemistry,Economics and Econometrics,Media Technology,Forestry
Reference37 articles.
1. Kubanova A. A., Kubanov A. A., Znamenskaya L. F., Chikin V. V., Bakulev A. L., Hobeish M.M. et al. Psoriasis. In the book: Federal clinical guidelines. Dermatovenereology, 2015: Skin diseases. Sexually transmitted infections. 5th ed., Rev. and add. Moscow: Business Express, 2016. P. 415–470.
2. Schäfer T. Epidemiology of psoriasis. Review and the German perspective. Dermatology. 2006; 212: 327–337.
3. Wu JJ, Nguyen TU, Poon KT, Herrington LJ. The association of psoriasis with autoimmune diseases. J Am Acad Dermatol. 2012; 67: 924–930.
4. Kruglova L.S., Pushkina A.V., Hotko A.A. Psoriasis and psychiatric comorbidity (literature review) Pharmateca, 2019, No. 8. DOI: https://dx.doi.org/10.18565/ pharmateca.2019.8. 8-12
5. Edson-Heredia E, Zhu B, Lefevre C, Wang M, Barrett A, Bushe CJ, et al. Prevalence and incidence rates of cardiovascular, autoimmune, and other diseases in patients with psoriatic or psoriatic arthritis: a retrospective study using Clinical Practice Research Datalink. J Eur Acad Dermatol Venerol 2015; 29: 955–963.