After apremilast treatment, psoriasis patients experienced weight loss (mainly abdominal subcutaneous fat) and improved disease activity.
According to recently published data, Rheumatology.
This prospective, open-label study evaluated adults receiving 30 mg apremilast as part of regular treatment for psoriasis and/or psoriatic arthritis. These patients (median age 54.5 years, 63% female, median BMI 33.2 kg/m)2), apremilast was associated with a mean weight loss of 2.2 kg (95% CI 1.4-3.0; P.<0.001) and a mean BMI reduction of 0.8 kg/m2 (95% CI 0.5-1.2; P.<0.001) after 6 months of treatment.Body composition analysis demonstrated reduction in total abdominal fat [mean decrease 0.52L (95% CI 0.08-0.96), P=0.022]mainly subcutaneous adipose tissue [mean decrease 0.37 L (95% CI 0.05-0.68), P= 0.022]There was no change in fat cell diameter, hemoglobin A1c, lipids, glucagon-like peptide-1, or vascular function. Psoriatic disease activity improved with apremilast, but this did not correlate with weight change.
Lynn Ferguson MBChB, a physician and researcher at the Institute of Cardiovascular Medicine, University of Glasgow, Scotland, served as the first author of the paper. Here she discusses her main research findings. Reading roomThe exchange has been edited for length and clarity.
Why should we study weight loss in people with psoriasis?
Ferguson: Obesity, type 2 diabetes, and cardiovascular disease are significant comorbidities in patients with psoriasis and psoriatic arthritis. Increased BMI is associated with worse psoriasis disease activity, whereas weight loss appears to improve its activity.
Why was your study initiated to evaluate apremilast in this context?
Ferguson: Previous research suggested that the anti-inflammatory drug apremilast may have additional metabolic effects.
An immunometabolic study in psoriatic arthritis is an exploratory study designed to assess whether the phosphodiesterase (PDE)-4 inhibitor apremilast is associated with weight loss and other cardiometabolic benefits in patients with psoriasis. It was research.
To determine whether treatment with apremilast is associated with weight loss, including changes in body fat distribution on MRI and adipocyte morphology on subcutaneous fat biopsy, and whether weight loss correlates with improved disease activity. I investigated.
We also assessed whether there were improvements with apremilast in glucose homeostasis, lipid profiles, levels of the incretin hormone glucagon-like peptide-1 (GLP-1), and vascular function.
How would you describe your key findings?
Ferguson: Apremilast was associated with a modest weight loss of 2.2 kg and a reduction in BMI of 0.8 kg/m.2 After 6 months of treatment. Weight loss was primarily in the abdominal subcutaneous fat, with no significant changes in adipocyte size.
HbA did not change1c, GLP-1, lipids, or vascular function parameters are measured with apremilast. Improvements in disease activity were independent of body weight change, suggesting that apremilast likely acts through immunological rather than metabolic effects.
What clinical suggestions can you offer in light of these findings?
Ferguson: Clinicians should be aware that patients with psoriatic arthritis are at increased risk for metabolically related complications, including obesity, insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, and cardiovascular disease. .
Proper management of psoriatic disease must address these realities. Obesity also appears to be associated with worsening disease activity. Future research should focus on weight loss interventions in psoriatic disease to improve disease activity and reduce cardiometabolic complications.
Impact on practice:
- Apremilast resulted in significant weight loss in psoriasis patients.
- Improvements in disease activity were independent of body weight change, suggesting that apremilast likely acts through immunological rather than metabolic effects.
- Clinicians treating patients with psoriasis should be aware of obesity, insulin resistance, and similar comorbidities in addition to cardiovascular disease.
Ferguson has not disclosed any relevant financial ties to the industry.
