Esposito M, Mazzotta A, Saraceno R, Schipani C, Chimenti S
Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.
Int J Immunopathol Pharmacol. 2009 Jan-Mar;22(1):219-25. doi: 10.1177/039463200902200124.
A relationship between psoriasis, pro-inflammatory cytokines and obesity has been demonstrated. Tumour necrosis factor-alpha (TNF-alpha), that is involved in the pathogenesis of psoriasis, is commonly over-expressed in obese subjects, and seems to be derived from inflammatory cells and adipocytes. The primary aim of this study is to investigate whether the Body Mass Index (BMI) of patients influences the clinical response to etanercept, a competitive inhibitor of TNF-alpha approved for the treatment of moderate-to-severe plaque-type psoriasis. The secondary aim is to evaluate whether the TNF-alpha inhibition influences the weight and BMI profile of patients. One hundred patients received 50 mg etanercept twice weekly for 12 weeks, followed by 25 mg. At weeks-12 and 24, treatment efficacy and tolerability were evaluated, as well as body weight and BMI. BMI values did not correlate with etanercept efficacy. Mean PASI score variation did not show significant differences among the BMI groups. A statistically significant weight gain and BMI variation were observed in a consistent rate of patients. Patient BMI does not influence psoriasis efficacy parameters. Although the role of anti TNF-alpha molecules on weight regulation need to be confirmed, our study shows that etanercept treatment may induce weight gain and a BMI increase.
银屑病、促炎细胞因子与肥胖之间的关系已得到证实。参与银屑病发病机制的肿瘤坏死因子-α（TNF-α）在肥胖受试者中通常过度表达，且似乎来源于炎症细胞和脂肪细胞。本研究的主要目的是调查患者的体重指数（BMI）是否会影响对依那西普的临床反应，依那西普是一种被批准用于治疗中度至重度斑块型银屑病的TNF-α竞争性抑制剂。次要目的是评估TNF-α抑制是否会影响患者的体重和BMI情况。100名患者每周两次接受50mg依那西普治疗，持续12周，之后为25mg。在第12周和第24周时，评估治疗效果和耐受性，以及体重和BMI。BMI值与依那西普疗效无关。各BMI组的平均银屑病面积和严重程度指数（PASI）评分变化无显著差异。在一定比例的患者中观察到有统计学意义的体重增加和BMI变化。患者的BMI不影响银屑病疗效参数。尽管抗TNF-α分子对体重调节的作用有待证实，但我们的研究表明依那西普治疗可能会导致体重增加和BMI升高。
