Department of Dermatovenerology, University Medical Centre Ljubljana, Gradiškova ulica 10, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, Ljubljana, Slovenia.
Arch Dermatol Res. 2024 Sep 27;316(9):647. doi: 10.1007/s00403-024-03403-4.
Metabolic disorders are common in patients with psoriasis and contribute significantly to an increased cardiovascular risk. While biologic therapy is very successful in clearing skin lesions, its impact on metabolic parameters is uncertain. Our aim was to investigate the residual metabolic burden in psoriasis patients successfully treated with biologic therapy. We conducted a cross-sectional study of 80 young patients (54 men, 26 women, aged 30-45 years) successfully treated with either adalimumab, secukinumab or guselkumab and topical therapy or methotrexate, and 20 healthy controls. Anthropometric parameters, lipid levels and metabolic indices (HOMA-IR, TyG index and FIB-4 index) were measured. Patients did not receive any other treatments to exclude confounding effects. After analysis, we found that patients treated with three different biologics had similar metabolic status, only the FIB-4 index was higher in the adalimumab group than in the secukinumab and guselkumab treatment groups. There were no significant differences between the patients treated with biologics and the control group. The comparison with patients treated topically or with methotrexate showed that only triglyceride levels, HOMA-IR, TyG index, and FIB-4 index were elevated in patients treated with adalimumab compared to patients treated with topical therapy. Finally, metabolic status was also similar in patients treated with methotrexate or topical therapy. In conclusion, this study suggests that psoriasis patients successfully treated with biologics have similar metabolic parameters to the control group and patients treated with topical therapy or methotrexate. This indicates that there is no significant residual metabolic burden in young patients successfully treated with biologics. These results are clinically relevant and should be considered in the treatment of psoriasis patients.The study is registered at http://clinicaltrials.gov (identifier: NCT05957120). Date of registration: 24th of July 2023.
代谢紊乱在银屑病患者中很常见，会显著增加心血管风险。虽然生物疗法在清除皮肤损伤方面非常成功，但它对代谢参数的影响尚不确定。我们的目的是研究成功接受生物疗法治疗的银屑病患者的残余代谢负担。我们进行了一项横断面研究，纳入了 80 名年轻患者（54 名男性，26 名女性，年龄 30-45 岁），这些患者成功接受了阿达木单抗、司库奇尤单抗或古塞库单抗联合局部治疗或甲氨蝶呤治疗，以及 20 名健康对照者。测量了人体测量参数、血脂水平和代谢指标（HOMA-IR、TyG 指数和 FIB-4 指数）。患者未接受任何其他治疗以排除混杂影响。分析后发现，接受三种不同生物制剂治疗的患者代谢状态相似，仅阿达木单抗组的 FIB-4 指数高于司库奇尤单抗和古塞库单抗治疗组。生物制剂治疗组与对照组之间无显著差异。与接受局部治疗或甲氨蝶呤治疗的患者比较，仅接受阿达木单抗治疗的患者的甘油三酯水平、HOMA-IR、TyG 指数和 FIB-4 指数高于接受局部治疗的患者。最后，接受甲氨蝶呤或局部治疗的患者代谢状态也相似。总之，这项研究表明，成功接受生物制剂治疗的银屑病患者的代谢参数与对照组和接受局部治疗或甲氨蝶呤治疗的患者相似。这表明成功接受生物制剂治疗的年轻患者没有明显的残余代谢负担。这些结果具有临床意义，应在银屑病患者的治疗中加以考虑。该研究在 http://clinicaltrials.gov 注册（标识符：NCT05957120）。注册日期：2023 年 7 月 24 日。
