Mustață Maria-Lorena, Ionescu Mihaela, Radu Lucrețiu, Neagoe Carmen-Daniela, Ahrițculesei Roxana-Viorela, Cîmpeanu Radu-Cristian, Matei Daniela, Amzolini Anca-Maria, Predoi Maria-Cristina, Ianoși Simona-Laura
Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Diagnostics (Basel). 2024 Dec 23;14(24):2887. doi: 10.3390/diagnostics14242887.
BACKGROUND/OBJECTIVES: Psoriasis is a chronic dermatological condition with systemic implications, especially with metabolic syndrome (MS). This study evaluated the vicious cycle where obesity and MS exacerbate systemic inflammation that complicates the efficacy of psoriasis therapies by examining the PASI score over a one-year period. Patients were classified into two subgroups: those with psoriasis alone (PSO) and those with both psoriasis and metabolic syndrome (PSO-MS).
A total of 150 patients, half of whom also concomitantly presented with metabolic syndrome, received biologic therapies comprising anti-IL-17, anti-IL-23, and anti-TNF-a, or methotrexate, with PASI scores assessed at baseline and at 3, 6, and 12 months.
All treatments showed significant reductions in PASI; however, patients with PSO showed more marked reductions in PASI score than those in the PSO-MS group. Anti-IL-17 treatments produced the greatest sustained long-term improvements, whereas anti-IL-23 produced prompt early improvements. Increases in BMI and leptin concentrations were associated with a modest rate of reduction in PASI score, underlining the impact of obesity and metabolic dysfunction on treatment efficacy.
This study highlights the importance of managing comorbidities such as MS in the treatment of psoriasis, as the interplay between systemic inflammation and metabolic health further complicates therapeutic outcomes.
背景/目的：银屑病是一种具有全身影响的慢性皮肤病，尤其是与代谢综合征（MS）相关。本研究通过在一年时间内检查银屑病面积和严重程度指数（PASI）评分，评估了肥胖和MS加剧全身炎症从而使银屑病治疗效果复杂化的恶性循环。患者被分为两个亚组：仅患有银屑病的患者（PSO）和同时患有银屑病和代谢综合征的患者（PSO-MS）。
共有150名患者接受了生物治疗，其中一半还同时患有代谢综合征，治疗包括抗白细胞介素-17（IL-17）、抗白细胞介素-23（IL-23）和抗肿瘤坏死因子-α（TNF-α），或甲氨蝶呤，并在基线以及3个月、6个月和12个月时评估PASI评分。
所有治疗均使PASI显著降低；然而，PSO患者的PASI评分降低幅度比PSO-MS组患者更明显。抗IL-17治疗产生了最大的持续长期改善，而抗IL-23治疗则产生了迅速的早期改善。体重指数（BMI）和瘦素浓度的增加与PASI评分的适度降低率相关，突出了肥胖和代谢功能障碍对治疗效果的影响。
本研究强调了在银屑病治疗中管理如MS等合并症的重要性，因为全身炎症与代谢健康之间的相互作用使治疗结果更加复杂。
