The effectiveness of the treatment of psoriasis with IL-17 inhibitor in a patient with concomitant obesity: a clinical case


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Abstract

Background. Obesity is one of the most common comorbid diseases in patients with psoriasis. It is assumed that systemic inflammation in obesity is accompanied by the release of adiponectin and pro-inflammatory cytokines, including key cytokines of psoriasis - interleukin-17 (IL-17) and IL-23, which in turn act as triggers for psoriasis and thereby can provoke its more severe course. In addition, obesity can reduce the effectiveness of drugs, including genetically engineered biologic drugs. Description of the clinical case. The article describes the observation of a patient with severe plaque psoriasis and concomitant obesity treated with IL-17 inhibitors with a good clinical effect. Against the background of a decrease in body weight, a stable remission of the disease for a year and a half after the cessation of therapy was noted. Conclusion. The treatment of psoriasis requires an integrated approach and the choice of treatment method. Obesity, one of the most common concomitant diseases, can not only interfere withthe achievement of the drug effect, but also aggravate the course of other comorbid conditions. It is important to choose a method of therapy that can pathogenetically affect psoriasis and obesity, for example, IL-17 inhibitors.

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About the authors

I. S Vladimirova

Dermatovenerologic Dispensary №10 - Clinic of Dermatology and Venereology

I. O Smirnova

St. Petersburg State University; City Dermatovenerologic Dispensary, St. Petersburg

References

  1. Schä fer T. Epidemiology of psoriasis. Review and the German perspective. Dermatol. 2006;212:327-37. doi: 10.1159/000092283
  2. Blauvelt A, Chiricozzi A. The immunologic role of IL-17 in psoriasis and psoriatic arthritis pathogenesis. Clin Rev Allergy Immunol. 2018 Aug 14. [Epub ahead of print]. doi: 10.1007/s12016-018-8702-3 3
  3. Chiricozzi A, Saraceno R., Chimenti M.S., et al. Role of IL-23 in the pathogenesis of psoriasis: a novel potential therapeutic target? Expert Opin Ther Targets. 2014;18(5):513-25. doi: 10.1517/14728222.2014.889686
  4. Lowes M.A., Russell C.B., Martin D.A., et al. The IL-23/T17 pathogenic axis in psoriasis is amplified by keratinocyte responses. Trends Immunol. 2013;34:174-81. Doi: 10.1016/]. it.2012.11.005
  5. Davidovici B.B., Sattar N., Prinz J.C., et al. Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions. J Invest Dermatol. 2010;130:1785-96. doi: 10.1038/jid.2010.103.
  6. Смирнова И.О., Владимирова И.С. Псориаз и сердечно-сосудистая коморбидность (обзор литературы). Медицинский алфавит. 2020;6:18-21.
  7. Chiricozzi A., Gisondi P., Girolomoni G. The pharmacological management of patients with comorbid psoriasis and obesity. Expert Opin Pharmacother. 2019;20(7):863-72. doi: 10.1080/14656566.2019.1583207.
  8. Neimann A.L, Shin D.B, Wang X., et al. Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol. 2006;55 (5):829 35. doi: 10.1016/j.jaad.2006.08.040
  9. Phan C, Sigal M.L., Lhafa M, et al. Metabolic comorbidities and hypertension in psoriasis patients in France. Comparisons with French national databases. Ann Dermatol Venereol. 2016;143(4):264-74. Doi: 10.1016/j. annder.2015.06.024
  10. Armstrong A.W., Harskamp C.T., Armstrong E.J. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes. 2012;2(12):e54. doi: 10.1038/nutd.2012.26.
  11. Snekvik I., Smith C.H., Nilsen T.I.L., et al. Obesity, waist circumference, weight change, and risk of incident psoriasis: prospective data from the HUNT study. J Invest Dermatol. 2017;137(12):2484-90. doi: 10.1016/j.jid.2017.07.822.
  12. Kumar S., Han J., Li T., et al. Obesity, waist circumference, weight change and the risk of psoriasis in US women. J Eur Acad Dermatol Venereol. 2013;27(10):1293-98. Doi: 10.1111/ jdv. 12001.
  13. Chehimi M., Vidal H., Eljaafari A. Pathogenic Role of IL-17-Producing Immune Cells in Obesity, and Related Inflammatory Diseases. J Clin Med. 2017;6(7):68. doi: 10.3390/jcm6070068.
  14. Sumarac-Dumanovic M., Stevanovic D., Ljubic A., et al. Increased activity of interleukin-23/ interleukin-17 proinflammatory axis in obese women. Int J Obes. (Lond). 2009;33(1):151-56. doi: 10.1038/ijo.2008.216.
  15. Бакулев А.Л., Кравченя С.С. Применение гепато-протекторов при псориазе: сравнительная клинико-лабораторная и ультрасонографическая оценка эффективности. Вестник дерматологии и венерологии. 2010;1:112-17.
  16. Chiricozzi A., Gisondi P., Girolomoni G. The pharmacological management of patients with comorbid psoriasis and obesity. Expert Opin Pharmacother. 2019;20(7):863-72. doi: 10.1080/14656566.2019.1583207.
  17. Singh S., Facciorusso A., Singh A.G., et al. Obesity and response to anti-tumor necrosis factor-a agents in patients with select immunemediated inflammatory diseases: a systematic review and metaanalysis. PLoS. One. 2018;13(5):e0195123. doi: 10.1371/journal.pone.0195123.
  18. Subasi C.F., Aykut U.E., Yilmaz Y. Comparison of noninvasive scores for the detection of advanced fibrosis in patients with nonalcoholic fatty liver disease. Eur J. Gastroenterol Hepatol. 2015;27:137-41. Doi: 10.1097/ MEG.0000000000000255.
  19. Corbetta S., Angioni R., Cattaneo A., et al. Effects of retinoid therapy on insulin sensitivity, lipid profile and circulating adipocytokines. Eur J. Endocrinol. 2006;154:83-6. doi: 10.1530/eje.1.02057.
  20. Lowe N.J., Wieder J.M., Rosenbach A., et al. Longterm low-dose cyclosporine therapy for severe psoriasis: effects on renal function and structure. J. Am Acad Dermatol. 1996;35:710-19. doi: 10.1016/s0190-9622(96)90726-4.
  21. Vilarrasa E., Notario J., Bordas X., et al. (Outcome and retention rate of biologic treatments for psoriasis): a retrospective observational study on biologic drug survival in daily practice. J. Am Acad Dermatol. 2016;74(6):1066-72. doi: 10.1016/j.jaad.2016.01.037.
  22. Clark L., Lebwohl M. The effect of weight on the efficacy of biologic therapy in patients with psoriasis. J. Am Acad Dermatol. 2008;58:443-46. doi: 10.1016/j.jaad.2007.11.011.
  23. Duarte A.A., Chehin F.B. Moderate to severe psoriasis treated with infliximab - 53 patients: patients profile, efficacy and adverse effects. An Bras Dermatol. 2011;86:257-63. Doi: 10.1590/ s0365-05962011000200008.
  24. Reich K., Puig L., Mallbris L., et al. The effect of bodyweight on the efficacy and safety of ixekizumab: results from an integrated database of three randomised, controlled Phase 3 studies of patients with moderate-to-severe plaque psoriasis. J. Eur Acad Dermatol Venereol. 2017;31(7):1196-207. doi: 10.1111/jdv.14252.
  25. Upala S., Sanguankeo A. Effect of lifestyle weight loss intervention on disease severity in patients with psoriasis: a systemic review and meta-analysis. Int J. Obes. 2015;39:1197-202. Doi: 10.1038/ ijo.2015.64.

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