Impact of excess weight on clinical features of psoriasis and efficacy of biologic therapies in children with severe psoriasis: Analysis of data from the BiPe cohorts

Abstract

Background

Being overweight or obese is associated with both the occurrence of childhood psoriasis and increased severity thereof. We evaluated the impact of being overweight or obese on the clinical features of severe psoriasis in children treated with etanercept, adalimumab, or ustekinumab, and on the therapeutic effectiveness of these treatments using data from the BiPe cohorts.

Patients and methods

Children from the BiPe cohorts with available baseline body mass index data were included. Data from two groups, “normal weight” and “overweight-to-obese” (OTO), and from two OTO subgroups, overweight and obese, were analyzed.

Results

Of the 134 children included, 98 (73.1%) were of normal weight, and 36 (26.9%) were OTO, including 21 (15.7%) overweight and 15 (11.2%) obese children. There were no between-group differences in age at psoriasis onset, family history, clinical features, or severity. Compared to the normal weight group, psoriatic arthritis was more frequent in the OTO group (5.1% versus 16.7% respectively; P = 0.03) and in the overweight and obese subgroups (5.1% versus 14.3% and 20.0%, respectively; P = 0.08). Analysis of PASI scores after 3 months of treatment suggested that biologic therapy efficacy was higher for the OTO group than the normal weight group. Drug continuation rates tended to be lower for the OTO group, particularly for adalimumab (P = 0.0002).

Discussion

OTO status was associated with a higher frequency of psoriatic arthritis in children with psoriasis. Except for lower rates of adalimumab continuation, overall biologic therapy efficacy was similar in the normal and OTO groups. Studies involving larger cohorts are needed to confirm these findings.