Effects of six months treatment with liraglutide among patients with psoriasis and obesity, beyond metabolic control?

Introduction

Obesity and psoriasis are two closely related chronic diseases and share multiple comorbidities. The common etiopathogenic basis would be a low-grade chronic inflammation, with a cross talk between adipose tissue and the skin. Obesity in patients with psoriasis results in a worse prognosis of the lesions and reduces the effectiveness of treatment.

Objectives

To assess the mid-term effect of liraglutide 3 mg on anthropometric and morphofunctional, biochemical, and dermatological parameters in patients with psoriasis and obesity.

Material and methods

48 patients were included (52.1%♀, age 48.7 ± 11.8 years, BMI 37.9 ± 5.6 kg/m², psoriasis duration 17.8 ± 11.1 years). The severity of the lesions was evaluated with the PASI (Psoriasis Area Severity Index) and the VAS (pain visual analog scale), and DLQI (Dermatology Quality Index) and the Beck depression test (BDI). Also, biochemical and anthropometric determinations were performed baseline and after 6 months.

Results

There was a reduction in BMI (37.9 ± 5.6 vs 35 ± 4.9; p < 0.001), waist circumference (111.6 ± 7 vs 104.7 ± 9.3 cm; p = 0.001) and preperitoneal fat (1.6 ± 0.6 vs 1.2 ± 0.6 cm; p < 0.0001). PASI (12 ± 8.4 to 4.3 ± 2.9; p < 0.0001), VAS (4.4 ± 1.9 vs 2.2 ± 1.6; p = 0.003), DLQI (11.9 ± 6.2 vs 4.8 ± 3.4; p < 0.0001) and BDI (15.5 ± 3.6 vs 7.6 ± 2.5; p < 0.0001) improved significantly. C-reactive protein (3.9 ± 3.1 vs 1.8 ± 3.2 mg/L; p < 0.0001), homocysteine (13 ± 3.3 vs 9.6 ± 2.5 μmol/L; p < 0.0001), and plasma cortisol (12.5 ± 4 vs 8.9 ± 3.7 μg/dL; p = 0.001). In multiple regression analysis, dermatological improvement was independent of weight loss.

Conclusions

Liraglutide exerts beneficial effects not only on BMI and visceral fat, but also reduces inflammatory parameters in patients with psoriasis and obesity, improving skin lesions and quality of life.