Eva Galíndez1, Loreto Carmona2. 1. Servicio de Reumatología, Hospital Universitario Basurto, Bilbao, Vizcaya, España. Electronic address: evagalindez@gmail.com. 2. Instituto de Salud Musculoesquelética, Madrid, España.
Abstract
OBJECTIVES: To assess the association between obesity, control of inflammatory activity and increased adverse effects in psoriatic arthritis (PsA) with disease-modifying anti-inflammatory drugs (DMARD). METHODS: A systematic literature review was performed using MEDLINE and EMBASE databases following the guidelines of the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) consensus statement. Studies were selected if they included patients with PsA, obesity was studied as a predictive factor, and the outcome was adverse effects, including efficacy failure. Quality was assessed using an ad hoc risk of bias tool. A qualitative analysis was carried out by type of study and study population, quality and specific results. RESULTS: We found 1043 articles, discarding most of them on the basis of title and abstract. Ten articles were studied in detail and finally excluded three. The majority concluded, with statistically significant results, that in patients with PsA and treated with TNFα inhibitors (TNFαi), obesity is associated with poorer chances of achieving and maintaining a minimal disease activity, higher treatment discontinuation rates, and lower skin response. Regarding conventional synthetic DMARD, a trend toward a moderate increase in transaminases with methotrexate (MTX) was observed in obese patients with PsA. CONCLUSIONS: Obesity is a negative predictor of clinical response in patients with PsA being treated with TNFαi. Except MTX hepatotoxicity, no other adverse effects, either with TNFαi or other drugs, were found in relation to obesity in PsA.
OBJECTIVES: To assess the association between obesity, control of inflammatory activity and increased adverse effects in psoriatic arthritis (PsA) with disease-modifying anti-inflammatory drugs (DMARD). METHODS: A systematic literature review was performed using MEDLINE and EMBASE databases following the guidelines of the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) consensus statement. Studies were selected if they included patients with PsA, obesity was studied as a predictive factor, and the outcome was adverse effects, including efficacy failure. Quality was assessed using an ad hoc risk of bias tool. A qualitative analysis was carried out by type of study and study population, quality and specific results. RESULTS: We found 1043 articles, discarding most of them on the basis of title and abstract. Ten articles were studied in detail and finally excluded three. The majority concluded, with statistically significant results, that in patients with PsA and treated with TNFα inhibitors (TNFαi), obesity is associated with poorer chances of achieving and maintaining a minimal disease activity, higher treatment discontinuation rates, and lower skin response. Regarding conventional synthetic DMARD, a trend toward a moderate increase in transaminases with methotrexate (MTX) was observed in obesepatients with PsA. CONCLUSIONS:Obesity is a negative predictor of clinical response in patients with PsA being treated with TNFαi. Except MTXhepatotoxicity, no other adverse effects, either with TNFαi or other drugs, were found in relation to obesity in PsA.
Authors: Juan Carlos Torre-Alonso; Loreto Carmona; Mireia Moreno; Eva Galíndez; Jesús Babío; Pedro Zarco; Luis Linares; Eduardo Collantes-Estevez; Manuel Fernández Barrial; Juan Carlos Hermosa; Pablo Coto; Carmen Suárez; Raquel Almodóvar; Jesús Luelmo; Santos Castañeda; Jordi Gratacós Journal: Rheumatol Int Date: 2017-04-07 Impact factor: 2.631
Authors: Eva Klingberg; Annelie Bilberg; Sofia Björkman; Martin Hedberg; Lennart Jacobsson; Helena Forsblad-d'Elia; Hans Carlsten; Björn Eliasson; Ingrid Larsson Journal: Arthritis Res Ther Date: 2019-01-11 Impact factor: 5.156
Authors: Marco Fiore; Sebastiano Leone; Alberto Enrico Maraolo; Emilio Berti; Giovanni Damiani Journal: Biomed Res Int Date: 2018-02-06 Impact factor: 3.411