Anti-tumour necrosis factor-alpha therapy increases body weight in patients with chronic plaque psoriasis: a retrospective cohort study.

Background Chronic plaque psoriasis is associated with overweight or obesity. Anti–tumour necrosis factor- α (anti-TNF- α ) treatments are now frequently used in psoriasis management. TNF- α is deeply involved in body weight homeostasis, which may be affected by TNF- α –targeted therapy. Objective To investigate whether anti-TNF- α treatments is associated with changes in body weight in patients with chronic plaque psoriasis. Methods We performed a retrospective controlled analysis comparing the variations in body weight and body mass index (BMI) in three closed cohorts of psoriatic patients during a 6-month treatment with etanercept ( N = 58), infliximab ( N = 40) or methotrexate ( N = 43). Results We observed a body weight increment of 1.5 ± 2.7 kg (mean ± SD; P = 0.0002) and 2.5 ± 3.3 kg ( P = 0.004) in patients treated with etanercept and infliximab, respectively. In contrast, a non-significant change (0.6 ± 1.4 kg; P = 0.4) was measured in patients treated with methotrexate. The BMI increased with 0.5 ± 0.5 ( P = 0.01) and 0.8 ± 1 ( P = 0.003) points in patients treated with etanercept and infliximab, respectively, whereas it did not change (< 0.2 ± 0.5; P = 0.06) in patients treated with methotrexate. About one fourth of patients experienced a 4- to 10-kg weight gain. Differences in body weight variations among patients treated with anti-TNF- α therapies and methotrexate were statistically significant ( P = 0.0005). We could not identify clinical parameters predicting this phenomenon. Conclusions Patients with psoriasis treated with long-term anti-TNF- α therapies may manifest a body weight gain. This effect should be taken into account in the global approach to patients with psoriasis.