Weight gain and tumour necrosis factor-alpha inhibitors in patients with psoriasis.

Objective: To compare the effect of anti-tumour necrosis factor (TNF)-α therapies with agents that do not target TNF-α on bodyweight and body mass index (BMI) in patients with psoriasis.

Methods: A retrospective analysis of patients from the Skin and Cancer Foundation and St Vincent's Hospital Melbourne. Bodyweight and BMI were compared at baseline and weeks 12, 24 and 48.

Results: A total of 143 patients were studied, equating 286 treatment courses in all. Of these, 178 courses were with an anti-TNFα agent (54 on adalimumab, 61 on etanercept and 63 on infliximab) and 108 courses were on non-anti-TNFα agents (73 on efalizumab and 35 on ustekinumab). Anti-TNFα therapy with adalimumab and infliximab resulted in weight gain from week 12 until week 48. At week 12 the infliximab group gained 1.7 ± 4.7 kg and adalimumab group gained 1.5k ± 4.5 kg. This effect persisted at week 24 (infliximab: 3.4 ± 5.7 kg; adalimumab: 2.2 ± 4.4 kg) until the end of the study (infliximab: 1.3 ± 2.9 kg; adalimumab: 2.4 ± 6.4 kg). There was a trend for weight gain in the etanercept group that did not reach statistical significance. Therapy with ustekinumab and efalizumab did not result in weight gain.

Conclusions: Therapy with adalimumab and infliximab is associated with a significant increase in bodyweight and BMI.