Weight loss with treatment can help psoriatic arthritis

| Melissa Leavitt

Weight loss and treatment may work together to improve disease symptoms in overweight people with psoriatic arthritis

A recent study, published in June in Annals of the Rheumatic Diseases, found that patients who took a certain kind of biologic medication while losing weight improved more than patients who just took the medication.

The study involved 138 patients with psoriatic arthritis starting treatment with biologics that target tumor necrosis factor-alpha (TNF-alpha), which is a cytokine, or protein, that promotes inflammation. 

People with psoriatic disease who are also overweight may experience a double dose of inflammation, according to the researchers. Previous studies have found that losing weight can reduce psoriasis severity.

As the research team noted in an article published last year in Rheumatology, fat cells secrete many of the same cytokines involved in psoriatic disease, such as TNF-alpha. Even if an overweight patient takes a TNF-alpha blocker, the researchers hypothesized, their body weight may prevent the medication from working.

This study sought to determine whether coupling TNF-alpha treatment with weight loss could improve outcomes for obese patients.

The biologics used in the study were Enbrel (etanercept), Humira (adalimumab) and Remicade (infliximab). All of the participants were overweight or obese, with a body mass index of 25 or more. Half of the patients were placed on a low-calorie diet, restricted to less than 1,500 calories a day, while the other half were simply given nutritional guidelines. Of the original patient group, 126 participants completed the study.

Patients were evaluated once a month, with a final assessment at the end of the six-month study. Researchers employed many different methods of measuring disease improvement, such as the number of swollen or tender joints, the degree of pain the patient experienced and the severity of skin symptoms. These measurements were combined to determine which patients achieved Minimal Disease Activity (MDA), which the researchers defined as a successful treatment outcome.

At the end of the study, almost 43 percent of patients on the diet achieved MDA, along with almost 35 percent of patients in the non-diet group. This number included patients from each biologic group.

The diet had less of an impact on treatment outcome than whether or not the patients lost weight. Researchers found that almost 45 percent of the patients who lost between 5-10 percent of their body weight—and almost 60 percent of the patients who lost more than 10 percent—achieved MDA. This group included both patients who followed the diet and those who did not. 

According to the researchers, this suggests that regardless of what a patient eats, losing weight may play a major role in determining treatment outcomes for obese patients who take TNF-alpha blockers.


Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

Recent Advance Posts

abstract representation of data streams
Scientists have moved way past the old, slow ways of gathering data. Read on to...
doctor and patient
Despite some limitations, phototherapy provides lasting relief for many people...
Piggy bank and money
Italian researchers, after assessing the direct and indirect costs of biologics...
Lunch at picnic table in bright sun
Simple things you can do to protect your skin as the weather warms up – plus a...
Joni Kazantzis and her two daughters
Parenting is enough of a challenge without adding a chronic disease to the mix...
Eric Fielding
Two men with no scientific training bridge the gap between patients and...
Katie Chambers
Katie Chambers never gave up until she found the right doctor, the right...
table full of fresh fruits, vegetables, nuts and herbs
Registered dietitian nutritionist Paula Vokoun clears up the confusion when it...
Jody Quinn with Mayor Marty Walsh, Zakim Bridge in NPF colors, Quinn and Team NPF
Jody Quinn, of Kingston, Massachusetts, has had an impressive run advocating...