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Year : 2020  |  Volume : 38  |  Issue : 3  |  Page : 166-171

Changes in metabolic parameters in psoriasis patients treated with interleukin-12/23 blockade (ustekinumab)

1 Department of Dermatology, College of Medicine, Chang Gung Memorial Hospital, Linkou Branch; School of Medicine, College of Medicine; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
2 Department of Dermatology, College of Medicine, Chang Gung Memorial Hospital, Linkou Branch; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
3 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University; Department of Statistics, National Taipei University, Taipei, Taiwan
4 School of Medicine, College of Medicine, Chang Gung University; Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan

Correspondence Address:
Dr. Ya-Ching Chang
Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fushin Street, Taoyuan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ds.ds_27_20

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Background: The associations between psoriasis, metabolic syndrome, and cardiovascular events are increasingly recognized. Studies have shown decreased cardiovascular events with the treatment of methotrexate and anti-tumor necrosis factor-α. However, effects of interleukin (IL)-12/23 blockade remain debatable. Objectives: Our study sought to investigate the effect of IL-12/23 blockade on the metabolic parameters in patients with psoriasis. Methods: We performed a retrospective cohort study to assess 93 consecutive patients with moderate-to-severe plaque-type psoriasis who received IL-12/23 blockade (ustekinumab) for 24 weeks between January 2012 and May 2016. Results: Metabolic parameters and disease activity (psoriasis area severity index score) at baseline and 24 weeks of treatment were collected. At week 24 (wk24), the disease activity improved significantly (mean: baseline, wk0: 21.35 ± 11.55 to wk24: 6.87 ± 6.81, P < 0.0001), with a significant reduction of erythrocyte sedimentation rate. Conversely, body mass index was significantly elevated in PASI-75 responders at wk24 of treatment and was independent of disease severity. Fasting sugar and triglyceride level were elevated at wk24. Cholesterol (Chol), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) remained unchanged. These metabolic parameters were not correlated with the improvement in disease severity after ustekinumab treatment. Nonetheless, the atherogenic index, LDL/HDL ratio, and Chol/HDL ratio remained unchanged. Male gender is a predictor of elevated plasma triglyceride level. Conclusion: Our results suggest that despite tremendous improvement in disease activity after ustekinumab treatment, obesity, fasting sugar, and hypertriglyceridemia are still present in these patients. Regular screening of lipid profile and obesity control is advised during the treatment of ustekinumab, especially in male psoriasis patients with predisposing cardiovascular risks.

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