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Body mass index in patients with moderate-to-severe psoriasis in Spain and its impact as an independent risk factor for therapy withdrawal: results of the Biobadaderm Registry

Authors


  • Conflicts of interest

    Dr Carrascosa served as a consultant and participated in speakers' bureaus for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyeth. Dr Garcia-Doval received a travel grant for a congress from Merck/Schering-Plough Pharmaceuticals. Dr Carretero served as a consultant for Abbott Laboratories, Janssen-Cilag Pty Limited, MSD, and Pfizer Inc; gave expert testimony for Abbott Laboratories, MSD, and Pfizer Inc; received grants from Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer Inc and equipment from MSD and Pfizer Inc. Dr Vanaclocha participated in speakers' bureaus for Abbott Laboratories, Pfizer Inc, MSD, and Janssen Pharmaceuticals Inc. Dr Daudén served as a consultant for Abbott Laboratories, Amgen, Astellas, Celgene, Centocor Ortho Biotech Inc, Galderma, Glaxo, Jannsenn-Cilag, Leo Pharma, MSD, Novartis, and Pfizer Inc; received honoraria form Abbott Laboratories, Amgen, Celgene, Janssen-Cilag Pty Ltd, Leo Pharma, MSD, Novartis, and Pfizer Inc; participated in speakers' bureaus for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer Inc; and received grants from Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer Inc. Dr Herrera-Ceballos served as a consultant and participated in speakers' bureaus for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyett. Dr De la Cueva acted as a consultant for Janssen-Cilag, Abbott, MSD, Pfizer, Leo-Pharma and Novartis. Dr Belinchón acted as a consultant for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyeth. Dr Sánchez-Carazo acted as a consultant for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyeth. Dr Alsina gave expert testimony for Abbott Laboratories and Merck/Schering-Plough. Dr López-Estebaranz served as a consultant for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyeth and participated in speakers' bureaus for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyeth. Dr Ferrán acted as a consultant for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyeth; participated in speakers' bureaus for Janssen Pharmaceuticals Inc and MSD; and received grants from Serono. Dr Rivera participated in speakers' bureaus for Abbott Laboratories, Janssen Pharmaceuticals Inc, MSD, and Pfizer-Wyeth. Dr Ferrandiz served as a consultant for Abbott Laboratories, Janssen Pharmaceuticals Inc, and Almirall SA; received honoraria from Abbott Laboratories, Almirall SA, Janssen Pharmaceuticals Inc, and Pfizer Inc; participated in a speaker's bureau for Abbott Laboratories, Almirall SA, and Janssen Pharmaceuticals Inc and received grants from Abbott Laboratories. The remaining authors declare no conflicts of interest.

  • Funding sources

    The BIOBADADERM project is financed by the Fundación Academia Española de Dermatología y Venereología, which receives support from the Spanish Medicines and Health Products Agency (AEMPS) and from pharmaceutical companies (Abbott, Pfizer, MSD and Janssen). The Spanish Academy of Dermatology offered administrative support, and the Agencia Española del Medicamento y Productos Sanitarios reviewed the study protocol. Apart from these contributions, none of the sponsors had a role in the design and conduct of the study; in the collection, analysis, and interpretation of data; or in the preparation, review or approval of the manuscript.

Abstract

Background

There are few data on the prevalence of obesity in the general psoriasis population and on the real impact of obesity on the management of psoriasis patients in the clinical setting.

Objectives

To evaluate the prevalence of overweight and obesity in patients with moderate-to-severe psoriasis compared to the general population and to assess the relationship between Body Mass Index (BMI) and the risk of discontinuing treatment.

Methods

Patients registered on Biobadaderm, a prospective registry, were grouped according the different categories of BMI and compared to the general Spanish population. Drug survival was analysed considering only drug withdrawal due to lack of effectiveness, remission and adverse events.

Results

A total of 1162 moderate-to-severe psoriasis patients on systemic conventional or biological treatment were recruited. The prevalence of obesity was found to be significantly higher in psoriasis patients than in the general Spanish population (P < 0.001). In multivariate analysis a 5-unit increase in BMI, similar to a change in BMI category from normal weight to overweight and from overweight to obesity, was associated with a 12% increased risk of discontinuing therapy due to lack of effectiveness (HR 1.12, 95% CI: 1.01–1.24) and with a 17% increased risk of having an adverse event (HR 1.17, 95% CI: 1.02–1.36), both independently of the drug used.

Conclusions

Patients with moderate-to-severe psoriasis had a higher prevalence of obesity than the general population. Increased BMI was associated with an increased risk of treatment discontinuation due to lack of effectiveness and a higher risk of adverse events.

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