Anti-Interleukin-17 Therapy of Severe Psoriatic Patients Results in an Improvement of Serum Lipid and Inflammatory Parameters’ Levels, but Has No Effect on Body Composition Parameters

BACKGROUND: Psoriasis is frequently accompanied by metabolic syndrome. Effect of anti-tumor necrosis factor therapies on increases in body weight is well-known. Data on the effects of interleukin-17 inhibitors are limited. Authors determined the effect of anti-interleukin-17 therapies on the body composition and serum lipid and inflammatory parameters among severe psoriatic patients. METHODS: Thirty-five severe psoriatic patients were enrolled. Twenty-two received secukinumab and 13 received ixekizumab as their 2nd-or 3rd-line biological treatment. Before treatment initiation and 6 months later, laboratory examinations measuring metabolic and inflammatory panels and body composition analyses were performed. RESULTS: After 6 months, a significant reduction was observed in psoriasis area severity index (p < 0.001) from 18 to 0, in c-reactive protein (p < 0.001) from 6.6 to 4.00 mg/L, in low-density lipoprotein-cholesterol (p = 0.004) from 3.69 to 3.19 mmol/L, and an improvement in high-density lipoprotein-cholesterol (p = 0.022) from 1.31 to 1.40 mmol/L. Median baseline body mass index was 32.80 kg/m2 . The body composition parameters did not show any significant changes. CONCLUSIONS: Anti-interleukin-17 therapy of severe psoriatic patients does not cause significant changes in body composition parameters. Improvements in the lipid and inflammatory parameters might have a beneficial effect on patients’ cardiometabolic status. This effect might be detectable in high-risk obese psoriatic patients

DLQI-R scoring improves the discriminatory power of theDermatology Life Quality Index in patients with psoriasis,pemphigus and morphea

Background The Dermatology Life Quality Index (DLQI) rates ‘not relevant’responses (NRRs) as the item on the questionnaire having no impact on thepatients’ lives at all. The DLQI-Relevant (DLQI-R) is a recently developed scoringthat adjusts the total score of the questionnaire for the number of NRRs indicatedby a patient.Objectives To compare the discriminatory power of the original and DLQI-R scor-ing approaches in terms of absolute and relative informativity.Methods Cross-sectional data from 637 patients with morphea, pemphigus andpsoriasis were used for the analyses. To assess absolute and relative informativity,Shannon’s index and Shannon’s evenness index were calculated for the 10 itemson the questionnaire and for DLQI and DLQI-R total scores.Results Mean DLQI and DLQI-R scores of patients were 613 vs. 691. In the su b-set of patients wit h NRRs (n = 261, 41%), absolute informativity was higherwith the DLQI-R scoring for all eight items with NRR options in all three condi-tions. The DLQI-R exhibited a better relative informativity in 8, 8 and 6 items inpemphigus, morphea and psoriasis, respectively. The DLQI-R led to an improve-ment in average item-level informativity in all DLQI score bands up to 20 points.Regarding total scores, the DLQI-R produced both a higher absolute and relativeinformativity in all three conditions.Conclusions In patients with morphea, pemphigus and psoriasis, DLQI-R scoringimproves the discriminatory power of the questionnaire by benefiting from theadditional informa tion in NRRs. DLQI-R scoring may be us eful both in clinicalpractice and research. A scoring chart has been developed to aid physicians withscoring