Successful use of anti-IL-23 molecules in overweight-to-obese psoriatic patients: A multicentric retrospective study

Advances in treatment with biological agents have changed the course of psoriasis. However observational reports and controlled trials draw attention to the heterogeneity of treatment response and point out that Body Mass index (BMI) may be a key factor for therapy efficacy. Therefore, we investigated the impact of BMI on the efficacy of the most recent biological molecules (anti IL-23 inhibitors) to improve patient care management. A bicentric retrospective study was performed to assess efficacy and safety of guselkumab, risankizumab and tildrakizumab in overweight-to-obese patients with moderate to-severe psoriasis up to 52 weeks of treatment. This study involved 113 patients classified according to BMI as overweight or obese. The clinical response to treatment was assessed by Psoriasis Area and Severity Index (PASI) at week 0, 24 and 52. Across all anti-IL-23 treatments, mean PASI score was ≤2 (1.1) after 6 months of treatment and decreased under 1 after 12 months in all groups. No severe adverse events, death or malignancy cases were recorded. Our results suggest that overweight or obesity does not influence therapeutic response in psoriatic patients treated with anti-IL-23 antagonists. Therefore, therapeutic strategies with this mechanism of action would be more suitable for high BMI patients.