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Impact of 24-month treatment with etanercept, adalimumab, or methotrexate on metabolic syndrome components in a cohort of 210 psoriatic arthritis patients

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Abstract

Psoriatic arthritis (PsA) is a chronic inflammatory condition, characterized by an excess of metabolic disorders. Metabolic syndrome (MetS) is a cluster of classic cardiovascular risk factors, due to an imbalance between pro- and anti-inflammatory adipokines. Tumor necrosis factor (TNF)-α is a pro-inflammatory adipocytokine mainly produced by monocytes and macrophages with a central role in inflammatory responses, but it also induces adipocytes apoptosis, promotes insulin resistance, and stimulates lipolysis. The aim of this study was to evaluate the impact of therapy with etanercept (ETN), adalimumab (ADA), and methotrexate (MTX) on MetS components in a cohort of PsA patients with a follow-up period of 24 months. A retrospective study has been conducted in a cohort of PsA patients. On the basis of the inclusion criteria, we identified the first 70 consecutive patients, respectively, on ADA, ETN, and MTX, for a total of 210 patients achieving PsARC criteria during the observation period. As part of the routine clinical practice, assessment of metabolic parameters and of disease activity was recorded at baseline (T0), at 12 months (T1), and at 24 months (T2). The results show that when the specific components of the MetS were considered, taking also into account by regression analysis the effect of the confounding factors, the patients on etN and ADA show a significant improvement of the metabolic syndrome components (in detail, waist circumference, triglycerides, high-density lipoprotein cholesterol, and glucose) as compared to the MTX group. In conclusion, these data suggest that the biologic treatment in PsA can no longer be taken into consideration only for its positive effect on articular and cutaneous symptoms but also on the various aspects of this complex picture.

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Authors and Affiliations

  1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University Federico II, via S. Pansini 5, 80131, Naples, Italy

    Luisa Costa, Mariangela Atteno, Antonio Del Puente & Raffaele Scarpa

  2. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy

    Luisa Costa, Francesco Caso, Augusta Ortolan, Ugo Fiocco, Roberta Ramonda & Leonardo Punzi

  3. Department of Statistical Sciences, University of Padova, Padova, Italy

    Md Abud Darda

  4. Sapienza Università di Roma, Rome, Italy

    Paolo Caso

Authors
  1. Luisa Costa
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  2. Francesco Caso
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  3. Mariangela Atteno
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  4. Antonio Del Puente
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  5. Md Abud Darda
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  6. Paolo Caso
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  7. Augusta Ortolan
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  8. Ugo Fiocco
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  9. Roberta Ramonda
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  10. Leonardo Punzi
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  11. Raffaele Scarpa
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Corresponding author

Correspondence to Luisa Costa.

Additional information

Luisa Costa and Francesco Caso contributed equally to this study.

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Costa, L., Caso, F., Atteno, M. et al. Impact of 24-month treatment with etanercept, adalimumab, or methotrexate on metabolic syndrome components in a cohort of 210 psoriatic arthritis patients. Clin Rheumatol 33, 833–839 (2014). https://doi.org/10.1007/s10067-013-2369-1

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  • DOI: https://doi.org/10.1007/s10067-013-2369-1

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