Change in body weight and body mass index in psoriasis patients receiving biologics: A systematic review and network meta-analysis

Background: Previous studies have suggested that biologic therapy for psoriasis might relate to body weight gain. Objective: To assess the changes in body weight and body mass index (BMI) in psoriasis patients after receiving various biologics. Methods: We conducted a systematic review and network meta-analysis to evaluate the changes in body weight and BMI in psoriasis patients receiving biologics. On March 1, 2019, we searched Medline, Embase, and Cochrane Central Register of Controlled Trials for relevant studies. The Newcastle-Ottawa scale was used to assess the risk of bias. Results: We included 6 studies with 862 psoriasis patients. Compared with conventional systemic treatments, treatment with tumor necrosis factor α inhibitors was associated with a significant increase in body weight (mean difference 1.40 kg, 95% confidence interval 0.88-1.93 kg) and BMI (0.39 kg/m², 95% confidence interval 0.24-0.54 kg/m²). In contrast, no significant increase in body weight or BMI was found among patients receiving anti-interleukin (IL)-12/23 or anti-IL-17 biologics. Limitations: Only 1 study reported body weight and BMI for patients receiving the anti-IL-17 biologic. Conclusion: Tumor necrosis factor α inhibitor treatment appears to be associated with an increase in body weight and BMI, and treatment with anti-IL-12/23 and anti-IL-17 biologics do not. This association should be considered before initiating biologics for overweight and obese patients.