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Review
. 2025 Apr;92(4):807-815.
doi: 10.1016/j.jaad.2024.12.016. Epub 2024 Dec 19.

The association between obesity and efficacy of psoriasis therapies: An expert consensus panel

Joshua Burshtein  1 , April Armstrong  2 , May Chow  3 , Lauren DeBusk  4 , Brad Glick  5 , Alice B Gottlieb  6 , Linda Stein Gold  7 , Neil J Korman  8 , Peter Lio  9 , Joseph Merola  4 , David Rosmarin  10 , Angela Rosenberg  4 , Abby Van Voorhees  11 , Mark Lebwohl  12
Affiliations
Review

The association between obesity and efficacy of psoriasis therapies: An expert consensus panel

Joshua Burshtein et al. J Am Acad Dermatol. 2025 Apr.

Abstract

Background: Psoriasis is a chronic inflammatory skin disease often associated with obesity. Psoriasis therapies may be less effective in patients with obese. The purpose of this expert consensus panel is to evaluate the relationship between obesity and efficacy of psoriasis therapies, thereby optimizing patient care.

Methods: A comprehensive literature search was completed on July 19, 2024, using the keywords "psoriasis," "obesity," "efficacy," "treatments," and "therapies." A panel of 11 dermatologists with significant expertise in treatment of psoriasis gathered to review the articles and create consensus statements. A modified Delphi process was used to approve each statement and a strength of recommendation was assigned.

Results: The literature search produced 500 articles. A screening of the studies resulted in 22 articles that met criteria. The panel unanimously voted to adopt 10 consensus statements and recommendations, 6 were given a strength of "A," 2 were given a strength of "B," and 2 were given a strength of "C."

Conclusion: Psoriasis and obesity have a strong association. Obesity decreases efficacy of biologics and may decrease efficacy and potentiate side effects of conventional therapies. It also impacts drug survival. Weight control is a vital component of caring for patients with psoriasis and the number of therapeutic options available is rising.

Keywords: TNF inhibitors; biologics; efficacy; new therapies; obesity; psoriasis; weight loss.

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Conflict of interest statement

Conflicts of interest Dr Armstrong has served as a research investigator, scientific adviser, or speaker to AbbVie, Almirall, Arcutis, ASLAN, Beiersdorf, BI, BMS, EPI, Incyte, Leo, UCB, Janssen, Lilly, Nimbus, Novartis, Ortho Dermatologics, Sun, Dermavant, Dermira, Sanofi, Regeneron, and Pfizer. Dr Glick has served as an adviser, consultant, speaker, or investigator for Amgen, AbbVie, AstraZeneca, Almirall, Arcutis, Bausch Health/Valeant, Ortho Dermatologics, Boehringer Ingelheim, Bristol-Myers Squibb, Brickell Biotech, Cara, ChemoCentryx, Dermavant, Dermira, Eli Lilly, EPI/Novan, Incyte, Janssen Pharmaceuticals, LEO Pharma, Galderma, Nimbus Lakshmi, Inc, Novartis, Sun Pharma, Pfizer, Sanofi, Regeneron, UCB and the CorEvitas AD, CorEvitas PSO, and PROSE Registries and is a shareholder of Top MD. Dr Gottlieb has received research/educational grants from Highlights Therapeutics, Bristol-Myers Squibb, Janssen, and UCB Pharma (all paid to Mount Sinai School of Medicine) and has received honoraria as an advisory board member and consultant for Amgen, AnaptysBio, Avotres Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Dice Therapeutics, Eli Lilly, Highlights Therapeutics, Janssen, Novartis, Sanofi, Teva, UCB, and XBiotech (stock options for RA). Dr Gold has served as an adviser, consultant, speaker, or investigator for Amgen, AbbVie, Almirall, Arcutis, Bausch Health/Valeant, Ortho Dermatologics, Bristol-Myers Squibb, Cara, Dermavant, Dermira, Eli Lilly, Incyte, Janssen Pharmaceuticals, LEO Pharma, Galderma, Novartis, Sun Pharma, Pfizer, Sanofi, Regeneron, and UCB. Dr Korman has served as an adviser, consultant, speaker, or investigator for AbbVie, Abcentra, Amgen, Argenx, Astrazeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Castle Bioscience, Celgene, ChemoCentryx, Dermavant, Eli Lilly, Galderma, Incyte, Janssen, Kyowa Hakko Kirin Pharma, Leo Pharma, Menlo Therapeutics, Novartis, Olix, Pfizer, Principia, Regeneron, Sun Pharma, Trevi, UCB, and XBiotech. Dr Lio reports research grants/funding from AbbVie and AOBiome, is on the speaker’s bureau for AbbVie, Arcutis, Eli Lilly, Galderma, Hyphens Pharma, Incyte, La Roche-Posay/L’Oreal, MyOR Diagnostics, ParentMD, Pfizer, Pierre-Fabre Dermatologie, Regeneron/Sanofi Genzyme, and Verrica, reports consulting/advisory boards for Alphyn, AbbVie, Almirall, Amyris, Arcutis, ASLAN, Boston Skin Science, Bristol-Myers Squibb, Burt’s Bees, Castle Biosciences, Codex Labs, Concerto Biosci, Dermavant, Eli Lilly, Galderma, Janssen, Johnson & Johnson, Kimberly-Clark, LEO Pharma, Lipidor, L’Oreal, Merck, Micreos, MyOR Diagnostics, Regeneron/Sanofi Genzyme, Skinfix, Theraplex, UCB, Unilever, Verrica, and Yobee Care, stock options with Codex, Concerto Biosciences, and Yobee Care, and has a patent pending for a Theraplex product with royalties paid and is a Board Member and Scientific Advisory Committee Member of the National Eczema Association. Dr Merola is a consultant and/or investigator for Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, AbbVie, Dermavant, Eli Lilly, Incyte, Novartis, Janssen, UCB, Sanofi-Regeneron, Sun Pharma, Biogen, Pfizer and Leo Pharma. Dr Rosmarin has consulted, spoken for, or conducted trials for AbbVie, Abcuro, Almirall, AltruBio, Amgen, Astria, Boehringer Ingelheim, Bristol Meyers Squibb, Celgene, Concert, CSL Behring, Dermavant, Dermira, Dualitas, Galderma, Incyte, Janssen, Kymera, Kyowa Kirin, Lilly, Merck, Nektar, Novartis, Pfizer, RAPT, Regeneron, Recludix, Revolo Biotherapeutics, Sanofi, Sun Pharmaceuticals, UCB, Viela Bio, and Zura Bio. Dr Van Voorhees has served as a consultant for BMS, BI, and Eluciderm. Dr Lebwohl is an employee of Mount Sinai and receives research funds from AbbVie, Amgen, Arcutis, Avotres, Boehringer Ingelheim, Cara therapeutics, Dermavant Sciences, Eli Lilly, Incyte, Inozyme, Janssen Research & Development, LLC, Ortho Dermatologics, Pfizer, Sanofi-Regeneron, and UCB, Inc, and is a consultant for Almirall, AltruBio Inc, AnaptyBio, Apogee, Arcutis, Inc, AstraZeneca, Atomwise, Avotres Therapeutics, Brickell Biotech, Boehringer Ingelheim, Bristol-Myers Squibb, Castle Biosciences, Celltrion, CorEvitas, Dermavant Sciences, EPI, Evommune, Inc, Facilitation of International Dermatology Education, Forte biosciences, Foundation for Research and Education in Dermatology, Galderma, Genentech, Incyte, LEO Pharma, Meiji Seika Pharma, Mindera, Pfizer, Sanofi-Regeneron, Seanergy, Strata, Takeda, Trevi, and Verrica. The other authors have no conflicts of interest to declare.

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