Weight Loss from Bariatric Surgery Reduces PsA Symptoms

For patients with psoriasis and psoriatic arthritis, obesity is strongly correlated. How does bariatric surgery and its associated weight loss affect psoriasis and psoriatic arthritis? The answer was revealed in a poster presentation by Soumya M. Reddy on Nov. 8 at the 2015 ACR/ARHP annual meeting in San Francisco, Calif. “A few studies have shown that weight loss results in better outcomes for these patients. Surgical weight loss, a more dramatic weight loss measure, really has not been looked at prior to this study,” said Reddy in an interview.

For the study, researchers used 2002-2013 data from one surgical center. From the 9,073 patients in the database who underwent bariatric surgery, they found 128 patients who were diagnosed with psoriasis before their surgery, and 21 of these patients who also had psoriatic arthritis. Of the 128 patients, 86 completed the study, answering questions about their psoriasis and psoriatic arthritis history, symptom changes and treatment before and after surgery. Patients lost an average of 46.2% of their excess weight, and the mean time between surgery and the study was 6.1 years.[[{"type":"media","view_mode":"media_crop","fid":"43648","attributes":{"alt":"©CLIPAREACustommedia/Shutterstock.com","class":"media-image media-image-right","id":"media_crop_3633176903240","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4803","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":"","typeof":"foaf:Image"}}]]

The results showed that a majority of patients expressed an improvement in their symptoms after bariatric surgery. The reason? It might involve two factors: adipocytes and fat cells producing pro-inflammatory mediators, and also biomechanical forces, said Reddy. “We know that obesity increases mechanical load on joints. In psoriatic arthritis, biomechanical forces are thought to play a role in the exacerbation or initiation of the disease,” she said. Reddy is an assistant professor of rheumatology at NYU Langone Medical Center, and co-director of the NYU Langone Psoriatic Arthritis Center.

References:

"Clinical Improvements in Psoriasis and Psoriatic Arthritis with Surgical Weight Loss," Soumya M. Reddy. ACR 2015. Nov. 8, 2015.