Dr Steven R. Feldman on the Effect of Metabolic Syndrome on Treatments for Psoriasis

Steven R. Feldman, MD, PhD, professor of dermatology, Wake Forest School of Medicine, discusses how some drugs for psoriasis are less effective in the presence of metabolic syndrome.

TranscriptHow does the presence of metabolic syndrome impact the efficacy of psoriasis treatment?

The presence of metabolic syndrome does affect the efficacy of psoriasis treatments, or at least it’s associated with worse efficacy. So, there was a study done that found people with metabolic syndrome had high rates of failing their treatment for their psoriasis. It may help to use medicines that are either more potent or don’t care whether you have metabolic syndrome.

Are there any data to help clinicians select an effective psoriasis treatment for patients who also have metabolic syndrome?

There are some data that tell us what drug might be more effective for someone with metabolic syndrome. Some of the drugs are dosed based on weight. And for those drugs, the heavier patients do well on a higher dose—and we have the data to support that. Other drugs may not be weight based, and they may have some tendency to be less effective in people who are more obese. One of the drugs, tildrakizumab, had some data showing it worked equally well in patients who either had or did not have metabolic syndrome.