Objective: Psoriasis is an inflammatory skin disease affecting 2–4% of the world population. The objective of this study was to perform a systematic review and meta-analysis synthesizing the epidemiological associations between psoriasis and obesity. Data sources: We searched for observational studies from MEDLINE, EMBASE and Cochrane Central Register from 1 January 1980 to 1 January 2012. We applied the Meta-Analysis of Observational Studies in Epidemiology guidelines in the conduct of this study. Study selection: We identified 16 observational studies with a total of 2.1 million study participants (201 831 psoriasis patients) fulfilling the inclusion criteria. Results: Using random-effects meta-analysis, the pooled odds ratio (OR) for obesity among patients with psoriasis was 1.66 (95% confidence interval (CI) 1.46–1.89) compared with those without psoriasis. From the studies that reported psoriasis severity, the pooled OR for obesity among patients with mild psoriasis was 1.46 (95% CI 1.17–1.82) and the pooled OR for patients with severe psoriasis was 2.23 (95% CI 1.63–3.05). One incidence study found that psoriasis patients have a hazard ratio of 1.18 (95% CI 1.14–1.23) for new-onset obesity. Conclusions: Overall, compared with the general population, psoriasis patients have higher prevalence and incidence of obesity. Patients with severe psoriasis have greater odds of obesity than those with mild psoriasis.

Psoriasis is an immune-mediated skin disease associated with multiple comorbidities, including psoriatic arthritis, cardiometabolic diseases, and mental health conditions.^1-5 Psoriasis and its comorbidities can lead to significant decrement in quality of life and incur substantial societal costs.⁶

Effective, well-tolerated oral psoriasis treatments are needed. To compare the efficacy and safety of deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, versus placebo and apremilast in adults with moderate to severe plaque psoriasis. Participants were randomized 2:1:1 to deucravacitinib 6 mg every day (n = 332), placebo (n = 166), or apremilast 30 mg twice a day (n = 168) in the 52-week, double-blinded, phase 3 POETYK PSO-1 trial (NCT03624127). Coprimary end points included response rates for ≥75% reduction from baseline in Psoriasis Area and Severity Index (PASI 75) and static Physician's Global Assessment score of 0 or 1 (sPGA 0/1) with deucravacitinib versus placebo at week 16. At week 16, response rates were significantly higher with deucravacitinib versus placebo or apremilast for PASI 75 (194 [58.4%] vs 21 [12.7%] vs 59 [35.1%]; P < .0001) and sPGA 0/1 (178 [53.6%] vs 12 [7.2%] vs 54 [32.1%]; P < .0001). Efficacy improved beyond week 16 and was maintained through week 52. Adverse event rates with deucravacitinib were similar to those with placebo and apremilast. One-year duration, limited racial diversity. Deucravacitinib was superior to placebo and apremilast across multiple efficacy end points and was well tolerated in moderate to severe plaque psoriasis.

Psoriasis is a chronic, inflammatory skin condition that is associated with significant morbidity.¹ The direct and indirect costs of psoriasis are estimated at $11 billion annually in the United States.² Patients with severe psoriasis often experience decrements in health-related quality of life similar to those with depression, diabetes mellitus, and congestive heart failure.³ In addition to the physical and functional impairments from their joint destruction, patients with psoriatic arthritis experience significant decrements in other aspects of activities of daily living, decreased quality of life, and loss of work productivity.⁴