Psoriasis and psoriatic arthritis symptoms have been found to be improved by bariatric surgery and excessive weight loss. Psoriasis is an autoimmune disease that causes the skin to become scaly. Some patients also develop inflammation known as psoriatic arthritis, which affects the joints.
Treatment for psoriasis and psoriatic arthritis typically involves drug treatments that suppress the immune system and reduce inflammation.
Obesity has been found to be more common in psoriasis patients and this has been found to be linked to fat tissue-driven systemic inflammation.
Lead investigator Dr. Soumya M. Reddy said, “Recent studies suggest that obesity is a risk factor for the development of psoriasis and psoriatic arthritis, and precedes the onset of these conditions in many cases. Obesity is thought to drive systemic inflammation because adipose tissue (fat cells) are known to produce pro-inflammatory molecules, known as adipokines, and cytokines. In addition, increased biomechanical stress at the entheses due to obesity is also proposed as another mechanism that may trigger systemic inflammation at this site.”
The researchers reviewed a database of 9,073 bariatric patients and contacted them to discuss their medical history involving psoriasis and psoriatic arthritis. The researchers contacted 128 patients and 86 of them participated in the study. Follow-up was on average six years after the surgery and the researchers were looking for a five-point reduction in symptoms based on a zero to 10 scale.
Dr. Reddy explained, “When asked to compare their symptoms before surgery to their symptoms one year and after, 55 percent of participants with psoriasis, and 62 percent with psoriatic arthritis, reported improvements in their symptoms to our team.”
On average, psoriasis patients dropped on average from 5.6 to 4.4 on the 10-point scale and psoriatic arthritis patients dropped from 6.4 to 4.5.
“Our study suggests a relationship of surgical weight loss and subjective improvements in psoriasis and psoriatic arthritis. It does not demonstrate a causal link, and further prospective studies are required to confirm these findings,” added Dr. Reddy.
Additional research is required to confirm the results, but in the meantime Dr. Reddy recommends that rheumatologists talk to their patients about maintaining a healthy weight.
“It is important to undertake healthy choices for diet and exercise for weight management.” Dr. Reddy concluded, “Recent studies show that weight loss may improve a person’s response to medications for psoriasis and psoriatic arthritis and increase the chances of achieving a minimal disease activity state. While we do not have enough information yet to make clear recommendations for medication or surgical interventions for weight loss at this time, there is enough literature that points to the need to have conversations about weight management with our patients now. At our NYU Psoriatic Arthritis Center, we take a multidisciplinary approach to these issues, and patients are referred to a dedicated nutritionist on site when appropriate.”
The link between psoriasis and psoriatic arthritis
Psoriasis – an autoimmune disorder – causes inflammation that attacks the joint. This is known as a separate condition – psoriatic arthritis. It may not make much sense that a skin condition and a joint condition are related, but in fact, both conditions have a strong underlying cause, that being an immune system problem.
Unfortunately, preventing psoriatic arthritis is not yet possible, but researchers believe as long as it is caught early on, treatment can be administered right away, which can reduce damage caused to the joints. There are many medications that your doctor can prescribe in order to treat your psoriatic arthritis, so speak to them to determine which one is the best option for you.