- In a new study, researchers say they found the medication Otezla may help people with psoriasis lose subcutaneous and visceral fat.
- They say the reduction in this body fat can improve overall cardiovascular health.
- In addition to Otezla, experts say there are a number of topical creams available to treat psoriasis.
Otezla (apremilast) is a medication approved by the Food and Drug Administration for treating plaque psoriasis.
In a
Researchers at the Perelman School of Medicine at the University of Pennsylvania measured changes in 70 study participants in inflammation around the aorta as well as looking at changes in body composition and examining 68 cardiometabolic biomarkers.
A biomarker is a molecule found in blood or other bodily fluids or tissues that signals normal and abnormal processes or a condition or disease, according to the
The Penn researchers reported that taking Otezla:
- Did not bring about meaningful changes in inflammation around the aorta
- Generated variable but generally positive decreases in cardiometabolic biomarkers
- Influenced an average of 5% to 6% reduction in subcutaneous and visceral fat. The reduced fat appeared about four months after treatment began and continued throughout the study
“The study’s most provocative findings are that the drug decreased subcutaneous and visceral fat,” said Dr. Joel M. Gelfand, MSCE, the lead author of the study and vice chair of clinical research as well as medical director of the Penn Medicine Dermatology Clinical Studies Unit and director of the Psoriasis and Phototherapy Treatment Center, in a press statement.
“We’re trying to untangle cardiovascular disease for this population so they can achieve better outcomes in the skin and joints, and live longer healthier lives,” he noted.
Subcutaneous fat is stored just under the skin or is found in the arms and legs.
Visceral fat wraps around the abdominal organs, such as the liver, stomach, and intestines. Men with a waist 40 inches or larger and women with a waist of 35 inches or larger are at risk of health problems from visceral fat, according to the Harvard TH Chan School of Public Health.
Some of the health problems associated with visceral fat include:
- Insulin resistance and diabetes
- High blood pressure
- Heart attack and heart disease
- Stroke
- Breast cancer
- Colorectal cancer
- Alzheimer’s disease
“Apremilast has been associated with mild weight loss in the past and this study supported this finding,” said Dr. Jessica Kaffenberger, a dermatologist specializing in psoriasis at The Ohio State University Wexner Medical Center.
“Unfortunately, it did not show a decrease in aortic inflammation,” Kaffenberger told Healthline. “However, it is possible that the decrease in adipose could provide cardioprotective effects. We don’t know that for sure based on this data so it would be good to see data over a longer period.”
Gelfand also worked on a
The researchers of the current study believe larger controlled studies are needed. In the meantime, they urge doctors to screen for cardiovascular disease in people with psoriasis.
This study was funded by Celgene and Amgen, both companies in the pharmaceutical industry. They do or did manufacture Otezla.
“I don’t think this is an issue,” says Kaffenberger. “There is a negative finding that the drug did not decrease aortic vascular inflammation, so I don’t think the funding sways anything.”
Topical treatments are typically the first line of treatment for people newly diagnosed with psoriasis.
These work to slow down or normalize excessive cell replication and reduce inflammation, according to the National Psoriasis Foundation.
Dr. Robert Brodell, a professor and founding chair of the Department of Dermatology and a professor in the Department of Pathology at the University of Mississippi Medical Center, detailed for Healthline some of the current topical treatments:
- Moisturizing lotions
- Tar gels and tar shampoos – Some are designed to mask odor. They are safe, but not strong compared to other options
- Topical steroids of various potencies – Because psoriasis can be difficult to treat topically, doctors often start with higher potency topical steroids and try to taper back with improvement. To maintain progress, some people can use treatments only on the weekend.
- Topical vitamin D (Calcipotriene) – This is a safer topical for long-term use, but it is not as powerful as topical steroids.
- Roflumilast cream – This is the newest topical. There haven’t been any studies comparing this to other topicals, but it appears to be quite effective without topical steroid side effects. However, it can be expensive, based on your prescription coverage.
Phototherapy is another type of treatment. When undergoing phototherapy, your skin is exposed to ultraviolet light in a controlled environment. This helps heal plaque patches.
Otezla, an oral treatment for plaque psoriasis and psoriatic arthritis, was first approved by the FDA in 2014. It is meant to be taken continuously to maintain symptom improvement. The drug is effective and is generally well tolerated, according to a
Kaffenberger prescribes the medication in her practice.
“I think it is a great choice for patients with moderate psoriasis who want an oral medicine. The other injectable biologics have a greater efficacy so they likely are a better choice for severe psoriasis,” she said. “However, we choose medications based on many factors, including comorbidities, disease severity, insurance coverage, and other factors, and I definitely use it.”
Other medications for psoriasis include Stelara, Humira, and Cosentyx.