P166 High body mass index psoriasis is associated with higher prevalence of cardiometabolic disease, psoriatic arthritis, and systemic inflammation

Abstract Background/Aims Psoriasis and obesity share inflammatory pathways, suggesting a bidirectional relationship with overlapping comorbid complications that can impact overall patient health. This analysis evaluated baseline data from 17 clinical trials of patients with moderate-to-severe psoriasis to assess baseline comorbidities across the body mass index (BMI) spectrum. Methods This integrated data set included 17 randomised clinical trials on psoriasis described by Lebwohl et al., 2025. Participants were adults with moderate-to-severe psoriasis. Baseline comorbidities and disease severity were analyzed by the following BMI groups ≥18.5 to 25 (Normal), ≥25 to 30 (Overweight), and ≥30 (Obesity). The non-parametric Mann-Whitney U test was used to statistically compare differences between the Obesity or Overweight groups vs the Normal BMI group, with p-value ≤0.05 signalling statistical differences. Results Among 7029 trial participants, BMI groups included 1710, 2291, and 3028 participants in the Normal BMI, Overweight and Obesity categories, respectively. Mean BMIs (kg/m2) were 36.7, 27.5 and 22.5 for Obesity, Overweight and Normal BMI groups, respectively. Participants with Obesity and Overweight had statistically significantly higher baseline prevalence of comorbidities: hypertension in Obesity (41.7% 40.0%; 43.5%) and Overweight (24.5% 22.7%; 26.2%) groups vs Normal BMI (10.8% 9.3%; 12.3%) group: hyperlipidaemia in Obesity (25.2% 23.6%, 26.7%) and Overweight (16.8% 15.2%; 18.3%) groups vs Normal (8.3% 7.0%, 9.6%) BMI group; diabetes in Obesity (16.9%, 15.6%; 18.2%) and Overweight (8.1%, 7.0%; 9.2%) groups vs Normal BMI (3.5%, 2.6%; 4.4%) group; cardiovascular disease in Obesity (3.1% 2.5%; 3.8%) and Overweight (2.0% 1.4%; 2.5%) groups vs Normal BMI (0.9% 0.5%; 1.4%) group; asthma in Obesity (7.3% 6.4%; 8.2%) and Overweight (4.1% 3.3%; 4.9%) groups vs Normal BMI (3.6% 2.7%; 4.5%) group; metabolic dysfunction-associated liver disease in Obesity (3.4% 2.7%; 4.0%) group vs Normal BMI (0.9% 0.4%; 1.3%) group. No significant difference was observed between the Overweight and Normal BMI groups for metabolic dysfunction-associated liver disease. Psoriatic Arthritis (PsA) baseline diagnosis was higher in Obesity (23.6% 22.1%; 25.2%) and Overweight (18.2% 16.6%; 19.8%) groups vs Normal BMI (14.5% 12.8%; 16.2%) group. C-reactive protein (CRP) levels (Mean mg/L SD) levels were also significantly higher in Obesity (7.6 10.6, p 0.001) and Overweight (4.2 7.0, p 0.001) groups vs Normal BMI (4.1 11.3) group. Measures of psoriasis severity including Static Physician’s Global Assessment (sPGA) score and Psoriasis Area and Severity Index (PASI) were significantly higher in Obesity vs Normal BMI groups. Conclusion In patients with moderate-to-severe psoriasis, overweight or obesity was associated with higher baseline psoriasis severity, cardiometabolic burden, asthma, metabolic dysfunction-associated liver disease, PsA, and systemic inflammation. These burdens underscore the broader unmet healthcare needs in high BMI psoriasis. Emerging therapeutic strategies offer dermatologists opportunities to intervene to modify the overall health and disease of patients with both moderate-to-severe psoriasis and obesity or overweight BMI. Disclosure J.F. Merola: Consultancies; AbbVie, Amgen, Biogen, Bristol Myers Squibb, Dermavant, Eli Lilly and Company, Janssen, LEO Pharma, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharma, and UCB Pharma. M. Lebwohl: Honoraria; AnaptysBio, Arcutis, Arena Pharmaceuticals, Aristea Therapeutics, Avotres, BiomX, Boehringer Ingelheim, Brickell Biotech, Castle Biosciences, CorEvitas, Dermavant, Evommune, FIDE, FortéBio, Foundation. Grants/research support; AbbVie, Amgen, Arcutis, Avotres, Boehringer Ingelheim, Cara Therapeutics, Dermavant, Eli Lilly and Company, Incyte Corporation, Inozyme Pharma, Janssen, Novartis, Ortho Dermatologics, Regeneron. Other; Hexima, Meiji Seika Pharma, Mindera, National Society for Cutaneous Medicine, New York College of Podiatric Medicine, Pfizer, Seanergy Maritime Holdings, Sun Pharma, Verrica Pharmaceuticals, and Vial. C.E.M. Griffiths: Grants/research support; AbbVie, Almirall, AnaptysBio, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Eli Lilly and Company, Evelo Biosciences, Inmagene, Janssen, Kyowa Kirin, Novartis, Nxera, ONO Pharmaceutical, Pfizer. Y. Okubo: Consultancies; AbbVie GK, Amgen, Bristol Myers Squibb, Eli Lilly Japan, Janssen, Kyowa Kirin, Nippon Boehringer Ingelheim, and Sanofi. Honoraria; AbbVie GK, Amgen, Kyowa Kirin, Nippon Boehringer Ingelheim, and UCB Japan. Grants/research support; Sun Pharma Japan, AbbVie GK, Janssen, Pfizer Japan, and Syneos Health Clinical. Other; AbbVie GK, Amgen, Bristol Myers Squibb, Eli Lilly Japan, Janssen, Kyowa Kirin, Maruho, Nippon Boehringer Ingelheim, Sanofi, and UCB Japan. R. Bahl: Corporate appointments; Employee and shareholder of Eli Lilly and Company. B. Park: Corporate appointments; Employee and shareholder of Eli Lilly and Company. N. Somani: Corporate appointments; Employee and shareholder of Eli Lilly and Company. J. Swift: Corporate appointments; Employee and shareholder of Eli Lilly and Company.