Bariatric Surgery Reduces Psoriatic Arthritis Symptoms!

NYU Langone Medical Center researchers have found that psoriatic arthritis and psoriasis symptoms were significantly lessened in patients who underwent bariatric (weight loss) surgery. The study was led by Soumya Reddy, M.D., an assistant professor of medicine in the division of rheumatology at NYU Langone, and co-director of NYU Langone’s Psoriatic Arthritis Center.

According to the November 7, 2015 news release, Dr. Reddy and her colleagues reviewed the medical charts of 9, 073 weight-loss surgery patients who were treated between 2002 and 2013 at NYU Langone’s Weight Management Program. “They identified 86 patients who had psoriasis before their operation, 21 of whom were also diagnosed with psoriatic arthritis, and compared their symptoms before and after undergoing bariatric surgery. Patients were on average monitored for more than six years, with an average excess weight loss of 46.2% body weight.”

The researchers found that 62% of patients with psoriatic arthritis and 55% of patients with psoriasis reported improvements in their disease.

Dr. Reddy commented to OTW, “We undertook this study because of the increasing evidence of the association of obesity and psoriasis and psoriatic arthritis (PsA) and recent studies showing obesity may be a risk factor for the development of PsA. Several case reports and a two smaller case series have reported an improvement in psoriasis after bariatric surgery but no studies have evaluated PsA after bariatric surgery. We were not surprised to see improvement in psoriasis and psoriatic arthritis after bariatric surgery but we were surprised to see that improvement was associated with more severe disease and older age at diagnosis.”

“It is important to be aware of the association of both obesity and PsA in psoriasis patients who may be presenting to the orthopedist for management of joint issues given treatment of these conditions may alter management. We have planned a prospective study evaluating psoriasis and PsA before and after bariatric surgery using objective physician derived measures such as PASI scores and joint counts. We also plan to evaluate for changes in inflammatory markers, adipokines, cytokines, and micro biome post surgery.”

“It’s important to have conversations with our patients with psoriatic diseases about healthy choices for weight management in overweight and obese individuals since there is growing evidence that excess weight may impact disease severity and response to medications. At the NYU psoriatic arthritis center we take a multidisciplinary approach to patients with referral to a nutritionist when appropriate.”