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Bariatric surgery found to improve psoriasis symptoms

"Psoriasis on back1" by Psoriasis_on_back.jpg: User:The Wednesday Island (of the English Wikipedia)derivative work: James Heilman, MD (talk) - Psoriasis_on_back.jpg. Licensed under CC BY-SA 3.0 via Commons

Psoriasis and psoriatic arthritis (PsA) symptoms were significantly lessened in patients who underwent bariatric surgery, according to a poster session on Nov. 8, 2015 at the American College of Rheumatology (ACR/ARHP) Annual Meeting in San Francisco.

“Our new study shows that those who shed excess weight could see significant symptomatic relief,” stated lead study author Dr. Soumya Reddy, an assistant professor of medicine in the Division of Rheumatology at NYU Langone Medical Center in New York City and co-director of NYU Langone's Psoriatic Arthritis Center, in a press release.

The researchers noted that excess weight loss may reduce the body-wide inflammation and pain triggered by extreme excesses of fat tissue. For the study, Dr. Reddy and 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 PsA—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 55% of patients with psoriasis and 62% of patients with PsA reported improvements in their disease.

Disease severity rating (0-10 scale) significantly decreased from prior to surgery compared to one year post surgery for psoriasis (5.6 vs 4.4, p<0.01) and PsA (6.4 vs 4.5, p=0.01), and was more pronounced among severe (rating >5) psoriasis (7.7 vs 5.7, p<0.01) and PsA (8.2 vs 4.8, p<0.01).

Further analysis showed those who lost the most excess weight a year after surgery showed the biggest improvements in their disease activity. Patients who saw the most improvements had more severe disease at the time of surgery and were of an older age at diagnosis.

“This study highlights the collaborative spirit of academic medicine, and how our rheumatology and bariatric surgery researchers worked together to not only help our patients directly, but inform the medical community at large,” said study co-author Dr. Jose U. Scher, assistant professor of rheumatology and co-director of the NYU Langone’s Psoriatic Arthritis Center. “These findings can be used to identify people who may benefit most from this type of intervention.”

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