A NEW review has revealed that obesity plays a critical role in shaping disease severity, treatment response, and long-term outcomes in psoriatic arthritis, calling for more coordinated care that addresses both inflammation and metabolic health.
Despite advances in disease management, obesity has remained a critical factor influencing disease severity, treatment response, and patient outcomes, yet its full clinical implications remained underexplored in routine practice.
The authors conducted a comprehensive narrative review using a non-systematic search of PubMed, Embase, and Scopus, analysing literature on psoriatic arthritis, obesity, cytokine signalling, and therapeutic outcomes, with priority given to clinical trials, meta-analyses, and large cohort studies. The review examined the interplay between psoriatic arthritis and obesity, current clinical guidelines, gaps in clinical practice, shared inflammatory pathways, treatment implications, and the potential of weight-loss interventions to modify disease progression.
Obesity exacerbated psoriatic arthritis through systemic inflammation, adipokine dysregulation, and mechanical joint stress, contributing to worse clinical outcomes, increased comorbidity, and poorer response to biologic therapies. Shared inflammatory pathways, including interleukin-6, tumour necrosis factor, and interleukin-17, were identified as key drivers linking obesity to reduced treatment efficacy across conventional synthetic, biologic, and targeted synthetic disease-modifying antirheumatic drugs. Weight management improved disease activity and therapeutic efficacy, although its effects on underlying pathophysiology remained underexplored.
Emerging obesity therapies, including glucagon-like peptide-1 receptor agonists, were highlighted as having potential weight-loss and anti-inflammatory benefits relevant to psoriatic arthritis.
These findings have highlighted that obesity should be recognised as both a risk factor and a comorbidity in psoriatic arthritis, requiring integral management alongside disease-directed therapy. Clinical guidelines have recommended a coordinated care approach for patients with psoriatic arthritis and obesity, and emerging data continue to support further focus on inflammation and metabolic dysfunction to improve long-term outcomes, quality of life, and cardiovascular health. The authors have called for further research to clarify the molecular effects of weight management and to optimise personalised treatment strategies.
Reference
Madsen N et al. Psoriatic arthritis and obesity: a review of clinical burden and considerations for comprehensive care. RMD Open. 2026;12:e006577
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