Tirzepatide reduces weight, improves metabolic markers, and lowers PASI scores in psoriasis patients with obesity

Patients with psoriasis often experience comorbidities like obesity and metabolic dysfunction, which can exacerbate disease severity and increase cardiovascular risk. While tirzepatide, a dual GIP/GLP-1 receptor agonist, has demonstrated substantial efficacy in improving weight and cardiometabolic parameters in general obesity populations, its specific metabolic effects in patients with co-occurring psoriasis have been underexplored. This study aimed to bridge that gap by investigating tirzepatide's impact on key metabolic parameters in this specific patient group.

This prospective observational study included 64 adults diagnosed with chronic plaque psoriasis and obesity (BMI ≥ 30 kg/m2). All participants received tirzepatide 2.5 mg weekly, with titration to 5 mg weekly, while maintaining stable ixekizumab therapy. Researchers assessed anthropometric measures, fasting glucose, lipid profiles, liver and renal function tests, and visceral adiposity indices at baseline and after 24 weeks of treatment. The primary endpoints focused on changes in these metabolic parameters.

At week 24, patients treated with tirzepatide showed significant improvements across multiple metabolic parameters. Body weight decreased by -10% (p<0.001), BMI by -3.5 units (p<0.001), and waist-to-hip ratio by -8% (p<0.001). Fasting glucose levels saw an -11.9% (p<0.001) reduction. Lipid profiles also improved, with low-density lipoprotein (LDL)-cholesterol decreasing by -6.7% (p<0.001) and triglycerides by -15.4% (p=0.003). Liver enzymes, aspartate aminotransferase (AST) and alanine transaminase (ALT), decreased by -12.4% and -11.6%, respectively, while renal function remained stable. Notably, a significant reduction in psoriasis severity was observed:

Psoriasis Area and Severity Index (PASI) scores decreased from 4.2 ± 3.9 to 1.01 ± 0.9, representing a -76% (p<0.001) reduction.