{
  "abstract": "Psoriatic arthritis (PsA) is a chronic inflammatory disease characterised by joint involvement, significant impact on quality of life and frequently linked with obesity, metabolic syndrome and cardiovascular comorbidities. Despite advances in PsA management, obesity remains a critical factor influencing disease severity, treatment response and patient outcomes. We examine the interplay between PsA and obesity, the current clinical guidelines, gaps in clinical practice, research on shared inflammatory pathways, treatment implications and the potential of weight-loss interventions to modify disease progression. This comprehensive narrative review uses a non-systematic search of PubMed, Embase and Scopus databases and analyses literature on PsA, obesity, cytokine signalling and therapeutic outcomes, with priority to clinical trials, meta-analyses and large cohort studies. Obesity exacerbates PsA through systemic inflammation, adipokine dysregulation and mechanical joint stress, contributing to worse clinical outcomes, increased comorbidity and poorer response to biologics. Weight management improves disease activity and therapeutic efficacy, although its effects on PsA pathophysiology remain underexplored. Our review highlights that obesity should be recognised as a risk factor and comorbidity in PsA for the integral management of patients. Further research is needed to elucidate the cytokine and molecular changes induced by weight management, generate more clinical data and optimise personalised management strategies. While clinical guidelines recommend a coordinated care approach to optimising the management of PsA in patients with obesity, emerging clinical data support further focus on the role of targeting inflammation, obesity and metabolic dysfunction to improve long-term PsA outcomes and quality of life, mitigate complications and provide better cardiovascular and overall health to patients.",
  "authors": [
    {
      "affiliations": [
        "Division of Allergy, Immunology and Rheumatology, Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, and Department of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA"
      ],
      "name": "Norman Madsen"
    },
    {
      "affiliations": [
        "Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK"
      ],
      "name": "Laura C Coates"
    },
    {
      "affiliations": [
        "Department of Dermatology, and Department of Medicine, Division of Rheumatic Diseases, UT Southwestern Medical Center, Dallas, Texas, USA"
      ],
      "name": "Joseph F Merola"
    },
    {
      "affiliations": [
        "Keck School of Medicine, University of Southern California, Los Angeles, California, USA"
      ],
      "name": "Wayne Ho"
    },
    {
      "affiliations": [
        "Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA"
      ],
      "name": "Willa Hsueh"
    },
    {
      "affiliations": [
        "Ruhr University Bochum, Bochum, Germany",
        "Rheumazentrum Ruhrgebiet, Herne, Germany"
      ],
      "name": "Uta Kiltz"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine and Department of Computational Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA"
      ],
      "name": "Veena K Ranganath"
    },
    {
      "affiliations": [
        "Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, Oregon, USA"
      ],
      "name": "Atul Deodhar"
    },
    {
      "affiliations": [
        "Division of Rheumatology, University of Southern California Keck School of Medicine and Providence Saint John’s Health Center, Santa Monica, California, USA"
      ],
      "name": "Orrin M Troum"
    },
    {
      "affiliations": [
        "Eli Lilly and Company, Indianapolis, Indiana, USA"
      ],
      "name": "Carlos Diaz"
    },
    {
      "affiliations": [
        "Eli Lilly and Company, Indianapolis, Indiana, USA"
      ],
      "name": "Andris Kronbergs"
    },
    {
      "affiliations": [
        "Eli Lilly and Company, Indianapolis, Indiana, USA"
      ],
      "name": "Natalia Bello"
    },
    {
      "affiliations": [
        "Providence Swedish Medical Center and University of Washington, Seattle, Washington, USA"
      ],
      "name": "Philip J Mease"
    },
    {
      "affiliations": [
        "Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Alexis Ogdie"
    },
    {
      "affiliations": [
        "Division of Allergy, Immunology and Rheumatology, Center for Musculoskeletal Research, University of Rochester School of Medicine and Dentistry, and Department of Allergy, Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, New York, USA"
      ],
      "name": "Christopher T Ritchlin"
    }
  ],
  "title": "Psoriatic arthritis and obesity: a review of clinical burden and considerations for comprehensive care",
  "uid": "affb8a78-d716-560f-885a-d7c614446325"
}