Roflumilast was associated with a decrease in appetite and weight loss in patients with psoriasis, according to a new study in JAAD.

"Recent evidence indicates that roflumilast holds a therapeutic potential in psoriasis, a chronic inflammatory disease linked to overweight/obesity," the authors wrote. "Weight loss is a frequently reported side effect to oral roflumilast."

To examine the effects of oral roflumilast on body weight and cardio-metabolic parameters in patients with psoriasis, a condition often associated with overweight or obesity, researchers included 46 patients with moderate-to-severe plaque psoriasis who were randomized to receive either oral roflumilast or a placebo for 12 weeks, followed by open-label treatment for another 12 weeks.

According to the results, patients receiving roflumilast experienced a median weight loss of -2.6% and -4% at weeks 12 and 24, respectively, compared to no significant change in weight for those initially taking placebo. Additionally, patients on roflumilast reported reduced appetite more frequently. However, there were no observed changes in blood pressure or laboratory tests. The study authors acknowledged the study limitations, including its post-hoc nature and small sample size.

These findings suggest that oral roflumilast may be a promising treatment option for patients with psoriasis, potentially offering benefits beyond its primary indication for chronic obstructive pulmonary disease. This information could be relevant for dermatologists considering treatment options for patients with psoriasis who also struggle with overweight or obesity.

"Weight loss and reduced appetite were observed after 24 weeks of oral roflumilast therapy in patients with psoriasis," the authors wrote. "With psoriasis being a chronic disease, strongly linked to overweight and obesity, the current findings support the growing evidence of oral roflumilast as a treatment alternative in patients with moderate-to-severe plaque psoriasis."

Source: Gyldenlove M, et al. Effects of oral roflumilast therapy on body weight and cardiometabolic parameters in patients with psoriasis – results from a randomized controlled trial (PSORRO). J Am Academ Dermatol. 2024;doi.org/10.1016/j.jaad.2024.02.036.