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However, the role of tumor necrosis factor (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>) inhibitor in mediating this risk is controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess this relationship, we estimated change in metabolic physiologic measures before and after initiation of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> inhibitor therapy compared with methotrexate (MTX) therapy among psoriasis patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study, 2007\u20132012, using computerized clinical data for 1274 new users of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> inhibitor and 979 new users of MTX therapy to compare change in blood pressure, lipids, triglycerides, fasting plasma glucose and body mass index (BMI) before and after start of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> inhibitors or MTX. The study was restricted to new users. We computed within\u2010person change in each measure, so that each patient served as their own control. In addition, we compared <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> inhibitor patients to MTX patients, by computing the adjusted difference in their group means. In secondary analyses, we examined phototherapy as a comparator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among starters of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> inhibitor and <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> therapy, within\u2010person change in physiologic measures at 6\u00a0months did not differ significantly. We observed no important or significant changes in any of the physiologic measures with initiation of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> inhibitor compared with MTX. The same results were found in subgroup analyses focused on men, and on those with hypertension, diabetes mellitus, or obesity. The same results were observed with phototherapy, except that diastolic blood pressure declined by 0.6\u00a0mmHg within person during the 6\u00a0months after starting phototherapy (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study provides no evidence for improvement of physiologic measures associated with the metabolic syndrome resulting from <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> inhibitor use for psoriasis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12296","type":"journal-article","created":{"date-parts":[[2013,11,7]],"date-time":"2013-11-07T11:58:21Z","timestamp":1383825501000},"page":"1380-1387","source":"Crossref","is-referenced-by-count":8,"title":["Initiation of <scp>TNF<\/scp> inhibitor therapy and change in physiologic measures in psoriasis"],"prefix":"10.1111","volume":"28","author":[{"given":"J.J.","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Dermatology Kaiser Permanente Los Angeles Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California Oakland CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.M.","family":"Asgari","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California Oakland CA USA"},{"name":"Department of Dermatology University of California San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.R.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Rheumatology University of Alabama Birmingham AL 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