Effect of Different Types of Hypoglycemic Medications on Psoriasis: An Analysis of Current Evidence

Xiaoying Sun; Xiaoce Cai; Liu Liu; Hongjin Li; Yaqiong Zhou; Ying Luo; Yonghua Su; Bin Li; Xin Li

doi:10.1159/000528026

Effect of Different Types of Hypoglycemic Medications on Psoriasis: An Analysis of Current Evidence

Dermatology. 2023;239(2):299-313. doi: 10.1159/000528026. Epub 2023 Jan 9.

Authors

Xiaoying Sun^{1

2}, Xiaoce Cai^{1

2}, Liu Liu^{1

2}, Hongjin Li^{1

2}, Yaqiong Zhou^{1

2}, Ying Luo^{1

2}, Yonghua Su^{1

2}, Bin Li^{2

3}, Xin Li^{1

2}

Affiliations

¹ Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
³ Department of Dermatology, Shanghai Dermatology Hospital, Shanghai, China.

PMID: 36623489
DOI: 10.1159/000528026

Abstract

Background: Psoriasis is a chronic recurrent inflammatory skin disease with a high risk of diabetes based on disease severity.

Objectives: The aim of the study was to evaluate the efficacy of different hypoglycemic medications in patients with psoriasis.

Methods: A systematic review and meta-analysis of studies were conducted to evaluate the efficacy of hypoglycemic medications in patients with psoriasis. The primary outcome was of changes in the psoriasis area and severity index (PASI) score, and a 75% improvement in PASI from baseline (PASI75). Subgroup analysis was used to investigate associations among the types of hypoglycemic medicines, combination therapy, patient characteristics, course of treatment, and curative effect.

Results: We included 3,286 patients from 19 studies to explore the effects of hypoglycemic medications. Patients randomized to receive hypoglycemic medicines showed a more significant decrease in the PASI score (standard mean difference = -0.55, 95% confidence interval (CI): -0.87 to -0.23, p = 0.0007) and a higher PASI75 ratio (RR: 1.80, 95% CI: 1.20-2.71, p = 0.0046). Patients consuming thiazolidinediones (TZDs) were more likely to reach PASI75 than those consuming glucagon-like peptide 1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase 4 inhibitors. The combined use of hypoglycemic medicines had an add-on effect on the standard psoriasis treatment, and the proportion of PASI75 in the combination group was nearly four times that in the noncombination group (p = 0.0216). In addition, hypoglycemic medications can reduce body weight, waist circumference, triglyceride, total cholesterol, low-density lipoprotein, and systolic blood pressure.

Conclusions: Certain hypoglycemic drugs, such as GLP-1 RAs and TZDs, are beneficial for treating psoriasis. Multidisciplinary collaboration is recommended for the management of systemic inflammation in patients with psoriasis and diabetes.

Keywords: Cardiovascular disease; Glucose metabolism; Hypoglycemic medicines; Lipid metabolism; Psoriasis.

Publication types

Systematic Review
Meta-Analysis

MeSH terms

Chronic Disease
Diabetes Mellitus* / drug therapy
Dipeptidyl-Peptidase IV Inhibitors* / therapeutic use
Glucagon-Like Peptide 1 / therapeutic use
Humans
Hypoglycemic Agents / therapeutic use
Psoriasis* / drug therapy
Randomized Controlled Trials as Topic
Thiazolidinediones* / therapeutic use

Substances

Hypoglycemic Agents
Dipeptidyl-Peptidase IV Inhibitors
Thiazolidinediones
Glucagon-Like Peptide 1