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

医学 银屑病 内科学 银屑病面积及严重程度指数 糖尿病 置信区间 2型糖尿病 甘油三酯 体质指数 胆固醇 内分泌学 皮肤病科
作者
Xiaoying Sun,Xiaoce Cai,Liu Liu,Hongjin Li,Yaqiong Zhou,Ying Luo,Yonghua Su,Bin Li,Xin Li
出处
期刊:Dermatology [Karger Publishers]
卷期号:239 (2): 299-313 被引量:2
标识
DOI:10.1159/000528026
摘要

Psoriasis is a chronic recurrent inflammatory skin disease with a high risk of diabetes based on disease severity.The aim of the study was to evaluate the efficacy of different hypoglycemic medications in patients with psoriasis.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.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.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.
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