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

Abstract

<b><i>Background:</i></b> Psoriasis is a chronic recurrent inflammatory skin disease with a high risk of diabetes based on disease severity. <b><i>Objectives:</i></b> The aim of the study was to evaluate the efficacy of different hypoglycemic medications in patients with psoriasis. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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, <i>p</i> = 0.0007) and a higher PASI75 ratio (RR: 1.80, 95% CI: 1.20–2.71, <i>p</i> = 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 (<i>p</i> = 0.0216). In addition, hypoglycemic medications can reduce body weight, waist circumference, triglyceride, total cholesterol, low-density lipoprotein, and systolic blood pressure. <b><i>Conclusions:</i></b> 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.

Efficacy of glucagon‐like peptide‐1 receptor agonists for psoriasis: An updated systematic review and meta‐analysis

“…Additionally, a sensitivity analysis performed using a leave-one-out approach confirmed the robustness of our findings. Our meta-analysis, which had a larger sample size and included more recent studies than previous publications, 4,5 reinforces the evidence supporting the benefits of GLP-1 RAs in psoriasis treatment. Importantly, these effects extend beyond patients with psoriasis and comorbid DM.…”

“…3 Two previous meta-analyses have reported that GLP-1 RAs reduce psoriasis severity. 4,5 However, their conclusions were drawn from pooled analyses comprising only two to four studies, which had mixed original study designs and included individuals without DM. Furthermore, new studies have been conducted after the publication of previous reviews.…”

Wirksamkeit von Glucagon‐like Peptide‐1‐Rezeptor‐Agonisten bei Psoriasis: Eine aktualisierte systematische Übersicht und Metaanalyse

“…3 Zwei frühere Meta-Analysen haben berichtet, dass GLP-1 RAs den Schweregrad der Psoriasis verringern. 4,5 Ihre Schlussfolgerungen wurden jedoch aus gepoolten Analysen gezogen, die nur zwei bis vier Studien umfassten, deren ursprüngliche Studiendesigns uneinheitlich waren und die Personen ohne DM einschlossen. Außerdem wurden nach der Veröffentlichung der früheren Übersichten neue Studien durchgeführt.…”