ω-3 Fatty acid–based lipid infusion in patients with chronic plaque psoriasis: Results of a double-blind, randomized, placebo-controlled, multicenter trial

Mayser, Peter; Mrowietz, Ulrich; Arenberger, Petr; Barták, Petr; Buchvald, J; Christophers, Enno; Jabłońska, Stefania; Salmhofer, Werner; Schill, Wolf‐Bernhard; Krämer, Hans‐Joachim; Schlotzer, E.; Mayer, Konstantin; Seeger, Werner; Grimminger, Friedrich

doi:10.1016/s0190-9622(98)70114-8

Cited by 132 publications

(113 citation statements)

References 24 publications

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“…Of the seven studies that reported the PASI score, only one 12 reported an improvement in quality of life (QoL). Three studies reported either no difference in the subjective skin-itch VAS score 6,16 or improvement in the joint-pain VAS score. 15 PASI score is a subjective assessment based on estimation by clinicians.…”

Section: Discussion Summary Of Main Resultsmentioning

confidence: 99%

“…They reported a steep increase in the generation of LTB5 and 5-HEPE starting from day 3 to day 10 of n-3 PUFA infusion, indicating the reduction of chemotactic and neutrophil activation. Mayser et al 16 also found a more than 40-fold increase of LTB5, evidenced from day 3 to day 15, but there was only a slight decrease of chemotactic LTB4 in both intervention and control groups with no significant difference. However, Veale et al 6 did not find any significant improvement by giving n-3 PUFA.…”

Section: Description Of Included Studiesmentioning

confidence: 87%

“…Bittiner et al 13 reported significant improvement of itching (P < 0.05) and erythema (P < 0.05) while improvement of scaling and area involved did not meet statistical significance. Mayser et al 16 reported significant improvement of PASI in both intervention and control groups compared to the baseline, in favor of then-3 PUFA group (P = 0.048). However, there was no difference in patients' own assessments (VAS) of psoriasis between the groups.…”

Section: Description Of Included Studiesmentioning

confidence: 95%

“…A total of 720 articles were excluded because they were not randomized controlled trials or observational studies (427 articles), did not involve dietary or pharmacologic interventions with n-3 fatty acids (210 articles), did not perform a comparison (65 articles), or did not include the outcome of interest (18 articles). Eleven randomized controlled trials [4][5][6][11][12][13][14][15][16][17][18] and one open-label controlled observational study 19 were included, and the data of all 12 studies were extracted. The characteristics of the extracted studies are outlined in Table 1.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…Six studies 4,[11][12][13]16,19 reported improvement in the patients' erythema, scaling, itching, area involved and infiltration. Gupta et al 4 reported 35-48% improvement of patients' scaling, erythema, area involved and thickness, especially during concurrent n-3 PUFA and ultraviolet B (UVB) treatment but not in the placebo group.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

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Effect of omega‐3 fatty acids on disease severity in patients with psoriasis: A systematic review

et al. 2017

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Aim: Many randomized controlled trials have been performed on the efficacy and mechanism of action of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on psoriasis. However, contradictory results have been obtained. This study wants to assess the effects of n-3 PUFAs on the severity of psoriasis. Methods:The Cochrane Central Register of Controlled Trials, PubMed/MEDLINE and EMBASE were searched for all randomized controlled trials and prospective observational studies comparing the efficacy of n-3 PUFAs versus control in adult patients with psoriasis. The primary outcome was psoriasis severity as measured by the Psoriasis Area Severity Index (PASI) score. Results:The initial search yielded 732 articles, 720 of which were excluded. The data of the 12 remaining studies were extracted. Some studies found that n-3 PUFAs were associated with improvements in the PASI score, erythema, scaling, itching, area involved and infiltration. However, some studies did not find reduction in scaling, erythema, area involved or thickness in the treatment group. Conclusion:It is still inconclusive whether use of n-3 PUFAs in patients with psoriasis is associated with improvements in severity of psoriasis and other outcomes.

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Section: Discussion Summary Of Main Resultsmentioning

confidence: 99%

Section: Description Of Included Studiesmentioning

confidence: 87%

Section: Description Of Included Studiesmentioning

confidence: 95%

Section: Description Of Included Studiesmentioning

confidence: 99%

Section: Description Of Included Studiesmentioning

confidence: 99%

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Effect of omega‐3 fatty acids on disease severity in patients with psoriasis: A systematic review

et al. 2017

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Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation

et al. 2018

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IMPORTANCEPsoriasis is a chronic, inflammatory skin disease and has significant associated morbidity and effect on quality of life. It is important to determine whether dietary interventions help reduce disease severity in patients with psoriatic diseases. OBJECTIVE To make evidence-based dietary recommendations for adults with psoriasis and/or psoriatic arthritis from the Medical Board of the National Psoriasis Foundation.EVIDENCE REVIEW We used literature from prior systematic reviews as well as additional primary literature from the MEDLINE database from January 1, 2014, to August 31, 2017, that evaluated the impact of diet on psoriasis. We included observational and interventional studies of patients with psoriasis or psoriatic arthritis. The quality of included studies was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias Tool for interventional studies. We made evidence-based dietary recommendations, which were voted on by the National Psoriasis Foundation Medical Board.FINDINGS We identified 55 studies meeting the inclusion criteria for this review. These studies represent 77 557 unique participants of which 4534 have psoriasis. Based on the literature, we strongly recommend dietary weight reduction with a hypocaloric diet in overweight and obese patients with psoriasis. We weakly recommend a gluten-free diet only in patients who test positive for serologic markers of gluten sensitivity. Based on low-quality data, select foods, nutrients, and dietary patterns may affect psoriasis. For patients with psoriatic arthritis, we weakly recommend vitamin D supplementation and dietary weight reduction with a hypocaloric diet in overweight and obese patients. Dietary interventions should always be used in conjunction with standard medical therapies for psoriasis and psoriatic arthritis.CONCLUSIONS AND RELEVANCE Adults with psoriasis and/or psoriatic arthritis can supplement their standard medical therapies with dietary interventions to reduce disease severity. These dietary recommendations from the National Psoriasis Foundation Medical Board will help guide clinicians regarding the utility of dietary interventions in adults with psoriatic diseases.

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Complementary and Alternative Medicine Therapies for Psoriasis

et al. 2018

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IMPORTANCE Up to 51% of patients with psoriasis report the use of complementary and alternative medicine (CAM) in their treatment regimen, although it is unclear which CAM therapies are effective for treatment of psoriasis.OBJECTIVE This review compiles the evidence on the efficacy of the most studied CAM modalities for treatment of patients with plaque psoriasis and discusses those therapies with the most robust available evidence. PubMed, Embase, and ClinicalTrials.gov searches (1950-2017) were used to identify all documented CAM psoriasis interventions in the literature. The criteria were further refined to focus on those treatments identified in the first step that had the highest level of evidence for plaque psoriasis with more than 1 randomized clinical trial supporting their use. This excluded therapies lacking randomized clinical trial (RCT) data or showing consistent inefficacy. EVIDENCE REVIEWFINDINGS Primary CAM therapy searches identified 457 articles, of which 107 articles were retrieved for closer examination. Of those articles, 54 were excluded because the CAM therapy did not have more than 1 RCT on the subject or showed consistent lack of efficacy. An additional 7 articles were found using references of the included studies, resulting in a total of 44 RCTs (17 double-blind, 13 single-blind, and 14 nonblind), 10 uncontrolled trials, 2 open-label nonrandomized controlled trials, 1 prospective controlled trial, and 3 meta-analyses. Compared with placebo, application of topical indigo naturalis, studied in 5 RCTs with 215 participants, showed significant improvements in the treatment of psoriasis. Treatment with curcumin, examined in 3 RCTs (with a total of 118 participants), 1 nonrandomized controlled study, and 1 uncontrolled study, conferred statistically and clinically significant improvements in psoriasis plaques. Fish oil treatment was evaluated in 20 studies ( 12RCTs, 1 open-label nonrandomized controlled trial, and 7 uncontrolled studies); most of the RCTs showed no significant improvement in psoriasis, whereas most of the uncontrolled studies showed benefit when fish oil was used daily. Meditation and guided imagery therapies were studied in 3 single-blind RCTs (with a total of 112 patients) and showed modest efficacy in treatment of psoriasis. One meta-analysis of 13 RCTs examined the association of acupuncture with improvement in psoriasis and showed significant improvement with acupuncture compared with placebo. CONCLUSIONS AND RELEVANCEThe CAM therapies with the most robust evidence of efficacy for treatment of psoriasis are indigo naturalis, curcumin, dietary modification, fish oil, meditation, and acupuncture. This review will aid practitioners in advising patients seeking unconventional approaches for treatment of psoriasis.

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ω-3 Fatty acid–based lipid infusion in patients with chronic plaque psoriasis: Results of a double-blind, randomized, placebo-controlled, multicenter trial

Cited by 132 publications

References 24 publications

Effect of omega‐3 fatty acids on disease severity in patients with psoriasis: A systematic review

Effect of omega‐3 fatty acids on disease severity in patients with psoriasis: A systematic review

Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation

Complementary and Alternative Medicine Therapies for Psoriasis

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