Abstract
BackgroundIncreased prevalence of metabolic syndrome (MS) is observed in psoriasis. Metformin has shown improvement in cardiovascular risk factors while pioglitazone demonstrated anti proliferative, anti-inflammatory and anti angiogenic effects. Study objective is to evaluate the efficacy and safety of Insulin sensitizers (metformin and pioglitazone) in psoriasis patients with metabolic syndrome (MS).MethodsSingle centre, parallel group, randomized, study of metformin, pioglitazone and placebo in psoriasis patients with MS.ResultsStatistically significant improvement was observed in Psoriasis Area and Severity Index (PASI), Erythema, Scaling and Induration (ESI) and Physician global assessment (PGA) scores in pioglitazone (p values – PASI = 0.001, ESI = 0.002, PGA = 0.008) and metformin groups (p values – PASI = 0.001, ESI = 0.016, PGA = 0.012) as compared to placebo. There was statistically significant difference in percentage of patients achieving 75 % reduction in PASI and ESI scores in metformin (p value – PASI = 0.001, ESI = 0.001) and pioglitazone groups (p vaue – PASI = 0.001, ESI = 0.001). Significant improvement was observed in fasting plasma glucose (FPG) and triglycerides levels in metformin and pioglitazone arms. Significant improvement was noted in weight, BMI, waist circumference, FPG, triglycerides and total cholesterol after 12 weeks of treatment with metformin while pioglitazone showed improvement in FPG, triglyceride levels, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol and LDL cholesterol levels. There was no difference in pattern of adverse drug reaction in three groups.ConclusionInsulin sensitizers have shown improvement in the parameters of MS as well as disease severity in psoriasis patients.Trial registrationCTRI Registration Number: CTRI/2011/12/002252. Registered on 19/12/2011.
Highlights
Increased prevalence of metabolic syndrome (MS) is observed in psoriasis
Our study is a part of larger study in which we evaluated the prevalence of MS in psoriasis
A total of 83 consecutive adult psoriasis patients with MS were screened from June 2010 to April 2011 (Fig. 1)
Summary
Metformin has shown improvement in cardiovascular risk factors while pioglitazone demonstrated anti proliferative, anti-inflammatory and anti angiogenic effects. Study objective is to evaluate the efficacy and safety of Insulin sensitizers (metformin and pioglitazone) in psoriasis patients with metabolic syndrome (MS). Metabolic syndrome (MS) is a cluster of risk factors including central obesity, atherogenic dyslipidemia, hypertension and glucose intolerance and is a strong predictor of cardiovascular diseases, diabetes and stroke [7,8,9]. Metformin is an ‘insulin sensitiser’, lowers glucose levels without increasing insulin secretion. It has shown additional beneficial effects in adults with type 2 diabetes, including weight reduction, decreasing hyperinsulinemia, improving lipid profiles, augmented fibrinolysis and enhanced endothelial function [19,20,21], that all are usual metabilic abnormalities observed in subjects with MS. Present study was planned as comparative evaluation of safety & efficay of metformin with pioglitazone in placebo controlled setting in patients of psoriasis with MS
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have