The Effect of Metformin and Biological Therapy on Insulin Resistance in Iraqi Psoriatic Patients

Abstract

Psoriasis refers to a medical condition involving long-term infl ammation, high insulin resistance, obesity and a likelihood of cardiovascular disease. Objective: This paper attempts to fi nd out if the addition of metformin to biological therapy has the benefi cial eff ect of increasing insulin sensitivity in moderate to severe Iraqi psoriatic patients. Subjects and Methods: The experimental group comprises 24 patients suff ering from moderate to severe psoriasis. They were randomly selected into two groups: group A comprises 13 psoriatic patients treated with 40 mg of adalimumab twice monthly for 12 weeks. While group B contains 11 psoriatic patients treated with 40 mg of adalimumab twice monthly and a single daily dose of 850 mg of metformin for 12 weeks. The psoriasis area and severity index (PASI), glycosylated hemoglobin (HbA1c), body mass index (BMI), as well as insulin-resistance parameters, which include fasting blood glucose (FBG) and fasting serum insulin (FSI) are estimated for each patient before and after completion of therapy. Results: The two groups showed a signifi cant reduction in insulin resistance. Nonetheless, group B showed greater reduction. Furthermore, the PASI score of the two groups exhibited improvement, but group B exhibited a higher percentage improvement than group A, and the diff erence was signifi cant (p <0.05). Conclusion: This study demonstrates that adding a single daily dose of 850 mg of metformin has a more benefi cial eff ect on insulin resistance (IR) in psoriasis patients than using only biological therapy.