Patients with chronic stable plaque-type psoriasis who lose weight by adopting lifestyle changes appear to respond better to psoriasis treatment, according to study findings from Thailand.
In addition, quality of life, triglyceride and LDL cholesterol levels also improved with the lifestyle modifications, including a low-calorie diet. Previous studies have shown the relative risk of psoriasis is directly related to body mass index (BMI), and positive correlation exists between psoriasis severity and BMI.
Wanjarus Roongpisuthipong, MD, from Ramathibodi Hospital, Mahidol University and Vajira Hospital, University of Bangkok Metropolis, both in Bangkok, Thailand, and colleagues investigated whether moderate weight loss increased the therapeutic response to topical treatment in obese patients with chronic stable plaque-type psoriasis.
The primary measure of clinical response was improvement in patient scores on the Psoriasis Area and Severity Index at 12 and 24 weeks. The trials included 10 patients (70% male; mean age 48 years) with a mean weight of 95.9 kg, and mean BMI of 35.2 kg/m2. Baseline PASI was 5.72, and Dermatology Life Quality Index (DLQI) score was 8.00.
At week 12, patients who followed a very low-calorie diet had a mean reduction in weight of 9.69%, and fat mass decreased to 17.9%. Improvement from baseline of 50% or greater in the Psoriasis Area and Severity Index (PASI) was observed in 50% of patients.
The mean percentage improvement in the PASI from baseline was 31% (𝑃<0.05). Similar improvements were also observed in global assessments by physicians and patients and in the DLQI, according to the study data.
The 24-week results do not match the positive outcomes seen at 12-week results, according to the researchers, because a flood occurred in Thailand between the two measurement periods. This life-changing situation caused significant stress among the patients that resulted in nonadherence to the protocol diet.
“The improvement from baseline in the response as measured by overall treatment and rash satisfaction was statistically significant as early as week four,” Roongpisuthipong and colleagues wrote. “This study suggests that weight reduction by low-calorie diet in obese patients with chronic stable plaque-type psoriasis increases their response to psoriasis treatment.”
Disclosure: Roongpisuthipong reports no relevant financial disclosures.