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Lower blood glucose, prevent Psoraisis?
Glucose-lowering treatments 'reduce psoriasis risk'
Several small trials have suggested that blood-glucose lowering drugs have a
beneficial effect on patients sufferiong from psoraisis.
Scientists from University Hospital Basel in Switzerland, and colleagues
examined data from the United Kingdom General Practice Research Database on
36,702 patients with a first-time psoriasis diagnosis and the same number of
matched controls.
Psoriasis risk was associated with current smoking and with obesity (a body
mass index of at least 30 kg/m
2. But individuals who were currently taking a glucose lowering drug, metformin,
had less than half the likelihood of psoriasis. The odds of developing psoriasis
associated with current use of a thiazolidinedione for at least five
prescriptions versus no use was 0.33, while the odds ratio for at least 15
metformin prescriptions versus no use was 0.77. For sulfonylureas, the odds
ratio of psoriasis for at least 15 prescriptions versus no use was 1.07.
"This population-based case-control study provides evidence that use of
thiazolidinediones may reduce the risk of developing a psoriasis diagnosis,"
the team writes in the Journal of the American Academy of Dermatology.
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Brauchli YB, Jick SS, Curtin F, Meier CR. Association between use of
thiazolidinediones or other oral antidiabetics and psoriasis: a population
based case-control study.
J Am Acad Dermatol
2008; doi:10.1016/j.jaad.2007.11.023.) published online 21 January 2008.
Background Small clinical trials suggest that thiazolidinediones may exert a beneficial effect on skin lesions of patients with psoriasis. Little is known about other classes of antidiabetic drugs and the psoriasis risk. Objective We sought to study the association between use of thiazolidinediones, sulfonylureas, biguanides, or acarbose and the risk of developing a first-time diagnosis of psoriasis. Methods We conducted a case-control analysis on the United Kingdom?based General Practice Research Database. We identified patients with an incident psoriasis diagnosis from 1994 to 2005 and matched one control subject to each patient on age, sex, general practice, calendar time, and years of history in the database. Conditional logistic regression was used to estimate the odds ratio with 95% confidence intervals (CI) of developing a first-time psoriasis diagnosis in relation to previous exposure to antidiabetic drugs, stratified by exposure timing and duration of use and adjusted for a variety of potential confounders. Results We identified 36,702 patients with a first-time psoriasis diagnosis and the same number of matched control subjects. As compared with no use, the adjusted odds ratio for current use of 1 to 4 prescriptions or greater than or equal to 5 prescriptions for thiazolidinediones were 1.01 (95% CI 0.34-3.01) and 0.33 (95% CI 0.16-0.66), respectively. Current use of greater than or equal to 15 prescriptions for metformin or sulfonylureas yielded adjusted odds ratio of 0.77 (95% CI 0.62-0.96) and 1.07 (95% CI 0.88-1.31), respectively. Limitations The findings are based on a small number of patients exposed to thiazolidinediones (100 in total, 48 current users of =5 prescriptions). Conclusions The findings of this large observational study provide further evidence for a potentially beneficial effect of thiazolidinediones on psoriasis. While current long-term use of metformin was also associated with a suggestion of a reduced psoriasis risk, no such effect was seen for use of other oral antidiabetics. |
COMMENT: I have known several cases where psoraisis has improved markedly when blood glucose is lowered — except that I do it merely by a change of diet to one low in carbs and high in fats rather that with drugs.
The benefits of this approach are, firstly, that there are no side effects and, secondly, this change of diet also helps many other possible medical conditons.
Last updated 1 August 2008
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