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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.
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.
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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 hepls many other possible medical conditons.
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