Effect Of Lifestyle Weight Loss Intervention On Disease Severity In Patients With Psoriasis: A Systematic Review And Meta-analysis | 36294
Journal of Obesity & Weight Loss Therapy
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Background: Psoriasis is a chronic inflammatory disease of the skin with joint manifestations. Psoriasis severity and lower
response to treatment have been linked to obesity. But the effect of weight reduction by non-pharmacologic intervention on
disease severity is still questionable. This is a systematic review and meta-analysis of randomized-controlled trials (RCT) of the
effect of dietary and lifestyle weight loss interventions on psoriasis severity.
Methods: We comprehensively searched PubMed/MEDLINE, EMBASE, and CENTRAL from their inception to August 2014.
Inclusion criteria were randomized controlled studies that examined lifestyle intervention by diet or exercise in overweight
or obese patients with psoriasis and measured the severity of psoriasis as an outcome compared with controls. Two authors
independently assessed article quality and extracted the data.
Results: From 11 full-text articles, 6 RCT involving 842 participants met our inclusion criteria, and 5 studies were included in
the meta-analysis that was based on the random effects model. There was a greater reduction of Psoriasis Area Severity Index
(PASI) score in those receiving weight loss intervention compared with controls with a pooled mean difference of −2.23 (95%
CI −3.77 to −0.69). More participants in the intervention group achieved a 75% reduction in PASI (PASI 75) than those in the
control group with pooled OR=2.92 (95% CI 1.39–6.13).
Conclusion: Non-pharmacologic, non-surgical weight loss intervention is associated with reduction in the severity of psoriasis
in overweight or obese patients. However, more randomized controlled studies with more participants or on different weight
loss methods are needed to provide better quality of evidence.
Sikarin Upala completed his medical degree from Faculty of Medicine Siriraj Hospital, Mahidol University in 2012 and master degree in nutrition and metabolic medicine from University of South Florida in 2013. He’s currently an internal medicine resident at Bassett Medical Center, Cooperstown, USA.