Clinical effects of "pioglitazone", an insulin sensitizing drug, on psoriasis vulgaris and its co-morbidities, a double blinded randomized controlled trialx1.

OBJECTIVES

To evaluate the therapeutic efficacy of pioglitazone on psoriasis vulgaris and its comorbidities.

MATERIALS AND

METHODS

Forty-eight patients with moderate-to-severe psoriasis vulgaris were enrolled in this randomized double blinded placebo-controlled trial. Active treatment included: oral pioglitazone 30 mg daily for 10 weeks. Primary outcome (treatment success) was PASI-75. Secondary outcomes included changes in metabolic syndrome, insulin resistance and cardiovascular risk.

RESULTS

Treatment success was achieved in 5/24 (21%) in the pioglitazone group compared to 1/24 (4%) in the placebo group; however, this difference was not significant (p = 0.081). Compared to placebo, no significant difference existed as regards high-sensitive C reactive protein. Metabolic syndrome and insulin resistance were not affected.

CONCLUSIONS

This short term (10 weeks duration) study revealed no effect of pioglitazone 30 mg daily neither on the clinical response of moderate-to-severe psoriasis nor on metabolic syndrome and insulin resistance. Cardio-protective role appears to be more related to improvement of psoriasis.

LIMITATION: Short duration of treatment and small number of subgroups.