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Clinical Summary

Plaque psoriasis: pioglitazone demonstrates modest benefit

Takeaway

  • Pioglitazone had a modest beneficial effect in the treatment of moderate-to-severe plaque psoriasis.
  • No significant difference was observed in patients treated with pioglitazone only or in combination with other therapies.

Why this matters

  • Findings provide further evidence for a potentially beneficial effect of thiazolidinediones on psoriasis.

Study design

  • 6 randomised controlled trials including 294 patients (149 received pioglitazone only and 145 received pioglitazone combination) were included after a search across electronic databases.
  • Primary outcome: ≥75% improvement in the Psoriasis Area and Severity Index score from baseline (PASI 75) at 12 or 10 weeks.
  • Funding: Tianjin science and technology committee.

Key results

  • In sub-group analysis, pioglitazone (OR, 8.74; 95% CI, 3.76-20.31) and pioglitazone combination (OR, 4.64; 95% CI, 2.03-10.60; P<.00001 for both) sub-groups had significant improvement in PASI 75 score vs placebo group.
  • Overall, pioglitazone group had significant improvement in PASI 75 compared with placebo (OR, 6.37; 95% CI, 3.55-11.43; P<.00001).
  • Pioglitazone vs placebo group did not significantly differ in the incidence of:
    • elevated liver enzymes (OR, 3.70; 95% CI, 0.56-24.31; P=.99),
    • weight gain (OR, 1.44; 95% CI, 0.60-3.47; P=.41), and
    • nausea (OR, 0.76; 95% CI, 0.23-2.49; P=.65).

Limitations

  • Heterogeneity among studies.

References


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