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Review finds limited evidence for weight loss in improving pre-existing psoriasis

A systematic review published in The British Journal of Dermatology, which evaluated lifestyle, pharmacological and surgical weight loss interventions in the treatment and prevention of psoriasis and psoriatic arthritis (PsA), found limited data to indicate that weight loss may improve pre-existing psoriasis and PsA and prevent the onset of psoriasis in obese individuals.

For this review, researchers identified 14 studies (randomised controlled trials [RCTs], 9; cohort studies, 3; case series, 2), after a search across electronic databases.

The pooled results of 6 RCTs showed significant improvement in psoriasis area and severity index in individuals receiving weight loss following lifestyle interventions vs control group (mean difference [ MD], −2.59; P<.001). Result of 1 RCT demonstrated that diet-induced weight loss showed greater likelihood of achieving minimal PsA activity vs control group (OR, 4.20; P<.001). Bariatric surgery, particularly gastric bypass, reduced the risk of developing psoriasis (2 cohort studies; aHR, 0.52; P<.01).

Authors wrote, “Together with National Institute for Health and Care Excellence guidance on obesity, our findings suggested a local obesity screening and management pathway providing multi-disciplinary weight loss interventions alongside conventional skin-focussed care for psoriasis.”


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