Efficacy of Adding Oral Simvastatin to Topical Therapy for Treatment of Psoriasis: The Vietnamese Experience
DOI:
https://doi.org/10.3889/oamjms.2019.060Keywords:
Simvastatin, psoriasis, dyslipidemiaAbstract
BACKGROUND: Psoriasis, the prevalence of which ranges from 2% to 3% of the general population, has been recently recognised as not only a chronic inflammatory skin disorder but also an immunometabolic systemic disease. Dyslipidemia is one of the most important comorbidities of psoriasis. Statins, frequently used as anti-hyperlipidemic agents, may be beneficial in the treatment of several autoimmune diseases, including psoriasis, due to their anti-inflammatory and immunomodulatory characteristics. Hence, we hypothesised that using this medication was not only beneficial for reducing hyperlipidemia but also improving psoriatic conditions.
AIM: We conducted a study to determine the prevalence of dyslipidemia in psoriatic patients as well as whether the addition of statins (simvastatin prescribed forms) to standard topical antipsoriatic treatment can improve skin lesions in psoriatic patients.
METHODS: A group of 128 psoriatic patients and 128 healthy controls who were matched with the patients regarding ethnicity, age, and sex were enrolled, and their lipid concentrations were determined. Furthermore, sixty patients were randomly selected from the former group and divided into two treatment subgroups to evaluate the effect of statins on the severity of psoriasis using the PASI score.
RESULTS: We found that the rate of dyslipidemia in the patient group was significantly higher than in the healthy group (53.9% versus 21.9%, p < 0.001), particularly the triglyceride concentration (1.86 ± 1.17 versus 1.43 ± 0.79 mg/dL, p < 0.001). Also, the PASI score reduction in the simvastatin-treated subgroup was significantly different from that in the placebo-treated one after eight weeks of therapy (8.63 ± 4.78 versus 5.34 ± 3.59, p < 0.01).
CONCLUSION: This study showed that simvastatin might play a role in controlling hyperlipidemia and in turn decrease the PASI score in psoriatic patients.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Foundation NP. Statistics. 2018. https://www.psoriasis.org/content/statistics.
Reich K. The concept of psoriasis as a systemic inflammation: implications for disease management. Journal of the European Academy of Dermatology and Venereology. 2012; 26:3-11. https://doi.org/10.1111/j.1468-3083.2011.04410.x PMid:22356630
Van de Kerkhof PCM NF. Psoriasis. 3th ed: Elsevier Saunders, 2012.
Nijsten T, Wakkee M. Complexity of the association between psoriasis and comorbidities. Journal of Investigative Dermatology. 2009; 129(7):1601-3. https://doi.org/10.1038/jid.2009.55 PMid:19521405
Mosiewicz J, Pietrzak A, Chodorowska G, et al. (2013). The rationale for statin use in psoriatic patients. Archives of dermatological research. 305(6):467-472. https://doi.org/10.1007/s00403-013-1374-1 PMid:23754638
Grundy SM, Becker D, Clark LT, Cooper RS, Denke MA, Howard J, Hunninghake DB, Illingworth DR, Luepker RV, McBride P, McKenney JM. Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Circulation. 2002; 106(25):3143-421. https://doi.org/10.1161/circ.106.25.3143
Egesi A, Sun G, Khachemoune A, Rashid RM. Statins in skin: research and rediscovery, from psoriasis to sclerosis. Journal of drugs in dermatology: JDD. 2010; 9(8):921-7. PMid:20684142
Jowkar F, Namazi MR. Statins in dermatology. International journal of dermatology. 2010; 49(11):1235-43. https://doi.org/10.1111/j.1365-4632.2010.04579.x PMid:20964647
Namazi MR. Statins: novel additions to the dermatologic arsenal? Experimental Dermatology. 2004; 13(6):337-9. https://doi.org/10.1111/j.0906-6705.2004.00208.x PMid:15186318
Pietrzak A, Michalak-Stoma A, Chodorowska G, Szepietowski JC. Lipid disturbances in psoriasis: an update. Mediators of inflammation. 2010; 2010.
Gisondi P, Fostini AC, Fossà I, Girolomoni G, Targher G. Psoriasis and the metabolic syndrome. Clinics in dermatology. 2018; 36(1):21-8. https://doi.org/10.1016/j.clindermatol.2017.09.005 PMid:29241748
Daudén E, Casta-Eda S, Suárez C, GarcÃaâ€Campayo J, Blasco AJ, Aguilar MD, Ferrándiz C, Puig L, Sánchezâ€Carazo JL, Working Group on Comorbidity in Psoriasis. Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis. Journal of the European Academy of Dermatology and Venereology. 2013; 27(11):1387-404. https://doi.org/10.1111/jdv.12024 PMid:23134338
Salihbegovic EM, Hadzigrahic N, Suljagic E, Kurtalic N, Sadic S, Zejcirovic A, Mujacic A. Psoriasis and high blood pressure. Medical archives. 2015; 69(1):13-15. https://doi.org/10.5455/medarh.2015.69.13-15 PMid:25870469 PMCid:PMC4384847
Jamil A AU, Malik LM, Azfar NA, Jahangir M. Frequency of dyslipidemia in patients with psoriasis. Journal of Pakistan Association of Dermatologists. 2018; 24(4):307-311.
Sahu S, Devi E, Poddar A, Ray S. Lipid profile: a conduit in the progression from psoriasis to cardiovascular disease. International Journal of Advances in Medicine. 2017; 4(1):173-5. https://doi.org/10.18203/2349-3933.ijam20170105
HajHeydari Z. Serum lipids and lipoproteins in patients with psoriasis. Archives of Iranian medicine. 2014; 17(5):343-346. PMid:24784863
El Asmi MA, Zidi W, Mebazaa A, et al. Serum lipid level in Tunisian patients with psoriasis. Clinical laboratory. 2014; 60(6):1043-1047. PMid:25016711
Aronson PJ, Friedman DB. Pharmacologic doses of lovastatin do not predictably affect the course of psoriasis. Archives of dermatology. 1992; 128(1):124. https://doi.org/10.1001/archderm.1992.01680110138028
Greenwood J, Steinman L, Zamvil SS. Statin therapy and autoimmune disease: from protein prenylation to immunomodulation. Nature Reviews Immunology. 2006; 6(5):358-370. https://doi.org/10.1038/nri1839 PMid:16639429 PMCid:PMC3842637
Weitz-Schmidt G, Welzenbach K, Brinkmann V, Kamata T, Kallen J, Bruns C, Cottens S, Takada Y, Hommel U. Statins selectively inhibit leukocyte function antigen-1 by binding to a novel regulatory integrin site. Nature medicine. 2001; 7(6):687. https://doi.org/10.1038/89058 PMid:11385505
Ghazizadeh R, Tosa M, Ghazizadeh M. Clinical improvement in psoriasis with treatment of associated hyperlipidemia. The American journal of the medical sciences. 2011; 341(5):394-8. https://doi.org/10.1097/MAJ.0b013e3181ff8eeb PMid:21233693
Shirinsky IV, Shirinsky VS. Efficacy of simvastatin in plaque psoriasis: A pilot study. Journal of the American Academy of Dermatology. 2007; 57(3):529-31. https://doi.org/10.1016/j.jaad.2007.05.040 PMid:17707157
Naseri M, Hadipour A, Sepaskhah M, Namazi MR. The remarkable beneficial effect of adding oral simvastatin to topical betamethasone for treatment of psoriasis: a double-blind, randomized, placebo-controlled study. Nigerian journal of medicine: journal of the National Association of Resident Doctors of Nigeria. 2010; 19(1):58-61. https://doi.org/10.4314/njm.v19i1.54216 PMid:20232758
Wolkenstein P, Revuz J, Roujeau JC, Bonnelye G, Grob JJ, Bastuji-Garin S. Psoriasis in France and associated risk factors: results of a case-control study based on a large community survey. Dermatology. 2009; 218(2):103-9. https://doi.org/10.1159/000182258 PMid:19060463
Wollina U, França K, Lotti T, Tirant M. Adjuvant treatment of chronic plaque psoriasis in adults by a herbal combination: Open German trial and review of the literature. Dermatologic Therapy. 2018:e12624. https://doi.org/10.1111/dth.12624 PMid:30175556
Damevska K, França K, Lotti T, Nikolovska S, Pollozhani N. Complementary and integrative therapies for psoriasis: Looking forward. Dermatologic Therapy. 2018; 31:e12627. https://doi.org/10.1111/dth.12627 PMid:30133906
El-Gammal A, Nardo VD, Daaboul F, et al. Is There a Place for Local Natural Treatment of Psoriasis? Open Access Maced J Med Sci. 2018; 6(5):839-842. https://doi.org/10.3889/oamjms.2018.106
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Nguyen Trong, Thang Nguyen Tat, Tu Tran Nguyen Anh, Nhi Pham Uyen, Thuong Nguyen Van, Khang Tran Hau, Marco Gandolfi, Francesca Satolli, Claudio Feliciani, Michael Tirant, Aleksandra Vojvodic, Torello Lotti
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0