Abstract

EFFICACY AND SAFETY OF METFORMIN AS ADD ON THERAPY IN ADULT PATIENTS OF PSORIASIS WITH AND WITHOUT METABOLIC SYNDROME

Kartik Nayak, Mahesh Chander Gupta*, Kamal Aggarwal

ABSTRACT

Background: Psoriasis is a chronic non communicable disease of unknown etiology. In recent years there has been a strong co relation between incidence of psoriasis and metabolic syndrome. A role of antihyperglycemic drug is being evaluated in reducing severity of psoriasis. Objective: To evaluate the efficacy and safety of metformin as add on therapy in adult patients of mild-moderate psoriasis with and without metabolic syndrome. Material and Methods: This was a prospective, controlled, randomized, open labelled comparative clinical study conducted on 44 psoriatic patients with and without metabolic syndrome. The patients were divided into two groups with and without MS and were randomised to give either standard treatment (Topical 0.05% betamethasone dipropionate applied twice daily) or therapy with metformin 500 mg orally once daily as add on to standard treatment. The study was conducted over a period of 12 weeks and efficacy assessment was done using Psoriasis assessment Severity Index (PASI) and change in parameters of metabolic syndrome (MS) in patients with MS. Change in quality of life assessed using Dermatological life Quality Index (DLQI). Results: After 12 weeks of treatment, in patients of psoriasis with MS, metformin caused greater reduction in PASI score (9.45 ± 0.56 to 3.85 ± 0.64) as compared to standard therapy alone (9.51 ± 0.70 to 6.67 ± 0.44). Metformin as add on was found to be significantly superior to standard therapy alone in such patients. In patients of psoriasis without metabolic syndrome both the treatment types were found to be equally effective with reduction of PASI score from 9.49 ± 0.59 to 5.22 ± 0.56 in metformin group and 9.72 ± 0.93 to 6.66 ± 0.47 in standard treatment group. Metformin caused more reduction in PASI score in patients with metabolic syndrome as compared to those without MS. With metformin as add on drug, 3 patients without MS and 9 patients with MS achieved PASI 50 and only 1 patient with MS achieved PASI 75. None of the patients with standard therapy alone achieved PASI 50 and PASI 75. Significant improvement in QoL was achieved by both the treatment types in patients with and without MS, however metformin was significantly superior to standard therapy in improving QoL in both these group of patients. Conclusion: Metformin given as add on therapy caused an additional improvement in clinical severity and QOL in psoriatic patients especially with metabolic syndrome.

Keywords: Psoriasis, Psoriasis Area and Severity Index, Dermatology Life Quality Index.