Psoriasis Improvement with Statin Use (Simvastatin)

• Take Home Message: Significant improvement of Psoriasis (PASI scores) were found with simvastatin use (not for atorvastatin). More studies are required (Study from the Philippines)

• Comments

-The rationale behind statins use is also the treatment of hypercholesterolemia (hyperlipidemia) which is associated with psoriasis in the metabolic syndrome (to read more on skin problems associated with the metabolic syndrome: click HERE 

-This study is a summary of randomized control trials in the literature (RCT; prospective studies)

-In the abstract the lipid and cholesterol levels have not been mentioned. It would be interesting to see results in patients with psoriasis comparing the disturbed lipid profile

-The use of statins has potential side-effects (including some described on the skin: to read more: click HERE 

-To read an introduction on statins: click HERE 

Abstract

–Background: Psoriasis is a chronic disorder caused primarily by T-cell mediated inflammation. It has been found to be associated with risk of atherosclerosis and cardiovascular disease, with inflammation as the link. Treatments targeting this shared inflammatory mechanism are being investigated to treat both conditions.

Statins have been found to have anti-inflammatory effects aside from its lipid-lowering capabilities. They can block leucocyte chemotaxis, antigen presentation, lymphocyte activation and proliferation, and cytokine expression. These effects can possibly improve psoriasis symptoms.

–Objective: To assess the efficacy and safety of oral statins as treatment for adult patients with chronic plaque psoriasis.

–Search Methods: We searched the Cochrane Clinical Trials Register and Medline for the terms PSORIASIS and (STATIN* or HMG-COA*).

–Selection criteria: Randomized controlled trials (RCTs) of oral statin treatment in adult chronic plaque psoriasis patients.

–Data collection and analysis: Two reviewers examined all retrieved trials independently for eligibility and quality. The difference in mean PASI score reductions between treatment and control groups along with reported adverse effects were the effects measured.

–Results: Four RCTs were identified and analyzed. Two trials compared atorvastatin with placebo while the rest compared simvastatin with placebo. The simvastatin trials demonstrated significant PASI score improvements in the simvastatin groups compared to placebo, while the atorvastatin trials failed to show the same significant differences between treatment groups. Statins, in general, were found to be well tolerated and safe.

Conclusions: Evidence is still inconclusive with regards to the statins’ efficacy in treating psoriasis. Additional studies are needed to further elucidate its role in psoriasis management.

Reference: Regional Congress of Dermatology (RCD) 2016 – Singapore. RCD16-0155 Psoriasis STATINS FOR PSORIASIS: SYSTEMATIC REVIEW AND META-ANALYSIS A. Calma1, C.D. Uy1, L. Frez1 1University of the Philippines-Philippine General Hospital, Section of Dermatology Department of Medicine, Manila, Philippines