Diabetes drug pioglitazone beneficial in treatment of plaque psoriasis

Pioglitazone, an antidiabetic drug, when used alone or in combination with other therapies, exhibits similar efficacy for the treatment of plaque psoriasis -- finds a recent study published in the Journal of Dermatological Treatment. The study further found no significant differences in the side effects between Pioglitazone and control. The side effects include elevated liver enzymes, weight gain, and nausea.

Pioglitazone was found to have a modest beneficial effect in the treatment of moderate to severe plaque psoriasis.

Pioglitazone belongs to a class of antidiabetic drugs called thiazolidinedoniones (TZD) that is known to have potential benefits in the treatment of cutaneous and metabolic disorders associated with psoriasis. TZD activates nuclear peroxisome proliferator-activated receptors (PPAR)-c that exerts their effect by promoting the terminal differentiation of keratinocytes, inhibiting epidermal growth, and reducing inflammatory responses.

Litao Zhang, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, China, and colleagues conducted a systematic review and meta-analysis to evaluate the efficacy of combined Pioglitazone treatment. They also pointed out 3 controversial side effects from the administration of Pioglitazone in psoriasis: elevated liver enzymes, weight gain, and nausea.

The researchers after searching across electronic databases included 6 randomised controlled trials including 294 patients (149 received pioglitazone only and 145 received pioglitazone combination).

Primary outcome: ≥75% improvement in the Psoriasis Area and Severity Index score from baseline (PASI 75) at 12 or 10 weeks.

Key findings of the study include:

• In sub-group analysis, pioglitazone and pioglitazone combination sub-groups had significant improvement in PASI 75 score vs the placebo group.


• Overall, the pioglitazone group had significant improvement in PASI 75 compared with placebo.


• Pioglitazone vs placebo group did not significantly differ in the incidence of elevated liver enzymes, weight gain, and nausea.

"Pioglitazone has efficacy for the treatment of plaque psoriasis. There is no significant difference between patients treated with Pioglitazone only or in combination with other therapies," write the authors. "The incidence rate of side effects associated with Pioglitazone treatment such as elevated liver enzymes, weight gain, and nausea were not significantly different compared with the control group."

To access the complete study log on to https://doi.org/10.1080/09546634.2019.1610552