Zhang MX, Zheng BY, Chen HX, Chien CW. Clinical effects of antidiabetic drugs on psoriasis: The perspective of evidence-based medicine. World J Diabetes 2021; 12(8): 1141-1145 [PMID: 34512883 DOI: 10.4239/wjd.v12.i8.1141]
Corresponding Author of This Article
Ching-Wen Chien, PhD, Professor, Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, No. 2279 Lishui Street, Shenzhen 518055, Guangdong Province, China. ihhca@sz.tsinghua.edu.tw
Research Domain of This Article
Dermatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mei-Xian Zhang, Evidence-based Medicine Center,Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Mei-Xian Zhang, Public Laboratory, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Bo-Yuan Zheng, Ching-Wen Chien, Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, Shenzhen 518055, Guangdong Province, China
Hai-Xiao Chen, Department of Orthopedics, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Author contributions: Zhang MX, Zheng BY, Chen HX and Chien CW conducted the study and drafted the manuscript; Zhang MX and Chien CW participated in the design of the study; all of the authors read and approved the final manuscript.
Conflict-of-interest statement: The authors have no proprietary interest in any aspect of this study.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ching-Wen Chien, PhD, Professor, Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, No. 2279 Lishui Street, Shenzhen 518055, Guangdong Province, China. ihhca@sz.tsinghua.edu.tw
Received: February 3, 2021 Peer-review started: February 3, 2021 First decision: March 30, 2021 Revised: April 8, 2021 Accepted: July 14, 2021 Article in press: July 14, 2021 Published online: August 15, 2021
Abstract
Psoriasis and diabetes shared common underlying pathophysiological mechanisms. Emerging data suggested that antidiabetic medications may improve the psoriasis severity in patients with diabetes mellitus. Several hypoglycemic agents including thiazolidinediones, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and biguanides have been reported to make a remarkable reduction in the Psoriasis Area and Severity Index score from baseline. This antipsoriatic effect could be mediated not only by the glucose-lowering action of these agents but also via inhibition of keratinocyte over proliferation, increase expression of differentiation markers, suppression the immune inflammatory pathway, and blocking the calcium channels and mitogen-activated protein kinase signaling pathways. On the other hand, there was no significant increase in adverse reactions associated with the treatment of pioglitazone or metformin. However, previous studies often had the relatively short duration of the trials, and did not have enough power to assess recurrence of psoriasis. Potential bias in the study and missing data could undermine the reliability of the results. Therefore, the appropriately randomized controlled studies with large sample sizes and long-term durations in various psoriasis patients are warranted for further support.
Core Tip: Several hypoglycemic agents including thiazolidinediones, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and biguanides have been reported to make a remarkable reduction in the Psoriasis Area and Severity Index score from baseline. The antipsoriatic effect could be mediated not only by the glucose-lowering action of these agents but also via inhibition of keratinocyte overproliferation, increase expression of differentiation markers, suppression the immune inflammatory pathway, and blocking the calcium channels and mitogen-activated protein kinase signaling pathways. Potential bias in the study and missing data could undermine the reliability of the results. Therefore, the appropriately randomized controlled studies with large sample sizes and long-term durations in various psoriasis patients are warranted for further support.
