Long-term effects of weight reduction on the severity of psoriasis in a cohort derived from a randomized trial: a prospective observational follow-up study
2016
Jensen, Peter | Christensen, Robin | Zachariae, Claus | Geiker, Nina RW | Schaadt, Bente K | Stender, Steen | Hansen, Peter R | Astrup, Arne | Skov, Lone
Background: Weight reduction may reduce the severity of psoriasis, but little is known about the long-term effects. Objective: We aimed to investigate long-term effects of weight reduction in psoriasis. Design: We previously conducted a randomized trial (n = 60) involving patients with psoriasis who were allocated to a control group or a low-energy diet (LED) group. Here we followed the participants for an additional 48-wk period. In total, 56 patients with psoriasis [mean ± SD body mass index (in kg/m²): 34.4 ± 5.3] underwent a 64-wk weight-loss program consisting of an initial 16-wk randomized phase with an LED for 8 wk and 8 wk of normal food intake combined with 2 LED products/d, followed by a 48-wk period of weight maintenance with the latter diet. After the randomization phase, the control group received the same 8 + 8-wk LED intervention, and all patients were then followed for 48 wk while on the weight-loss maintenance diet. The main outcome was the Psoriasis Area and Severity Index (PASI), and secondary outcome was the Dermatology Life Quality Index (DLQI). Results: For the present study, 56 patients were eligible, 38 agreed to participate, and 32 completed. After the 16-wk LED-only period, the mean weight loss was −15.0 kg (95% CI: −16.6, −13.4 kg), and PASI and DLQI were reduced by −2.3 (95% CI: −3.1, −1.5) and −2.3 (95% CI: −3.2, −1.4), respectively. At week 64, the mean weight loss compared with baseline was −10.1 kg (95% CI: −12.0, −8.1 kg), and PASI and DLQI were maintained at −2.9 (95% CI: −3.9, −1.9) and −1.9 (95% CI: −3.0, −0.9), respectively. Conclusion: Long-term weight loss in patients with psoriasis has long-lasting positive effects on the severity of psoriasis. This trial was registered at clinicaltrials.gov as NCT01137188.
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