Weight loss improves the response of obese patients with moderate-to-severe chronic plaque psoriasis to low-dose cyclosporine therapy: a randomized, controlled, investigator-blinded clinical trial  

Oleh:

Gisondi, Paolo ; Giglio, Micol Del ; Francesco, Vincenzo Di ; Zamboni, Mauro ; Girolomoni, Giampiero

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The American Journal of Clinical Nutrition vol. 88 no. 05 (Nov. 2008), page 1242.

Ketersediaan

Perpustakaan FK Nomor Panggil: A07.K.2008.04 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background: Chronic plaque psoriasis is frequently associated with obesity. The effect of a hypoenergetic diet on psoriasis has not been investigated. Objective: The objective was to investigate whether moderate weight loss (ie, 5–10% of body weight) increases the therapeutic response to a low dose of cyclosporine in obese patients with moderate-to-severe chronic plaque psoriasis. Design: A 24-wk randomized, controlled, investigator-blinded clinical trial was conducted in 61 patients. The efficacy of 2.5 mg · kg–1d–1 cyclosporine combined with a low-calorie diet (intervention group) was compared with cyclosporine alone (control group) in obese patients [body mass index (in kg/m2) > 30] with moderate-to-severe psoriasis. The primary endpoint was an improvement from baseline of 75% in the Psoriasis Area and Severity Index (PASI 75 response) at week 24. Results: At week 24, the mean (± SD) reduction in body weight was 7.0% ± 3.5 in the intervention group and was 0.2% ± 0.9 in the control group (P < 0.001). The PASI 75 response was achieved by 20 of 30 patients (66.7%) treated with cyclosporine plus a low-calorie diet and by 9 of 31 (29.0%) patients treated with cyclosporine alone (P < 0.001). Four patients (13.3%) from the intervention group and 14 (45.1%) from the control group withdrew prematurely from the study (P < 0.001). Conclusions: Obese patients with moderate-to-severe psoriasis increase their response to low-dose cyclosporine if a calorie-controlled diet is included in the treatment regimen. Lifestyle modifications, including a low-calorie diet, may supplement the pharmacologic treatment of obese psoriasis patients. This trial was registered at clinicaltrials.

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