Statins Added to Standard Psoriasis Therapy May Improve Disease Severity
March 15, 2010 (Miami Beach, Florida) — Adding statins to standard psoriasis therapy might be useful in treating symptoms of the skin condition, according to results from a retrospective chart review presented here at the American Academy of Dermatology 68th Annual Meeting.

"We still aren't sure of the exact role of statin therapy for these patients, but when used in conjunction with psoriasis therapy, it showed a trend toward greater improvements in psoriasis severity," said first author Adam Perry, a fourth year medical student at Emory University in Atlanta, Georgia, working with principle investigator Suephy Chen, MD, also from Emory.

Although statins have been shown to reduce inflammatory markers, only 1 other study, involving just 7 patients, has looked at the effects of adding statins to psoriasis therapy. "With the exception of that small study, there are very few data in the literature regarding the effects of statins in psoriasis patients," said Mr. Perry.

A Trend in Psoriasis Reduction

For this study, the investigators assessed the charts of 232 patients with psoriasis, each of whom had their body surface area (BSA) covered with lesions, which was "recorded at the last visit a new psoriasis medication was started (initial psoriasis severity) and the most recent visit (current psoriasis severity)," explained Mr. Perry. "To evaluate the differences between the 2 time points, as well as between the statin [n = 66] and nonstatin [n = 166] groups," t tests were used

The psoriasis therapies used included topical corticosteroids, topical vitamin D, and some ischemic treatments.

Although the statin users showed a trend toward more severe disease before starting a new psoriasis medication, with a BSA of 13.26%, compared with 12.25% for the nonstatin users (P = .6600), the trend reversed after initiation of the medication, with a BSA of 5.21% vs 7.43% for the statin and nonstatin users, respectively (P= .1214).

"The statin group also showed an overall 64% reduction in psoriasis severity, while the nonstatin group showed a 45% reduction following the initiation of a new psoriasis medication" (P = .2561), reported Mr. Perry.

However, he cautioned that there weren't enough patients in the study to reach clinical significance in decreased psoriasis severity in the statin group and that a prospective trial is now needed to "see if there is indeed this reduction in severity."

"Despite the fact that the difference did not reach statistical significance, there was an interesting trend toward greater improvement for those treated with statins, showing that it may be a useful adjunct medication for psoriasis patients," he added.

"This is important because there's a huge amount of data that shows that these patients have an increased cardiovascular risk anyway. So if there's a statin that will help decrease their psoriasis severity and their cardiovascular risk, then it's win–win," summarized Mr. Perry.

Prospective Data Needed

"This is something that really hasn't been looked at before, other than in 1 very small study," said Alan Menter, MD, chair of psoriasis research at Baylor Research Institute in Dallas, Texas, and founder of the International Psoriasis Council.

"The fact that the findings [from this trial] showed this trend is interesting. However, we'll need to look at prospective data, which is something we've actually talked about doing at the Council," added Dr. Mentor, who was not involved with this study.

"Whether statins by themselves are going to be valuable for ordinary psoriasis patients who don't have lipid abnormalities is something that needs to be looked into," he concluded.

Mr. Perry has disclosed no relative financial relationships. Dr. Menter reports doing studies for many of the companies involved with psoriasis therapies.

American Academy of Dermatology (AAD) 68th Annual Meeting: Abstract P3309. Presented March 7, 2010.