Can behavioural modifications impact patients with psoriasis? Researchers in Taiwan explored this question by performing a systematic cochran review, in which they compared behavioural modifications such as weight reduction, alcohol abstinence, smoking cessation and exercise to usual care.
Dr. Chi from the Department of Dermatology and Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan and colleagues included 10 randomized controlled trials (RCT) in the review, including:
- 6 dietary interventions
- 1 dietary intervention and exercise
- 1 exercise and health education
- 2 health education
- 0 trials investigating smoking cessation
- 0 trials investigating alcohol abstinence
When combined, these trials were composed of 1163 participants. The mean age of participants was 43 to 61, where 656 were men and 278 were women. The outcomes were measured at 24 weeks to 6 months.
Results showed that dietary intervention may lead to a PASI 75 (risk ratio (RR) 1.66, 95% confidence interval (CI) 1.07 to 2.58). However, the authors consider this low quality evidence. Adherence may have been greater in patients receiving dietary interventions adding bias. The authors found that dietary intervention improved DLQI compared to usual care (MD -12.20, 95% CI -13.92 to -10.48), though this was based on only one trial. BMI was also reduced in the dietary intervention group (MD -4.65, 95% CI -5.93 to -3.36).